Congressional Record, Volume 142 Issue 93 (Friday, June 21, 1996)

[Congressional Record Volume 142, Number 93 (Friday, June 21, 1996)]
[Senate]
[Pages S6643-S6654]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

HEALTH INSURANCE REFORM

Mr. REID. Mr. President, what we have seen take place here in the
last hour or 45 minutes is what has been going on in the Senate for the
last 8 or 10 months. We cannot do things quite perfect enough. There is
always some kind of a problem.
With the balanced budget, we agreed to a balanced budget but there
was always a poison pill that was involved. The poison pill with the
balanced budget was Medicaid, Medicare, whacking the environment. It
was not good enough that the President and Democrats agreed there would
be a balanced budget in 7 years using the figures from the CBO. That
was not good enough. What they had to do was the majority had to ruin
it. They ruined it with their poison pills, with excessive cuts in
Medicare and Medicaid.
Welfare reform--remember, we had a welfare reform bill. It passed
here in a bipartisan basis. But the majority in the House and Senate
decided they wanted to block grant Medicaid. They wanted to cut off a
million disabled children from welfare. That made it so we could not
pass welfare reform.
Minimum wage, something that is long overdue, about 90 percent of the
American public think it is the fair thing to do, to increase the
minimum wage, but, no, they have to tie on to that something called the
TEAM Act, some kind of small business exemption which is a disguise,
that is all it is, to, in effect, gut the minimum wage. Everyone knows
the jobs in America are not created by General Motors, Lockheed and the
big corporations, but by small businesses. So what is the poison pill
that the majority attaches to minimum wage? We will make a small
business exemption with the minimum

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wage; we will do indirectly what we cannot do directly.
So everything that comes out that is good for the American public,
the majority throws in a poison pill. They have done it with their
small business exemption with the minimum wage. They have done it with
the TEAM Act.
We should be on the floor here, talking about the things that we do
on a bipartisan basis. The American public is not concerned about big
government or small government, they are concerned about good
government. And good government means we must act together.
We could do that with health care reform. Everyone knows that on the
Kennedy-Kassebaum bill the senior Senator from Massachusetts represents
one constituency, the senior Senator from the State of Kansas
represents another constituency, and they got together. People who are
senior Members of this body got together and came up with a bill that
was not everything that everyone needed, that did not take care of all
the problems with health care delivery in this country, but certainly
it went a long way to answer two of the major problems that face the
American public and that is, what do we do about portability of health
insurance and what do we do about preexisting conditions?

The Kennedy-Kassebaum bill took care of that. It basically said we
can help get portable insurance. If you have a job and you have
insurance and you quit your job, leave your job, you can take your
insurance with you. If you have a preexisting condition you can have an
insurance company insure you. They cannot refuse you. Everyone in
America has had conditions with family, loved ones or neighbors, who
have problems with preexisting conditions. It may be a bad back, it may
be diabetes--these conditions are such the insurance companies simply
turn people down. The Kennedy-Kassebaum bill said no, you cannot do
that anymore.
Here we go again, just like as has happened for the past 18 months.
We have something which can solve a problem on a bipartisan basis and
another poison pill comes along. This time it is MSA's. Mr. President,
MSA's is something we should take a look at. Everyone has acknowledged,
on the minority side, we are willing to take a look at MSA's. Let us do
a pilot project. Let us see how they would work. Everything that has
been said about MSA's by the majority may be right. I mean, I think we
should take a look at it. They may be right. But whether they are right
or wrong, why do we not go ahead and do what Kennedy-Kassebaum
originally said we should do, take care of portability and take care of
preexisting conditions? That would go a long way to solving the
problems of health care delivery in America today.
No, we cannot do that because now we are not talking about a balanced
budget and ruining that with Medicare and Medicaid devastating cuts; we
are not talking about minimum wage and the poison pill thrown in there
with the small business exemption; we are not talking about welfare
reform, the poison pill there block-granting Medicaid and eliminating
about a million handicapped children. No, what we are doing now is we
have another poison pill with health care reform that is the medical
savings accounts. We are not willing to test, do a pilot project on
medical savings accounts. We want it all. If we cannot get it all we
are going to ruin portability and preexisting conditions.
I, personally, believe that medical savings accounts should be
tested. I think there is some merit to them. We should have a
demonstration to project to see what the benefits and drawbacks are of
MSA's. But the insurance reform bill which the Senate overwhelmingly
passed did not contain MSA's and the addition of MSA's is now
preventing a bipartisan step toward real health care reform. We failed
to pass real health care reform 2 years ago. But we did learn something
at that time. We must approach health care reform step by step. We
cannot get everything we want. But it seems the majority is saying we
want everything that we think is appropriate. If we do not get it, we
are going to kill health care reform.
The Kennedy-Kassebaum bill primarily targets two hurdles to insurance
coverage for the American public: Hurdle No. 1, preexisting conditions;
No. 2 is portability. By addressing these two major barriers to
insurance coverage we can help 25 million Americans.
We can stand on this floor and debate for weeks, months how good or
bad MSA's are. But let us do that and at the same time take care of 25
million Americans and take care of preexisting conditions and
portability.
The Kennedy-Kassebaum bill is a straightforward measure combining
items from the 1994 health care debate that are both noncontroversial
and bipartisan. We should not be holding up this bill with a debate
over MSA's.
I think, when it is all said and done, after we do the demonstration
projects, I think I would probably support MSA's.
But we really do not know just now. Why do we not go ahead and pass
what is good, and that is Kennedy-Kassebaum. The majority attempts to
add MSA's to the benefit, some say, of special interests. I think that
this special-interest legislation may just be threatening the coverage
of preexisting conditions and portability, because this is the poison
pill they found to kill that program.
If the majority is serious about helping millions of Americans
maintain their health coverage, they should abandon their attempts to
attach this overall, all-encompassing MSA provision to S. 1028.
The debate today is not about MSA's. That can wait for another day.
The debate is about whether Congress is going to help individuals who
change or lose their job to help maintain health coverage.
We can pass this bill today, Monday, Tuesday, Wednesday of next week
if the majority will agree to stop loading this bipartisan bill with
amendments that can be debated at another time.
Mr. President, there is a real question about what we are doing here.
What are the dangers of MSA's? Some of the concerns I have, that I hope
with the demonstration project can be overridden, is that they siphon
off the healthy and the wealthy and the young. They fragment and
undermine the current insurance market, and they cause premiums to rise
for others. They discourage cost-saving preventive care. They lack
consumer protections. They increase employer health care spending, and
they cost taxpayers, some say, almost $2 billion. In fact, who says
that is the Joint Committee on Taxation.
What the majority will not talk about today on this floor, or any
other time, about MSA's and the reason, perhaps, they are unwilling to
go forth with a demonstration project, is that the MSA provision added
in the House bill contains no standards for high-deductible
catastrophic plans that accompany these MSA's, forcing many individuals
to pay more in out-of-pocket costs than they might expect.
Here are some costly facts about this catastrophic insurance plan
that the majority will not be talking about during this debate. For
example: Once the deductible is reached, not all costs are covered.
Even after an individual or family meet their high-deductible, most
catastrophic plans require a copayment for health care services. The
majority wants individuals to think all their health care will be
covered. That is not the fact. They think they should be covered free
of charge once the high deductible is finally reached. It just will not
happen.
Also, only medically necessary services are covered. So many of these
plans only pay for those medical expenses that are medically necessary.
As determined by whom? Of course, by that all-knowing insurance
company.
Furthermore, insurers may count only medically necessary services
defined as indicated by the insurer toward the deductible. If it is not
covered by the insurer, the individual will get no credit for the
payments they have made toward the deductible.
We heard a lot 2 years ago when we debated health care reform, and
one of the things that the health insurance industry--and their
spending over $100 million in advertising trying to confuse and
frighten the American public, which they did--one of the things they
talked about a lot was people would lose their choice of physicians.
Well, those in the majority should understand that here is a question
with MSA's about whether you lose your choice of physician.
Individuals are free to choose their own doctors while paying for
medical

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care in full. However, under their insurance plan, they may have to pay
more to stay with their own family physician. Many catastrophic plans
require individuals to use specific doctors, and if they are not
willing to use specific doctors, they pay more, thereby adding
unexpected costs after meeting that high deductible.
Another problem we need to look at--and the reason we think there
should be a demonstration project and we should go forward with
portability and preexisting conditions and leave this debate for a
later day, and that later day would be based upon having a
demonstration project or projects where we would have all the
information that can answer these questions that are being raised today
by this Senator--exclusions to services coverage.
Many of these plans currently on the market today contain a long list
of services not covered by the plan. Some plans exclude pregnancy and
routine newborn care among their exclusions. Individuals would be
responsible for the cost of these services, even if the deductible has
been reached. Should we not look at this in a demonstration project?
I say to my friends in the majority, if you can answer all these
questions, then we should all be here joining arms and going with
MSA's. Why do we not pass what we think is good? That is, the
portability, preexisting conditions.
Another problem: Employers are not required to contribute to the
savings account. There is nothing in the House bill to require
employers to contribute an amount to cover the deductible or make a
contribution at all, forcing the individual to cover much, if not all,
of their medical expenditures.
Finally, with a demonstration project, we could determine if
employers could contribute to the premium cost or merely provide
information about plans available. Individuals alone may have to cover
the cost of the insurance again.
So, I say the time is here to help millions, 25 million people. Let
us set up some demonstration projects around the country and see if the
MSA's work, and then pass quickly, on a bipartisan basis, the Kennedy-
Kassebaum bill. That is what we should do. It would provide protection
for 25 million Americans who need that protection.
Mr. KENNEDY addressed the Chair.
The PRESIDING OFFICER. The Chair recognizes the Senator from
Massachusetts.
Mr. KENNEDY. Mr. President, I yield such time as I might use. I ask
the Chair to notify me when 20 minutes is up.
The PRESIDING OFFICER. The Chair will advise the Senator when 20
minutes is up.
Mr. KENNEDY. Mr. President, I rise on the floor of the Senate to
address the issues of medical savings accounts. I want to address some
of the observations that have been made by some of our colleagues this
morning, and over the last few days; and that have also been raised in
a number of their statements and speeches and press releases in the
newspapers.
Mr. REID. Will the Senator yield for a question prior to my leaving
the floor?
Mr. KENNEDY. Yes, I yield.
Mr. REID. I say to my friend, who has had a lot of experience in this
body, if the medical savings account provision were dropped, how long
do you think it would take to pass this bill?
Mr. KENNEDY. I think, as suggested by the Senator's question, I think
we could pass that in just a few moments here in the Senate. I expect
that would be true in the House of Representatives as well. It would
pass well within a day and be on the President's desk by tomorrow and
put into effect to protect the 25 million Americans who have some
disability and give protections to millions of Americans who are moving
from job to job to guarantee that portability.
The Senator is accurate in his questions. Why aren't we doing today
what was passed out of our committee with a unanimous vote of
Republicans and Democrats several months ago; and passed the Senate of
the United States by 100 to 0, and could pass the Senate of the United
States by 100 to 0 again this afternoon? We could send it to the
President to be signed into law and provide relief to the 25 million
American families that have some preexisting condition and know that
they will be excluded from any kind of health insurance; or know that
if they stay with a small group, that the costs for their insurance
will go through the roof; or that they will be excluded or canceled.
They could be canceled after having paid into their insurance program
for a lifetime under the existing rules.
We heard a lot of talk about freedom here this morning and over the
last few days. Well, there will be freedom for the insurance company to
drop that family. There will not be freedom for the family to look
after a child that has cancer. There will not be freedom for a husband
to look after a wife who has breast cancer. But there will be freedom
for the insurance company to drop them.
So I hope we will have an opportunity to talk a little bit about what
freedom really means. It is bandied around here loosely and generally
by people who have been in the vanguard of undermining Medicare and
Medicaid and protection for children. But I will get to that in a few
moments.
Mr. REID. I ask the Senator one more question. Does the Senator see a
pattern, as I see a pattern, that during the past 18 months the
majority, every time we are on the verge of passing something
meaningful, that a poison pill is thrown into the mix?
We passed Kennedy-Kassebaum 100 to 0, and suddenly we have MSA's. A
balanced budget, we agree on all the terms. The President agrees to the
year 2002, to use Congressional Budget Office figures. Welfare reform
passed here, I do not know, almost 100 to 0, big numbers, 80, a vast,
vast majority passing it, and suddenly we have block granting of
Medicaid and cutting off handicapped children. The minimum wage, which
90 percent of the American public wants. We have the small business
exemption. Is it just me or does the Senator see a pattern here that we
are not being able to pass meaningful legislation in this body because
of these poison pills?
Mr. KENNEDY. I will add to the Senator's list. We have a very
important program to which Senator Kassebaum provided great initiative.
It had been worked out over the period of the last 2 to 3 years in
human resources, to restructure and reorganize all the youth training
and job training programs, to eliminate--there are 148 different
programs, $20-odd billion in those programs, 11 different agencies, and
we had tried to work to consolidate those programs. It overwhelmingly
passed in the Senate by more than 90 votes. I think it was 92 to 4 or
something of that nature. Now we find out that we are stalemated in the
conference.
We passed our immigration bill. That was passed in a bipartisan way
by more than 90 votes. It is so interesting listening to my Republican
colleagues talk about the inappropriateness by some of us to resist a
stacked deck of conferees, when I happen to be a conferee on the
immigration bill, and have never even been invited to a single
conference, while the Republicans are meeting day after day.
Or whether it has been on the issue of health care, there are a whole
series of different items that we have passed overwhelmingly. And now
they are getting caught up, whether it is immigration or the job
training or the health care program. They have all passed
overwhelmingly. Now for some reason, as the Senator points out, there
is a desire to refuse to permit the process to work.
There was enough credit in here for our Republican friends. They
could get a share of the credit. It is true that this President has
supported this program. The American people have elected this
President. They might not like that. But the President ought to be
entitled to sign those pieces of legislation and not have that
successful effort of bipartisanship, which had been part of this effort
here, to be effectively denied. So I thank the Senator for raising this
point because it is an extremely important one.
Mr. President, let me just start off by observing that what this
issue is really all about, is to see where we are in the course of this
debate and discussion on the underlying legislation, the Kassebaum-
Kennedy bill. As I pointed out on other occasions, this legislation was
developed with the leadership of Senator Kassebaum in the wake of the
1994 debate on comprehensive health care. I

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hope comprehensive health care is still an objective of the American
people. I know that there are those in this body who believe that we
should not, as a matter of national policy, try to get quality health
care for the American people that they can afford. I know that this is
an offensive idea to many of them.

I still believe that we ought to find ways to accomplish this in a
manner that maximizes the involvement of the individual and the private
sector. In the areas where there are gaps there would be a public role,
particularly for the neediest individuals in our country. I am
referring to working families and their children who are on the lower
rungs of the economic ladder. Families that work hard 40 hours a week,
52 weeks a year, knowing that their child is without health insurance.
They worry that their child will be injured playing in a sport or will
fall from a bicycle, or have a skating accident, and they will not have
the resources to be able to pay for medical care. We need to provide
relief from that kind of anxiety.
I know that I will still feel strongly about that as long as I am in
the U.S. Senate. We have not been able to do that yet. But, Mr.
President, as I have pointed out on other occasions, under the
leadership of Senator Kassebaum, what we have effectively done is taken
the common elements in all the various proposals of Republicans and
Democrats. I remind my Republican friends, go back and read Bob Dole's
programs. Read John Chafee's programs or read the other Republican
programs.
They will find that portability and also preexisting conditions
provisions were common to all of those. How many times do we have to
repeat those statements by the Republican Presidential nominee that
said: Let us just try and find the common ingredients and pass them. He
said it before. He said it on the floor. He has said it repeatedly.
That is all we are trying to do here: find the common ground, and pass
legislation. That is what we did in our Labor Committee. That is what
we did on the floor of the U.S. Senate.
That is what we should be doing here this afternoon. The President
ought to be signing these provisions into law. And every day we delay,
Mr. President, every hour we delay, we are saying to those families, 25
million American families, ``No. We're more interested in the politics,
the politics of this issue.'' If you want to have an MSA program that
goes beyond a demonstration that is a true test, bring it up tomorrow.
Bring it up next week. Let us debate that issue at another time. But
why tag it on here? Why tag it on here?
Why are you not going to give that relief for 25 million Americans?
``We're going to deny you, workers, hard-working Americans. We're going
to deny you because we want it our way. We want a stacked conference
committee. And we're telling you now, we're either going to take it our
way or no way.'' That is what this debate and discussion is about.
Who are those wonderful Members? Whose interests are being advanced
by the medical savings accounts? Well, let us see who is on their side
and who is saying, ``No. We shouldn't go ahead. Consider the MSA's at
another time.''
Who are the ones that are saying, ``Go ahead. Please, Congress, go
ahead and pass the Kassebaum-Kennedy bill''? Who are they? They are the
organizations that represent the disabled individuals in this country.
We made progress with the Americans With Disabilities Act. We have made
progress on disability policy with regard to education. We have made
progress in mental health research at NIH.
Who are those that are saying, ``Put this off to another day?'' Is it
all of the representatives of the disability groups. I challenge the
other side. I challenge the other side, next time they organize and put
out their briefing sheets so that they will all have the same talking
points in the morning, answer the question. Tell us which leaders in
the disability groups are supporting your program. Give us one
organization. We are not asking for 10 or 5. Give us one organization--
one organization--that supports your position. Just give us one
organization.
Who do you want to stand with? The Golden Rule Insurance Co.? They
left the State of Vermont when it outlawed their abusive practices that
were so egregious that they nearly constituted fraud.
We will have Members come out here, ``We will document the fraud and
spend time going over that.''
I suggest to my colleagues they go over and read how they left the
State of Vermont. They are the principal supporters, they are the
principal gainers in medical savings accounts. We know that. They have
already contributed hundreds and thousands of dollars, over a $1.5
million to our Republican friends, to our Republican friends that are
the principal spokesmen for the medical savings accounts.
All right, so they have the Golden Rule that supports it. Who else?
Find us a serious senior citizen group. Find us one. The elderly
understand what this is all about. They understand what is going on
here. They understand that the principal critics of the position that
we are supporting here today are the same ones that want to cut back on
the Medicare Program.
I watched very briefly the debate here this morning. They are the
principals that voted aye in cutting back the Medicare Program, to
raise the premiums, double the deductibles. Where were all of these
voices when we were talking about protecting Americans for freedom?
They were stripping away the standards to protect the elderly in the
nursing homes. Where were all those voices then? ``We want to protect
freedom, but we will not protect freedom for the senior citizens that
go to nursing homes. We will take those guarantees and those
protections away from them. We will take those away from them, and we
are going to also take away the various additional protections for
children under the Medicaid Program--5 million.''
Find me one Senator that has spoken out in opposition to medical
savings accounts; not one of them this morning voted against knocking 5
million children out of our Medicaid system, 85 percent of whose
parents work 40 hours a week, 52 weeks of the year. Do not tell us who
is on whose side in terms of protecting Americans' health care. Each
and every one of them that spoke out here this morning were prepared to
cut out children in the Medicaid Program.
They have cut back about 20 percent of the mental health assistance
program. They permitted double buying of our elderly people under the
Medicare Program when it came back from the conference report.
It goes on and on. And all for what? To take those savings and give
them for tax breaks--tax breaks. Who are you kidding about your concern
about freedom and competition in the health care system when you are
busy undoing the present program, when your Republican leader in the
House of Representatives, Mr. Gingrich, said you want to have Medicare
wither on the vine, and the Republican nominee has indicated he is
proud of the fact he voted against Medicare in the beginning, and he
has restated it again.
We are supposed to believe those individuals who do not believe in
Medicare, who have been assaulting Medicare, who have been assaulting
Medicaid and protections for children and senior citizens, that, all of
a sudden, here they are, they are so concerned, because certain
Senators will not permit us to try out a new program, a new program
that is allegedly going to provide freedom.
This Senator is not going to let them have the freedom to go to the
Federal Treasury, because that is what you are asking about. They can
have all the freedom today to sell their medical savings account.
Understand this: My colleagues who have been complaining about our
positions on medical savings accounts, they can go out and sell them
today, and some of them do. But, no, no, that is not what they want.
They want the freedom to go into the Federal Treasury, put their hand
in the pocket of every working family and the pocketbook of every
working family. What do we mean by all that?
Mr. REID. Will the Senator yield?
Mr. KENNEDY. I will finish this one thought.
It is very interesting that the Joint Tax Committee estimates that
the costs to the Federal Treasury would be $3 billion in additional
deficits over a 10-year period.
The PRESIDING OFFICER. The Chair advises the Senator from
Massachusetts he has used 20 minutes.

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Mr. KENNEDY. I yield myself 10 minutes additional.
The Federal Treasury says the additional deficits for 10 years is $3
billion; $3 billion for a test with one million people.
What is the suggested program that is being supported by Mr.
Gingrich? Mr. President, 43 million American working families. That is
a test? Three billion for one million people--he is talking about a
range of 43 million Americans. It is the freedom of Golden Rule to put
its hand in the Federal Treasury and take out billions of dollars. That
is the freedom that those individuals are talking about in terms of
medical savings account.
I am happy to yield to the Senator.
Mr. REID. Mr. President, the Senator has been talking about freedom.
I have a quote that the Senator did make, and I ask if the Senator
recalls this statement having been made from the majority leader of the
U.S. House of Representatives, Dick Armey, who says, ``Medicare has no
place in a free world.''
Do you recall that statement having been made by the majority leader
of the House of Representatives saying, ``Medicare has no place in a
free world''?
Mr. KENNEDY. It has a familiar ring to it, Senator.
Mr. REID. Just so there is no misunderstanding, I want to state what
was said by the Republican nominee for the U.S. Presidency in October
of last year: ``I was there fighting the fight''--a direct quote--``one
of 12 voting against Medicare, because we knew it wouldn't work in
1965.''
Is that the reference that the Senator made?
Mr. KENNEDY. It is exactly the reference. We have leaders that are
now out there every day with their mimeograph machines saying those
really blocking this program are the same ones that were opposing the
Medicare Program before, oppose it now, cutting back and putting at
risk our senior citizens, and also other health programs of this past
budget.
Mr. REID. Briefly, does the Senator from Massachusetts recognize this
direct quote by the Speaker of the House in October of last year:

Now, we didn't get rid of it in round one because we didn't
think it was politically smart, but we believe Medicare is
going to wither on the vine.

Is that the reference the Senator was making?
Mr. KENNEDY. The Senator is exactly correct. They are the ones that
want to put these medical savings accounts in, same ones that want to
do that.
Mr. REID. I will close by giving the direct quote of the majority
leader of the U.S. House of Representatives:

Medicare has no place in a free world. Social Security is a
rotten trick. I think we are going to have to bite the bullet
on Social Security and phase it out over time.

Now, we have heard from the Republican nominee, we have heard from
the Speaker of the House of Representatives, we have heard from the
majority leader of the House of Representatives. I think it indicates
where they stand on Medicare and Medicaid, and I think the reference
made to how they feel about health care reform is pretty clear, is it
not?
Mr. KENNEDY. It certainly is, Senator. I appreciate you bringing
together these points. But the point about it is, we are trying to
determine who is on whose side here. Who is on the side of working
families, and who is on the side of the special interests? Special
interests, Golden Rule. Special interests, Golden Rule.

What I was mentioning just a moment or two ago is that we have
challenged the other side to find out any reputable group that
represents the disabled, who are at such risk from the cutbacks
proposed by our Republican friends, find the senior citizens, and come
back here this afternoon after our time is up, and give us those
examples of those senior organizations. Give us those quotes of our
seniors that say that this is a good idea.
You cannot get them. They are not there. They are not there. They are
not there from the disabled groups. They are not there from the seniors
groups. They are not there from the representatives of workers--the 128
million American families that are working in this country and their
principal representatives--you cannot get it. Then do not bring that
phony mine workers study that you have. You keep trotting that mine
workers study out, and it is absolutely wrong. They have denied it and
said it is completely inaccurate and wrong.
So, Mr. President, on the one side we have the disabled, the elderly,
the representatives of the working, and the principal spokesman for
children. Why children? Because what you are going to find out is that,
under these programs, they will not pay for preventive care programs
for children. It is going to discourage preventive care, which is a
scandal for children in our country--an absolute scandal. With our
infant mortality being the 18th or 20th--or 22d, I guess, this year, in
terms of the world. The fact is that we produce 80 percent of the
vaccines in the world, and we still have a quarter of the children not
vaccinated. We are still not providing the comprehensive screening for
children.
Those numbers are being reduced every year in the last 4 years. The
number of uninsured children in my State of Massachusetts--160,000--has
doubled. It has doubled in the last 4 years. Have we heard any of those
people that are out there now saying they want medical savings
accounts? Where were they when we were talking and battling about
children and the priorities earlier this year? Where were they speaking
about it? Oh, no, we want freedom, medical savings accounts. We want
freedom.
Now, Mr. President, is this just the position of those that allegedly
speak for the disabled or for the consumers in this country? Find a
consumer organization that wants to go down to the rope with the
medical savings accounts, full-blown medical savings accounts, which
are untested, untried.
They used to have the old adage in medicine to ``do no harm.'' Well,
this is a turkey, Mr. President, that has not been tried, has not been
tested, and could cause premiums to go up. It is a threat to insurance
that exists for millions of Americans at this time. That is believed to
be so.
We are asked to buy this pig in a poke. We are saying, let us debate
it and discuss it at another time. Let us agree on what is a reasonable
test and pilot. Many of those who support the Kassebaum-Kennedy bill do
not even think we ought to do that. But there are Members on our side
and on that side, as well, that think we ought to have a trial and a
test. I would not oppose that trial and test if it meant the passage of
this bill. But, I will tell you, I am not going to buy on and sign on
for an untested, untried program that can threaten--not only will
wealthy individuals just be able to purchase it, and healthy
individuals will benefit by it, but I am not going to represent to
people in my State who have some health insurance today and risk their
premiums escalating and going out of sight.
The PRESIDING OFFICER. The Senator has used his additional 10
minutes.
Mr. KENNEDY. I yield myself 7 more minutes, Mr. President.
Mr. President, I will just mention here, this is sort of an isolated
position. I ask those who come and are addressing the status of this
where we are with this issue.

Today, we found that the House leader, Mr. Armey, urged the White
House to ``call off Senator Kennedy on the health care bill.'' And
then, ``Why is Senator Kennedy stopping health care reform?''
Then we had the Business Coalition for Affordable Health Care, an ad
hoc committee established 3 years ago to lobby against the President's
comprehensive health care. They say, ``Senator Kennedy is killing the
health care bill today to socialize American medicine tomorrow.'' I did
not believe, when we had a 100 to 0 vote, that those supporting the
Kassebaum-Kennedy bill were going on to socialized medicine.
You better get it straight, Business Coalition. We had a 100 to 0
vote on the position that I take today, saying the bill that passed in
the Senate should be passed now, today. And you are saying, ``Senator
Kennedy is killing the bill in order to socialize medicine''?
All I want to do is pass what we passed. Then we have the Coalition
for Patient Choice. It is interesting that they all came out the same
day. Included in that was, ``Yes, Kennedy would kill health reform. He
still wants big government.''
All I want is what Senator Kassebaum stated that she wants, too, on

[[Page S6648]]

health care. Also, we have the Eagle Forum. That is a well-known
organization on health care, and the Christian Coalition, and Phyllis
Schlafly knows a lot about it. She has testified frequently on health
care. Then the list goes on. You can expect it from the Republican
National Committee. The list goes on.
Well, Mr. President, I would ask those groups to take a look at some
of these editorials, take a look at the Washington Post editorial by
Robert Samuelson and his analysis on MSA's. Look at the L.A. Times
editorial on June 6. Take a look at the New York Times on May 30. Take
a look at the Dallas Morning News. Take a look at the Baltimore Sun of
April 25. Take a look at the Washington Post on June 3.
Take a look at the June 13, Tacoma, WA, News Tribune:

Stick to the basics in the New Health Bill.

It says:

Many medical economists warn MSAs would be used mostly by
healthy and more affluent people, leaving older and sicker
people in the common insurance pool. That would force
insurance rates up for everybody else . . . The original
Kassebaum-Kennedy bill was a good one. More than 20 million
Americans would benefit from its modest reforms. Save the
fight over MSAs for the next Congress . . .

Come on, Mr. President. Do you think the News Tribune is for
socialized medicine?
Here is the San Francisco Chronicle article of June 10:

There may well be some merit to MSAs to the extent they
encourage health consumers to be more cost-conscious. But
that possible benefit is still outweighed by the virtual
certainty that MSAs would encourage healthy and wealthy
Americans--those who could afford the high-deductible
catastrophic coverage--to abandon the prevailing insurance
system, making it even more expensive for the poorer and less
healthy Americans left behind.

The Harrisburg Patriot wrote:

While the idea of medical savings accounts has a lot of
appeal on the surface, the Congressional Budget Office, the
National Association of Insurance Commissioners, and other
experts in health insurance have warned that it poses dire
consequences for the overall health care system. MSAs would
remove significant amounts of money from a pool of funds that
go to pay the Nation's health care bill, while their tax-
deductibility would pose another drain on the Treasury . . .
They ought to be considered separately.

A June 10, Columbus Dispatch article, entitled ``Clean Health Bill;
Get Rid of Those Two Killer Amendments,'' says that MSA's could
``appeal only to healthy people, throwing seriously ill people into a
pool whose costs would escalate. This proposal should be in separate
legislation, so the clamor it kicks up would not endanger the
Kassebaum-Kennedy bill.''
These are just a sample of the commentary from around the Nation. It
is time for Republicans to stop playing special interest politics.
I welcome being their target quite frankly, Mr. President. I do not
resent it. If they want to target me, I am glad to get in and debate
this, and will at any length at any time that they want to. The fact of
matter is we mentioned 15 or 20 recent editorials, and they are in
there every day. Maybe we ought to come up--I think I will--and start
putting them in from every part of the country representing every
different group.
Why is it that just the Republican National Committee and the
Business Coalition and Phyllis Schlafly care more about the American
health care system than all of the other kinds of commentaries that are
coming from all parts of America and from all different groups? Why are
all these people wrong? And they are right?
Finally, Mr. President, I would just hope that when our friends come
out to talk about this issue I hope they will come out and address some
of the questions that are raised about this program. They have a $5,000
deductible and $7,500 per couple. Are we to assume that the employer is
going to provide the money up to $5,000? Absolutely not. It is not in
their program. If it is, they ought to come on out and tell us. Who do
they think is going to contribute the $5,000? Guess who? The workers
are going to contribute, and then the workers will be able to take
back. How many working families are going to be able to afford $5,000
per individual, or $7,500 in their family to put that aside? Come on.
Come on. Freedom? Freedom? Come on.
Then what happens if the doctor charges $8,000 but the insurance
company only recognizes $5,000 because of a fee schedule? Will the
insurance company help you out? How about answering that question. I am
waiting to hear the answer. Will that insurance cover that particular
problem? Are there no limits? Are there no lifetime ceilings? I am
waiting to hear the answer. You do not hear them talk about the
substance of this proposal. You do not hear them talk about that
because it is not there. All you have to do is look at what the Golden
Rule Insurance Co. has done and other companies are doing. They stop
there, and the person is stuck with the additional. The deductible is
not the same thing as a cap. How much will the individual have to pay
after they finally reach the $5,000?
Mr. President, I hope our friends who are supporting their position
over there about the MSA's tell us about the deductible. How much does
the individual have to pay after they finally reach the $5,000? Does
that mean there is no co-pay? I have not heard them talk about that.
They are trying to suggest that once you get to $5,000 you are not
going to have a co-pay. They find the Golden Rule Insurance Co. does
not guarantee. That is not guaranteed by their proposal. What is going
to be the co-pay on that $5,000? Why do you not talk about out of
pocket limits? What are ``out of pocket limits''? Out of pocket limits
occur in most of all of the programs that are out there--that an
individual pays up to so high and then does not pay anything above it.
Are there any out of pocket limits in the MSA's? I hope that those who
are supporting it are talking about it.
Is the sky the limit? No. There are no out of pocket limits as there
are in many of the insurance companies at the present time; an
important consumer issue. Maybe our friends who are so enamored of this
great freedom of getting into the Federal Treasury are going to talk
about that issue.
Mr. President, is there anything in their bill that requires the
insurer to cover all the services that they need? One of the continual
choruses that we heard last year from those that are opposed to health
insurance was, ``Let us have the list of services that are covered.''
Are they prepared to give us the services that are going to be covered?
I cannot tell you how often we heard that talked about, and we provided
that last year. Do you think any of us have any idea about what
services are going to be covered and what are going to be excluded
before we put in a program that is going to raise the Federal Treasury
and maybe applicable to a third of the working families of this
country? Absolutely not. No one has talked about that.

What services are going to be covered? Are they going to be different
from what the IRS recognizes as being a legitimate medical deduction if
an individual has medical expenses? Is this going to mean that is going
to be a contribution to the deductible, or the co-pay for the purposes
of insurance? That is going to make a lot of difference to a lot of
families. Maybe they could elaborate a little bit on some of this.
Mr. President, is there anything in the bill that requires the
employer to contribute one thin dime to MSA's to cover the $5,000? I
hope they will address that. Are they saying that with the $5,000
deductible that the employer is going to contribute to and give
benefits to the working families to begin to say, ``OK, that is not
such a bad deal''? Absolutely not. Absolutely not. They are not saying
that they will provide one nickel up to the $5,000.
So, Mr. President, I welcome the chance to go through these questions
because we ought to have a good discussion and debate. Certainly before
we put in anything like this, we ought to have the answers to some of
these questions. We do not have them now. We do not have them; no
Senate hearings, no report, no deep analysis, nothing--nothing except
the strong lobbying of the Golden Rule.
Mr. President, when you put in the MSA's you are providing, the way
that this is structured at the present time, a lavish tax break for the
rich, the handout to the Golden Rule Insurance Co.; the threat to the
existing health insurance premiums for working Americans.
Make no mistake about it, Mr. President, after this goes into effect,
the next thing they are going to do is move

[[Page S6649]]

it over into Medicare. Our seniors understand that. The seniors
understand that. The relentless assault and attack on the Medicare
Program. It just does not stop. They go at it any which way they can.
They went at it in this last Congress, and are continuing now with
these unjustified cuts because they wanted tax breaks for the wealthy.
Now they are at it again.
So, Mr. President, I welcome the chance to speak on this issue and to
include those editorials in the Record. We will have more to say. I
just say in the final minute, why do we not just pass the Kassebaum-
Kennedy bill? That has the overwhelming support. I think it is the one
piece of legislation that has come out of a committee unanimously,
Republicans and Democrats. It came to this floor and passed
unanimously. Senator Dole's amendment was accepted to expand
deductibility for small business. We welcomed it. We also provide
extended long-term care--we support it--to provide some provisions to
deal with terminal illness, which is the humane approach on it. Senator
Dole has added an important ingredient to this bill. Senator Kassebaum,
the distinguished chairman, was the one who wrote this legislation.
Senator Dole has amended this legislation. We are supporting this
program. Why not just pass the program? Why not just pass it and let
the President sign it. And if we want to come back and debate the
medical savings account, let us do that. Let us have votes on those
particular provisions. Let us let the Senate make its will on it.

But, please, Mr. President, do not say no to the 25 million Americans
who have some form of preexisting condition and every single day that
we delay they are at risk. I do not know how you quantify in terms of
dollars their anxiety worrying about illness and sickness, wondering
where the next nickel or dime was going to come from so as to not bleed
the education funds for their children or eat up the retirement funds
of their parents. That is happening in every city of America. And that
is being held up by these various groups that pontificate as to who is
more concerned about the health care of the American people. That is
wrong.
I continue to believe that medical savings accounts are the poison
pill that could kill health reform. The House and Senate Republican so-
called compromise offer on medical savings accounts is a capitulation
to House Republicans, who are more interested in creating an issue and
serving a special interest constituency than in passing needed reform.
Discussions are continuing to see whether a genuine compromise can be
reached, without jeopardizing the health insurance that protects
millions of Americans today. I hope these negotiations will be
successful. But the American people need to understand why the current
Republican proposal is unacceptable--and why medical savings accounts
in the form proposed by the House Republicans are too extreme and have
no place in this consensus bill.
Medical savings accounts are an untested idea. Their great danger is
that they are likely to raise premiums and make health insurance
unaffordable for large numbers of citizens. Medical savings accounts
will clearly discourage preventive care and raise health care costs.
They are a multibillion-dollar tax giveaway to the healthy and wealthy
at the expense of working families and the sick. Their cost could
balloon the deficit by tens of billions of dollars.
With all of these obvious defects, it would be irresponsible for
Congress to impose medical savings accounts on the Nation without
testing the idea first. The entire controversy today is over whether
Newt Gingrich and the other extremists in the House Republican
leadership are willing to accept a reasonable test of their
controversial idea.
The current Republican offer is a sham. Their cynical negotiating
attitude is my way or the highway. Take it or leave it. They would
obviously rather attack me than defend their indefensible proposal,
which is no compromise at all--it is merely a transparent figleaf over
their cynical attempt to force their untested bad idea on the Nation.
Let's look at the record. Let's count the defects in the Republican
plan on medical savings accounts.
First, the Republican plan allows deductibles as high as $5,000 per
individual and $7,500 per family. That means a family needing medical
care must spend $7,500 out of their own pocket before their insurance
pays a dime. I ask Mr. Gingrich--``How many families can afford to pay
this much for medical care, and why in the world would you give a
special tax break for a policy providing such meager protection?''
Medical savings accounts are described as providing catastrophic
protection. Once you hit the cap, they say, you do not have to worry
about how to pay the doctor or hospital.
Actually, almost all conventional insurance policies already have a
feature like this--called a stop-loss--which caps your maximum spending
for covered services. Even among policies offered by small businesses,
which are typically less generous than those provided by large
companies, 90 percent have a stop-loss. And for virtually all of these
plans, the stop-loss is less than $2,000.
Contrast that to the House Republican plan. Protection does not even
start until you have spent $5,000--and there is no stop-loss. None
whatsoever. The plan even allows the insurer to charge a 30-percent
copayment for charges in excess of the deductible.
Forty thousand dollars doctor and hospital bills are usual for a
significant illness or surgery. In such cases, patients would owe
$15,500 for bills the policy would not pay. Under a conventional
current plan, their costs would be limited to $2,000 or less.
Instead of attacking the Democratic messengers who bring this bad
news, why don't the House Republicans explain to the American people
why their plan has no stop-loss requirement? How can they possibly
defend their view it's all right to make a family pay $7,500 before
their insurance covers them at all--and then leave them exposed to
unlimited further costs even, after they have paid the first $7,500?
The House Republicans claim that people can cover these huge gaps in
their insurance protection by using their medical savings accounts.
Perhaps their wealthy friends--who will get the GOP elephant s share of
the tax breaks under this plan--will be able to afford high medical
costs. But how are working families supposed to set aside the $5,000,
$10,000, $20,000 or even more that they would need to give them true
protection in the event of a serious illness? There is nothing in the
Republican plan that requires employers to contribute even one thin
dime to a medical savings account for their workers.
It is no coincidence that the leading proponents of medical savings
accounts are the Golden Rule Insurance Co. and other insurance firms
with close ties to the House and Senate Republican leadership that have
been the worst abusers of the current system. These firms specialize in
selling medical savings accounts. They have given millions of dollars
in political contributions to try to get their way.
Golden Rule's record, in particular, is so shameful that Consumer
Reports ranks it near the bottom of all companies because of its
inadequate coverage, frequent rate increases, and cruelty in canceling
policies.
These defection policies are a scandal, and the companies know it. In
fact, Golden Rule had to pull out of Vermont, because it was unwilling
to compete on the level playing field created by that State's insurance
reform.
So what happened next? Responsible insurers--Blue Cross and Blue
Shield took over the policies. They found that one in four Golden Rule
policies included unfair fine print. Arms, backs, breasts, and even
skin were often excluded from coverage. Newborn babies were excluded,
unless they were born healthy. Clearly, Congress should not be
conferring lavish tax subsidies on that kind of disgraceful insurance
coverage. Yet that is exactly what Republicans want to unleash on the
American people.
The details of the Republican plan will shock the American people
when they understand it. That is obviously why the Republican
leadership is engaged in this unseeingly campaign to whisk their
defective plan into law, before its flaws can be discovered. And that
is why I intend to do all I can to insist on a fair test of their
proposal.
By any standards, medical savings accounts are a dubious experiment

[[Page S6650]]

with the American people's insurance coverage.
The most troubling aspect is the skimming factor--the risk that
medical savings accounts will price conventional insurance out of reach
of most American families, by encouraging the healthiest people to
leave the insurance pool. As premiums rise for everyone else, more and
more working families will be forced to scale back their coverage or
drop their insurance altogether.
Ask the people who have studied these plans In the words of the
Congressional Budget Office, medical savings accounts ``could threaten
the existence of standard health insurance.''
Mary Nell Lehnhard, senior vice-president of Blue Cross and Blue
Shield, concluded that MSA's will destroy ``the whole principle of
insurance.''

Separate studies by the American Academy of Actuaries and the Urban
Institute found that premiums for conventional insurance could increase
by 60 percent--60 percent--if medical savings accounts become
widespread.
The Republican leadership pretends that their current compromise
offer is nothing more than a test--a fair attempt to deal with concerns
about medical savings accounts before they are sold broadly. But it is
nothing of the kind. Under their proposal, medical savings accounts
could be sold to all small businesses and the self-employed
immediately. MSA's would start out with a massive market consisting of
more than 40 million workers--one-third of the Nation's entire labor
force. I continue to believe that the so-called compromise is not a
test--it's a travesty.
Experts agree that the small business sector of the health insurance
market is the most vulnerable to the disruption that medical savings
accounts would cause. The Joint Tax Committee itself has concluded that
sales of medical savings accounts would be concentrated in small and
medium-sized firms.
The proposal would clearly go beyond the bounds of what is
acceptable, even if it stopped there. But it doesn't. After 3 years, in
which medical savings accounts would be launched in this vast market,
they would be open to everyone else, unless both the House and Senate
vote to stop the expansion.
In addition, instead of a neutral and objective evaluation of the
first massive phase, the evaluators would be chosen by the chairmen of
the Senate Finance Committee and the House Ways and Means Committee,
who are both strong proponents of MSA's. That is a stacked deck, and
the Republicans know it.
The strongest opponents of medical savings accounts are organizations
representing working families, senior citizens, consumers, and the
disabled. They are the ones who have the most to lose if the current
system of insurance is weakened or destroyed. We know whose voices
should be heard when Congress decides this issue--not the voices of
greedy special interests, but the voices of those who depend on
adequate insurance to get the care they need at a price they can
afford.
The American people need the basic bipartisan insurance reforms
included in the Kassebaum-Kennedy bill. These reforms will guarantee
that Americans will not lose their coverage or be subjected to
exclusions for preexisting conditions when they lose their job, or
change jobs, or because their employer changes insurance carriers. They
deserve to know that their insurance cannot be canceled if they become
sick. They should be protected against the worst abuses of the current
system.
The Kassebaum-Kennedy bill passed the Senate by a bipartisan vote of
100-0. If it were sent to the President today, it would be signed into
law tomorrow. It should not be held hostage to the partisan, special
interest Republican agenda that would foist an untried and dangerous
concept on the American people.
Last week, I placed into the Record editorials from a number of
leading newspapers around the country on the danger of medical savings
accounts. Today, I would like to place additional editorials in the
Record demonstrating the broad public opposition to MSA's.
The Tacoma, WA, News Tribune published an editorial on June 13,
entitled, ``Stick to the Basics in New Health Bill.'' It says,

Many medical economists warn MSA's would be used mostly by
healthy and more affluent people, leaving older and sicker
people in the common insurance pool. That would force up
insurance rates for everybody else. . . . The original
Kassebaum-Kennedy bill was a good one. More than 20 million
Americans would benefit from its modest reforms. Save the
fight over MSA's for the next Congress. . . .

The San Francisco Chronicle wrote on June 10 that,

There may well be some merit in MSA's to the extent they
encourage health consumers to be more cost-conscious. But
that possible benefit is still out-weighed by the virtual
certainty that MSA's would encourage healthy and wealthy
Americans--those who could afford the high-deductible
catastrophic coverage--to abandon the prevailing insurance
system, making it even more expensive for the poorer and less
healthy Americans left behind.

The Harrisburg Patriot wrote that

While the idea of medical savings accounts has a lot of
appeal on the surface, the Congressional Budget Office, the
National Association of Insurance Commissioners and other
experts in health insurance have warned that it poses dire
consequences for the overall health-care system. MSAs would
remove significant amounts of money from the pool of funds
that go to pay the nation's health-care bill, while their
tax-deductibility would pose another drain on the Treasury .
. . They ought to be considered separately.

A June 12 editorial in the Columbus Dispatch was entitled, ``Clean
Health Bill; Get Rid of Those Two Killer Amendments.'' It says that
MSA's could

. . . appeal only to healthy people, throwing seriously ill
people into a pool whose costs would escalate. This proposal
should be in separate legislation, so the clamor it kicks up
would not endanger the Kassebaum-Kennedy bill.

Mr. President, I ask unanimous consent that the editorials I
mentioned be printed in the Record.
There being no objection, the articles were ordered to be printed in
the Record, as follows:

[From the Tacoma (WA) News Tribune, June 13, 1996]

Stick to Basics in New Health Bill

So close, and yet so far. Only a few months ago it looked
like Congress might pass a modest health insurance bill that
would help millions of Americans worried about their health
coverage.
Now it looks like election-year politics could doom the
effort. Republicans and Democrats would rather have a
campaign issue than successful legislation.
The strategy behind the bipartisan legislation crafted by
Sen. Nancy Kassebaum (R-KA.) and Sen. Ted Kennedy (D-Mass.)
was to follow the KISS rule: Keep it Simple, Stupid. That way
Congress could avoid getting sucked into another morass like
the one that swallowed the Clinton administration's massive
health care package.
Kassebaum, chairman of the Senate labor and Human Resources
Committee, and Kennedy, the committee's ranking Democrat, won
strong bipartisan support for their proposal, which sailed
through the Senate in April. The Senate measure allows people
losing or changing jobs to continue their health coverage;
the bill also forbids insurers to refuse coverage for pre-
existing conditions.
But the House version includes a provision for medical
savings accounts, which couple high-deductible catastrophic
health insurance policies with tax-exempt savings accounts.
Proponents content MSAs would promote individual choice and
responsibility in making personal health-car decisions.
The concept is attractive, but many medical economists warn
MSAs would be used mostly by healthy and more affluent
people, leaving older and sicker people in the common
insurance risk pool. That would force up insurance rates for
everybody else. Even Kassebaum thought MSAs were too untested
to include in the Senate bill.
But MSAs have become a kind of Holy Grail to House
conservatives, who insist MSAs be included even it means a
certain presidential veto. This week Senate and House leaders
agreed on a compromise that initially ``restricts'' MSAs to
self-employed workers and employees of businesses with 50 or
fewer workers. After two years, everyone else would become
eligible, unless Congress intervenes.
Kennedy and the White House have signaled they might accept
a limited test of MSAs. But the Republican proposal is hardly
limited; Anywhere from 25 to 40 million people would be
eligible, and expansion in two years would be almost
automatic. That's no test.
The original Kassebaum-Kennedy bill was a good one. More
than 20 million Americans would benefit from its modest
reforms. Save the fight over MSAs for the next Congress and
the next president.
____

[From the San Francisco Chronicle, June 10, 1996]

Key Test for Dole

House and Senate conferees have come within one stubborn
whisker of passing the most significant health-care reform
since

[[Page S6651]]

the Clinton administration's national health insurance
proposal went down in flames in 1994. But the window of
opportunity could slam closed with the Tuesday retirement of
Senate Majority Leader Bob Dole, whose legislative skills are
needed one final time.
The problem is the medical savings account provision that
House Republicans added to the Kennedy-Kassebaum Health
Insurance Reform bill. That bill's main objectives are to
make insurance ``portable'' when workers change or leave jobs
and to make it more difficult for insurers to refuse coverage
to people with pre-existing medical problems. Those
provisions would greatly enhance the health security of
millions of Americans who are otherwise vulnerable to falling
into the ranks of the uninsured whenever they change or lose
jobs.
Because the Senate bill would mend a gaping crack in the
health insurance system--and do so without favoring any
special interests--it has won broad bipartisan support: it
passed 100 to 0. The problems have been with the House
version, which was loaded down with some hot-button GOP
proposals that would--and should--elicit a sustainable
presidential veto.
While most of the veto bait has been negotiated away--
including the Senate's call for ``parity'' on mental health
coverage--Republicans have shown little willingness to
compromise on the most contentious issue, the medical savings
accounts.
The MSA concept, which Dole favors, appeals mainly to
healthy and well-to-do consumers, who could use a tax-
deductible savings account--similar to an IRA--to cover the
costs of routine medical expenses, such as checkups and minor
treatments, as an alternative to health insurance. The
accounts would be coupled with high-deductible insurance
plans to deal with costly, catastrophic illness.
There may well be some merit in MSAs to the extent they
encourage health consumers to be more cost-conscious. But
that possible benefit is still far out-weighed by the virtual
certainty that MSAs would encourage healthy and wealthy
Americans--those who could afford the high-deductible
catastrophic coverage--to abandon the prevailing insurance
system, making it even more expensive for the poorer and less
healthy Americans left behind.
While President Clinton has properly threatened to veto any
bill containing MSAs, he has also left the door wide open to
an obvious compromise: permitting a pilot MSA program in
specific states for a long enough period to ensure that they
will not add to health insurance costs and thereby increase
the number of the uninsured.
Some form of that approach is what Dole now has to sell to
House Republicans if the 104th Congress--and candidate Dole,
himself--is to take credit for accomplishing at least a
portion of the health-care reform that the president tried
and failed to do. If he fails, we all lose.
____

[From the Harrisburg (PA) Patriot, Apr. 3, 1996]

Too Much Reform--House Amendments Weigh Down Effort To Make Health-Care
Insurance Portable

It represents the most modest of health-care reform, so
modest it is almost embarrassing. But progress, however
small, in helping people deal with medical expenses is
welcome progress nonetheless.
There is little visibly active opposition to the bipartisan
proposal jointly sponsored by U.S. Sens. Edward M. Kennedy,
D-Mass., and Nancy Kassebaum, R-Kan. Nonethless, their basic
proposal to ensure that people do not lose health coverage
when they change or lose their jobs is in some trouble.
Last week, the House of Representatives approved a bill
incorporating the basic features of the Kennedy-Kassebaum
bill. But also included were a number of odd controversial
items that dramatically alter the scope of the legislation.
Without much debate or consideration, the House tacked on a
scheme that would provide for tax-deductible medical savings
accounts and another that would cap punitive damages in
medical-related lawsuits at $250,000, or three times economic
damages, whichever is greater.
President Clinton has indicated that he could not accept a
bill with either of these provisions. The Senate is expected
to vote on the legislation this month.
While the idea of medical savings accounts has a lot of
appeal on the surface, the Congressional Budget Office, the
National Association of Insurance Commissioners and other
experts in health insurance have warned that it poses dire
consequences for the overall health-care system.
MSAs would remove significant amounts of money from the
pool of funds that go to pay the nation's health-care bill,
while their tax-deductibility would pose another drain on the
Treasury.
But the important point here is not whether MSAs or capping
punitive damages represent good or bad ideas. It is that they
generate sufficient objection to threaten to sink the modest
Kennedy-Kassebaum effort that most lawmakers agree has the
potential to help many of the 25 million Americans who change
jobs every year.
This legislation will not help the 41 million Americans who
already are uninsured, though it may serve to limit their
numbers from growing.
To the extent that more far-reaching reforms are proposed,
such as MSAs, limiting punitive damages or genuine health-
care reform, they ought to be considered separately.
If they aren't, it's pretty clear with will happen. There
will be no reform, just as nothing materialized out of the
major effort to pass health-care reform in 1994.
Modest though it is, the Kennedy-Kassebaum bill is better
than no reform at all.
____

[From the Columbus Dispatch, June 12, 1996]

``Clean'' Health Bill; Get Rid of Those Two ``Killer'' Amendments

It sounded so simple. Congress would pass a modest health-
care reform bill. Most significantly, it would prevent
insurers from denying coverage for pre-existing conditions.
Also, workers would be able to change jobs or start their own
businesses without losing health insurance.
This is the kind of scaled-down legislation that was
suggested when various well-financed lobbies smothered the
admittedly too-ambitious bill from the Clinton administration
two years ago.
The current measure is sponsored by Sen. Nancy Kassebaum,
Republican from Kansas, and Sen. Ted Kennedy, D-Mass. This is
Kassebaum's last year in the Senate, and she sees the bill as
her farewell accomplishment. Former Senate Majority Leader
Bob Dole, the presumptive GOP presidential nominee, also
supports the bill, but his leaving takes him out of the loop
for using his influence.
Unfortunately, ominous storm clouds are forming. Several
``killer amendments'' may doom this altogether worthy effort.
The amendments make sense to many, but they are not
universally admired and any one might doom the bill.
The solution? Strip the legislation down, so it is a
``clean bill,'' dealing only with the modest approaches in
the original proposal.
A provision for medical savings accounts is the most
contentious item in the plan. This would allow people to
build up tax-free accounts to pay medical bills. Sounds
constructive.
But there is some concern this would appeal only to healthy
people, throwing seriously ill people into a pool whose costs
would escalate. This proposal should be in separate
legislation, so the clamor it kicks up would not endanger the
Kassebaum-Kennedy bill.
Also, states have the option of passing their own MSA laws,
as Ohio just did. President Clinton has threatened to veto
the bill if it contains the MSA provision.
The other sticky measure would require employers to provide
coverage for mental illness. While this sounds sensible,
there is enough opposition so that this, too, could kill the
whole bill.
Mental-health coverage could be accomplished on the state
level, as is being attempted in Ohio.
Experts say there are hidden costs in mandated mental-
illness coverage. There has been a welcome suggestion that a
national commission be appointed to research this issue and
make recommendations.
Interest groups could make spirited defenses for medical
savings accounts and mental-illness coverage. Indeed, the
former has had the benefit of expensive lobbying. But keeping
touchy items in the health-reform legislation is a sure way
to defeat the whole bill. Better to settle for half a loaf.
That, at least, would provide some nourishment.

Mr. KENNEDY. These editorials are just a sampling of commentary
around the Nation. It is time for Republicans to stop playing special
interest politics with health insurance reform. The Kassebaum-Kennedy
bill passed by a bipartisan vote of 100-0. It should not be blocked
because some Republicans want to line the pockets of their campaign
contributors.
Mr. DORGAN. Mr. President, there has been an interesting discussion,
and an energetic discussion, I might say, in this Chamber this morning.
Early on this morning, beginning I believe at 9:30 for 1\1/2\ hours we
had a team come to the floor of the Senate, and it is a disciplined
team, all headed the same direction, all pulling in the same harness,
to tell the country that the problem with the health care bill, the so-
called Kassebaum-Kennedy bill that has been addressed this morning, is
that the Democrats are holding it up because of something called MSA's,
or medical savings accounts.
In truth, of course, the Kassebaum-Kennedy bill, which is a very
important bill, is being held hostage by people who voted for it; 100
to nothing it passed this Chamber, by those who insist that they want
to add something to it, and if they cannot add something to it they
will not let it pass.
Let me describe briefly what this bill is. Most of it has been
described. Let me go back a bit, if I can, to put it in perspective. I
come from a small town, 300 people, in southwestern North Dakota, down
near farming and ranching country, and we had one doctor in my
hometown. He was a wonderful doctor named Dr. Simon Hill. He came to my
hometown in the early 1900's, and he practiced medicine until he was
nearly 80 years old.
When he was practicing medicine in my hometown in the mid 1900's,
there

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was no Medicare Program. A fair number of people had no insurance. What
they had for health care in my hometown was one doctor. He had an
office. He had the drugstore on the ground floor. His doctor's office
was above the drugstore. When people came to see him, he would lock the
drugstore and walk upstairs to the examining office, or if people were
too sick to come to see him, he would get in his car and drive to see
them. He did, like most doctors did back then, make house calls. And if
people did not have any money and were sick, Doc Hill still drove out
to their place and administered medicine, administered health care, and
if they had no money but had a couple of laying hens or fryer chickens,
they gave him a couple of chickens or a half a beef. If they were
people with a fair amount of money, he would charge them an arm and a
leg, I guess.
He ran his own health care system in my little town. He charged those
who could afford a substantial amount and gave free health care to all
those who had no money, and that is the way the health care system
worked in Regent, ND, because one doctor did health care 24 hours a day
for some 60 years.
Now, was it a good health care system? It was the best he could do.
My neighbor had a toothache. We had no dentist, so his dad, Alvin, took
his son, Alton, to Doc Hill, who pulled his tooth. Doc Hill was not a
dentist, but he pulled his tooth. It turns out he pulled the wrong
tooth, but he did not get sued because we did not have a lawyer in my
hometown either.
It was a wonderful system--simple, administered by one person who was
humane and knew what the needs of the community were.
Back then, when someone had a cardiac problem, they were likely to
die when they had a heart attack. We were also 55 or 60 miles from a
hospital. When someone had a problem with cataracts, they could not
see. When someone had a problem with their hips, they went into a
wheelchair. If someone's knees gave out, they could not walk; they,
too, were in a wheelchair.
Of course, what has happened over time is Dr. Hill died, and my
hometown does not have a doctor anymore. Health care changed
dramatically, some of it in wonderful ways, breathtaking changes. Now,
if someone has a cardiac problem, eats too much fat all of their lives
or has a hereditary problem with their heart and it gets all plugged
up, what they do is they lay that person out on a table and unplug the
heart muscle and invest $50,000 or $75,000 and sew the person up and
the person feels like a million dollars 6 weeks later. Now they replace
the knees. Now they replace the hip. Now they offer cataract surgery,
and that person walks and sees and lives a new life with open heart
surgery.

All of that is wonderful. It is remarkable. It is expensive. Most all
of, it comes from breathtaking research done at the National Institutes
of Health and elsewhere, I would say, with substantial Federal grants
in order to achieve these health care breakthroughs and new
technologies. All of it is wonderful. But, of course, what has happened
in the intervening years is health care has also become very, very
expensive. It is full of near miracles because of this breathtaking new
medical technology, but it is also very expensive.
We have a lot of folks in this country who have no health care
coverage at all. Upwards of 40 million Americans are walking around
today with no health care coverage, and if they get sick, they do not
have any money to pay and they do not have insurance to cover it.
We also have a fair number of people in this country who work at a
job somewhere and they have a health insurance policy in a group plan
through their employment. But, of course, if they leave that
employment, they lose that insurance. There are a fair number of people
who cannot afford under any circumstances to leave their job because
they have someone in their family with a preexisting condition. And if
they leave that job and lose that health care insurance, they will
never get another policy anywhere. I have a daughter with a cardiac
problem. My expectation is that if I did not have health care coverage
here and went out on the open market to try to buy health care
coverage, no one is going to ensure someone with a preexisting
condition, with a cardiac problem. Millions and millions of Americans
confront that condition every day, a preexisting condition for which
they cannot now get health care insurance, a job that they are now
locked into because if they leave they cannot take their insurance with
them.
So Congress did something to address that. Congress said let us pass
a piece of legislation called the Kassebaum-Kennedy bill that does a
series of things that have great merit. Among them, you can take your
health care with you when you change jobs.
That makes an enormous amount of good sense. Among them is that a
preexisting condition shall not be a cause for denying health insurance
coverage to a family. Boy, that is going to help millions and millions
of families in this country.
So we passed that piece of legislation, and everyone now knows what
the vote was because Senator Kennedy this morning has talked about it
several times. The vote in this Senate, which is very, very rare, was
100 yeas and zero nays. By 100 to nothing, the Senate said let us pass
this legislation that does the right thing to address these health care
problems--100 to 0. That was many months ago. Why, after many months,
having passed a bill 100 to 0, do we not have that bill back through
here out of a conference and to the White House for signature? Why is
that bill not now law? It is very simple; because there are some who
insist on holding that bill hostage because they have other things that
they want to load onto that bill. They are saying if we cannot put what
we want on that bill, if we cannot add to it, then you are not going to
pass the bill. We insist, we demand that medical savings accounts be
added to that bill.

Let me describe medical savings accounts from my perspective. I do
not have the foggiest idea whether these things called medical savings
accounts are good or bad. I do not know, nor do I object to some sort
of demonstration project or some kind of approach that would give us
the ability to determine will this sort of thing, the medical savings
account, be good for our health care system or be inherently bad for
our system. I do not know the answer to that.
There is one company that has marketed these things aggressively.
They have been heavy, heavy contributors to Speaker Gingrich and
others, and they have just pushed and pushed and pushed this issue. But
I am not one who automatically says this is a bad thing to do. I do not
know. We probably ought to find out does this work or does it not work.
I do not object to some kind of demonstration project to find that
answer. But I do object to those who believe we should hold hostage the
Kassebaum-Kennedy bill, with the meritorious health care changes that
are desperately needed by many families in this country--hold that
hostage to the medical savings account legislation.
We had, I think, six or eight speakers come to the floor in the first
hour and a half this morning, arranged by the majority. That has been
happening often. There is nothing wrong with that. It is a deliberate
strategy to get a number of people to say the same thing, say it loud,
say it often, and get the American people to believe what they are
saying is somehow where we are. It is not where we are with respect to
this important issue on health care.
We are deadlocked on Kassebaum-Kennedy, an important health care
measure that will help millions and millions of American families,
because we have people in this Chamber who are doing to this bill what
they have done to every other piece of legislation that has had merit
in the last 1\1/2\ years or so. They are saying yes, that might have
merit, we might support that, but we will not allow it to move unless
we add our burdens to it, even though what they are adding to it they
know represent the kind of poison pills that will doom the legislation.
It is now Friday. On Tuesday, we could pass, once again 100 to 0, 100
to 0 the fundamental health care reform that is embraced in the
Kennedy-Kassebaum bill. We can do that. We should do that. But we
probably will not do that, notwithstanding what six or eight people
said earlier this morning. We probably will not do that because those
folks are saying we must insist on having medical savings accounts
attached to it or we will not

[[Page S6653]]

support it any longer. That makes no sense at all. I hope there will be
a compromise reached, there will be common ground found, so those who
hold this kind of bill hostage will decide and understand, finally, the
foolishness of doing so.
It is not just this bill. It is a whole series of other initiatives.
The minimum wage--should we adjust the minimum wage? Yes, I think so.
It was 1989, was the last time it was adjusted. We have a couple of
million people, 40 percent of whom are the sole breadwinners in their
family, who work for the minimum wage.

It is easy for someone to stand up here and blithely say the minimum
wage doesn't matter, it is a bunch of kids frying hamburgers. It is a
bunch of school kids. There are school kids working for minimum wage. I
do not disagree with that. But 40 percent of the people on minimum wage
are the sole breadwinners of their households. I ask you to read some
of the letters from those folks who are struggling to try to make ends
meet.
The kind of troubles some families have are pretty hard for some
people here to understand, I think. A family wrote to me some while ago
that I described. I read, late one evening, a four-page handwritten
letter from a woman in North Dakota. Her trailer house burned down.
They lost everything. She described the troubles she and her husband
have had, people who have not had the opportunity for education, people
who have four children, who lost everything. They struggle, they work
for minimum wage. Their only complaint was that she was hoping maybe we
could see some adjustment in the minimum wage at some point, it has
been 6 years they have been frozen at the bottom of that ladder. She
said,

You know, I do not know how to tell my sons who want to
play summer baseball I do not have the $25 to pay for their
registration, let alone buy them a baseball glove.

These issues sound like theory here in this Chamber, but they are
real to people who are trying to make a living; trying to deal with
family issues and family needs every single day.
The interesting thing I find is this. This floor is crowded,
literally cluttered with traffic when we are talking about things that
help the big interests in this country. When you talk about some tax
break that is going to help the biggest economic interests, the biggest
corporations, you can hardly get in this place. Everybody is rushing
down to vote ``aye.''
We have proposals now that say we want a balanced budget amendment
but we also want tax cuts. Of course, much of which will go to those
who already have plenty in this country. The bulk of those tax cuts are
going to go to the upper income folks, people who are making hundreds
of thousands of dollars a year. In fact, last year we offered an
amendment that said, if you insist on proposing tax cuts at a time when
we have deficits, let us at least agree on one thing. Let us agree we
will limit the tax cuts to those families under $100,000 in income. The
answer was, ``No, of course not, we will not do that.'' It was rejected
by a partisan vote.
``All right, if you will not do that, how about at least limiting the
tax cuts to families making less than a quarter of a million dollars a
year?'' They said, ``No, we will not agree with that. We insist the tax
benefits we are going to give go to people earning over a quarter of a
million dollars a year.''
We said, ``All right, what about a million? Would you at least limit
the tax cuts at the time when we have deficits and you are demanding we
cut people's taxes, would you at least limit them to people whose
incomes are less than $1 million a year? Would you at least do that?''
The answer was, ``No, no, we do not want to do that.''
Why would the answer be no? Because the bulk of the benefits are
going to go to those very upper income folks and they know it. That is
the problem around here. We have a lot of needs and we have a lot of
things to do. We should balance the budget. But, in my judgment, you do
not balance the budget by starting with tax cuts.

I know it is popular. I have a couple of children who love to eat
desert before dinner. But to suggest that tax cuts come before we
balance this Federal budget, especially tax cuts that are so
fundamentally opposed to what we are trying to do--let me give an
example, a tax cut that says let us make it easier to move American
jobs overseas. Let us spend $300 million of the American taxpayers'
money by giving that in tax breaks to companies who will take their
American jobs and move them overseas. Think of this. We are up to our
neck in debt, we are struggling to figure out how do we reduce the
Federal deficit, and we have people coming to the floor of the U.S.
Senate saying--at the time when not only do we have this debt but we
are losing jobs, our manufacturing base is being diminished, jobs are
moving overseas, we have people saying--``By the way, we want to change
the Tax Code so we provide more tax benefits to those who move their
jobs overseas.''
This simply does not add up. It is an agenda that does not relate in
any way to the interests or needs of people who are working for a
living and struggling, trying to make it in this economy.
I think you can summarize the baskets of issues in about three areas
that we need to address and address appropriately in this Congress. We
can, I suppose, just fight for the rest of the year and quibble and
have a tug-of-war and accomplish nothing, which would not very well
serve the interests of this country, in my judgment. Or we can find
ways to decide on something, for example like the Kassebaum-Kennedy
bill, which everyone in this Chamber believes has merit because every
single person voted for it. The vote was 100 to nothing. We can decide,
all right, we cannot agree on everything but we can agree on that.
Instead of spending all day trying to figure out what we cannot agree
on, let us spend part of the day trying to figure out what we can agree
on and advance that and pass it and make it law. That is exactly what
we ought to do on the Kennedy-Kassebaum health bill. We know we agree
on that. We have already had the vote. There was not one person in this
Chamber who disagreed. So, instead of exerting all of our energy trying
to figure out where we disagree, why do we not exert some energy to
understand where we agree and move it to the President and make that
law?
Mr. President, tens of millions of families will benefit by the
preexisting condition, by the portability of insurance--tens of
millions of families are waiting for this legislation to pass. It is
being held hostage by those who say that if they cannot add their
provision to it, if they cannot add their idea on MSA's, we are not
letting it go anywhere.
That is inherently selfish, in my judgment, to say, ``If I don't get
my way, you can't have your way.'' It just does not make sense to me to
continue to believe that the right approach for our country is to put
the brakes on good proposals, good ideas that the American people want
and deserve.
I think you can break these things down into three areas that I
discussed before: First is kids; second is jobs; third is values. Kids,
jobs, and values. If we address those, all of us, we ought to have a
common interest. There ought not be much difference in how we would
respond to the needs of American children, between Republicans or
Democrats. We all ought to understand this.
All of us ought to have one goal. We all ought to believe that, with
respect to our kids, our future is in educating our kids. Thomas
Jefferson once said, anyone who believes that a country can be both
ignorant and free believes in something that never was and never can
be.
Everyone in this Chamber, I expect, should believe that we want to
have the best education system in this world--the best in the world,
not second place, not 10th place, the best education system in the
world. Now, if that is our goal, then let's just spend the rest of the
year to figure out how do we work with others in our country who are
involved in our education system to accomplish that goal. How do we
accomplish having the best education system in the world, because that
determines who wins in the international economic competition, and the
international economic competition means you are going to have winners
and losers. The winners are going to have jobs, expanding economies and
opportunities, and the losers are going to suffer the British disease
of long, slow economic decline that we saw at the end of the last
century.

[[Page S6654]]

So, educate our kids? Does it make sense then when we understand
something that works, like a Head Start Program where you take a 3- or
4-year-old kid coming from a home of poverty, from a circumstance of
disadvantage, and we say to them, ``We're going to invest money in you
in a Head Start Program, and we know it works, and it makes life better
for those kids,'' does it make sense for us to say, ``Look, there are
60,000 of you who have names, Jim, Bill, Mary, Donna, and we've got
news for you; we can no longer afford to have you in a Head Start
Program''? Does that make sense?
Does it make sense, especially at a time when we are saying, ``By the
way, we have money to give tax breaks, especially to people over $1
million a year in income, but we can't afford to keep 60,000 of you
kids in a Head Start Program''?
The answer is, no, of course, it does not make sense. It is nuts. It
does not make any sense to establish priorities that are so far out of
bounds. Our kids matter. Investment in our kids matters to all of us.
The Head Start Program works. I use that simply as an example of the
need, the desperate need, to get our priorities straight.
Jobs: No one comes to the floor on any regular occasion and talks
about the merchandise trade deficit in this country. The merchandise
trade deficit is higher than our fiscal deficit. What does that mean?
Jobs that used to be here are elsewhere. Jobs that used to be American
jobs are now in Malaysia, Indonesia, Sri Lanka, Bangladesh. I know the
American people contribute to this. You cannot wear Mexican shorts and
Chinese pants and shirts made in Taiwan and television sets made in
Thailand and drive cars made in Japan and then complain about, ``Where
have American jobs gone?'' People do that, but you cannot do that.

American jobs are leaving to go to where the international
enterprises want to produce, where they can pay a dime an hour, a
quarter an hour, 50 cents an hour, $1 an hour to compete against
American workers, where we pay a living wage, minimum wage to those who
work in factories that are safe because we demand they be safe, compete
in circumstances where we will not allow 12-year-olds to work in
textile mills because we have child labor laws.
The jobs have left this country because we have not dealt with our
trade problem in a straightforward way, but you cannot get many people
on this floor to talk very thoughtfully about that. People just do not
want to discuss it.
But the issue of jobs is at the root of interest of families that are
going to sit down for supper tonight and talk about their lives and
their future and what they want for their kids. It is going to be,
``Are we going to have an opportunity to get a good job that pays a
good income?''
Values? The fact is the American people are very concerned about
collapsed values in this country. Just go out the door and look around
a bit--the rate of crime, the rate of violent crime--and understand
what is happening.
Look at the accelerated rate of teenage pregnancies and understand
what is happening. Look at the number of people who have fathered
children in this country and, once having fathered the child, said,
``Sayonara, I'm out of here,'' and takes no responsibility for that
child and refuses to make a payment.
Collapsed values? You bet. Teenage pregnancy, deadbeat dads, crime
epidemic, epidemic of violent crime--these are the issues that we have
to work on, and we have to work on them in a way that responds to the
way the American people want us to respond to these issues.
Welfare reform: That is part of the values issue. It is also part of
kids, but two-thirds of people on welfare in America are kids under 16
years of age.
But with respect to values, it seems to me our public policy ought to
be--there ought not be great debate about this--to say those who are
able-bodied in the welfare system have a responsibility to work.
We have offered a proposal called the Work First Program. What we
have said is, we want to turn welfare offices into employment offices.
We are not interested in paying welfare. We are interested in making
sure people who are able-bodied go to work. But while doing that, we
insist that we not subject America's children to lives of poverty and
circumstances that none of us in this room would allow our children to
live in.
We cannot decide that while we solve the welfare problem, we are
going to say to the poorest people in this country, and especially poor
children, ``By the way, you're not entitled to health care if you're
sick.'' Does that make any sense to anybody, at a time when we are
talking about tax cuts for the upper-income folks in this country? It
does not to me.
This week--the reason I recite some of this--is on the floor of the
Senate, on the heels of the proposal for a constitutional amendment to
balance the budget, which I will not go into, but it misuses the Social
Security trust fund to balance the budget, on the heels of that, with
all of the people saying, ``We want to balance the budget,'' the first
jump out of the chute this week is, again, adding money, adding
hundreds of millions of dollars, for a star wars program. Yes, a star
wars program. We cannot afford the basic things, but we can afford a
star wars program.

It seems to me at some point we are going to have to reconcile in
this Chamber what we say with what we do. At some point, we ought to
try to figure out, as I said when I began, what we agree on rather than
what we disagree on, and at least enact those things and move those
things that represent common interest.
Finishing where I started, one area of common interest, I think, is
the Kassebaum-Kennedy bill, unless those who voted for it were not
voting their hearts. Mr. President, 100 people voted for Kassebaum-
Kennedy to reform this health system in a way that will benefit every
American family. One hundred Senators voted for it, and now it is being
held hostage in some legislative prison because someone is insisting
that something else be added to it or they will simply not allow it to
move. What an outrage.
I hope next Monday or Tuesday that those who are insisting they get
their way or we will not have health care reform will finally decide
that is not in the public's interest. Let Kassebaum-Kennedy move and
bring your bill up the following day. That is just fine. None of us
object. You can do that. We are going to have a vote on that.
If you have the votes here, you win. We do not weigh votes here. We
count votes. If you want to bring it up, bring it up, but do not hold
hostage a health care reform bill that this country needs that passed
this Chamber 100 to 0.
Mr. President, I have gone on longer than I needed to. I know that my
colleague, Senator Lieberman, is on the floor. I ask unanimous consent
that Senator Lieberman be allowed to speak for 20 minutes.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. LIEBERMAN. I thank the Chair, and I thank my friend from North
Dakota. Mr. President, I appreciate his final request, and I express to
him and my colleagues my fervent desire not to use--particularly I
express this to the occupant of the chair--it is my fervent desire not
to use the full 20 minutes.
(The remarks of Mr. Lieberman pertaining to the submission of Senate
Resolutions 270 are printed in today's Record under ``Submission of
Concurrent and Senate Resolutions.'')

____________________