[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

[[Page S6652]]

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.'')

                          ____________________