[Congressional Record Volume 143, Number 114 (Wednesday, September 3, 1997)]
[Senate]
[Pages S8710-S8720]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




  DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND 
               RELATED AGENCIES APPROPRIATIONS ACT, 1998

  The Senate continued with the consideration of the bill.


                           Amendment No. 1056

  The PRESIDING OFFICER (Mr. Abraham). Under the previous order, the 
Senate will now vote on amendment No. 1056 offered by the Senator from 
Arizona. The yeas and nays have been ordered. The clerk will call the 
roll.
  The bill clerk called the roll.
  Mr. NICKLES. I announce that the Senator from Arkansas [Mr. 
Murkowski] is necessarily absent.
  The PRESIDING OFFICER. Are there any other Senators in the Chamber 
who desire to vote?
  The result was announced--yeas 25, nays 74, as follows:

                      [Rollcall Vote No. 213 Leg.]

                                YEAS--25

     Allard
     Ashcroft
     Breaux
     Brownback
     Cochran
     Coverdell
     Faircloth
     Feinstein
     Gorton
     Gramm
     Hatch
     Helms
     Hutchinson
     Hutchison
     Inhofe
     Kyl
     Lott
     Mack
     McCain
     McConnell
     Nickles
     Roberts
     Sessions
     Shelby
     Thurmond

[[Page S8711]]



                                NAYS--74

     Abraham
     Akaka
     Baucus
     Bennett
     Biden
     Bingaman
     Bond
     Boxer
     Bryan
     Bumpers
     Burns
     Byrd
     Campbell
     Chafee
     Cleland
     Coats
     Collins
     Conrad
     Craig
     D'Amato
     Daschle
     DeWine
     Dodd
     Domenici
     Dorgan
     Durbin
     Enzi
     Feingold
     Ford
     Frist
     Glenn
     Graham
     Grams
     Grassley
     Gregg
     Hagel
     Harkin
     Hollings
     Inouye
     Jeffords
     Johnson
     Kempthorne
     Kennedy
     Kerrey
     Kerry
     Kohl
     Landrieu
     Lautenberg
     Leahy
     Levin
     Lieberman
     Lugar
     Mikulski
     Moseley-Braun
     Moynihan
     Murray
     Reed
     Reid
     Robb
     Rockefeller
     Roth
     Santorum
     Sarbanes
     Smith (NH)
     Smith (OR)
     Snowe
     Specter
     Stevens
     Thomas
     Thompson
     Torricelli
     Warner
     Wellstone
     Wyden

                             NOT VOTING--1

       
     Murkowski
       
  The amendment (No. 1056) was rejected.
  Mr. SPECTER. Mr. President, I move to reconsider the vote.
  Mr. HARKIN. I move to lay that motion on the table.
  The motion to lay on the table was agreed to.
  The PRESIDING OFFICER. The Senate will please come to order so the 
Senator from Pennsylvania may be recognized.
  Mr. SPECTER. Mr. President, after consulting with the majority 
leader, it is our intention to proceed with a series of amendments and 
to have perhaps two stacked votes at about 7 o'clock. We have next up 
an amendment that will just take a moment or two, a very brief 
amendment by Senator McCain. Then we are going to follow that with a 
brief amendment by Senator Nickles.
  Will that require a rollcall vote, Senator Nickles? It will.
  Then we have an amendment by Senator Lieberman, and then we will be 
in a position to, we hope, have a list of amendments which will be 
limited so we can proceed to see precisely how we will finish the bill.
  Mr. WARNER. Mr. President, will the Senator entertain a unanimous-
consent request, a brief one?
  Mr. SPECTER. Yes.
  Mr. WARNER. I thank the manager.
  The PRESIDING OFFICER. The Senator from Virginia.


           Explanation of Absence--Vote on Amendment No. 1057

  Mr. WARNER. Mr. President, I was absent this morning during the vote 
on the Harkin amendment. Had I been here, I would have voted with the 
distinguished Senator from Iowa. I was at the funeral of a friend, an 
employee of 35 years, who passed on, and I was privileged to give the 
eulogy.
  The PRESIDING OFFICER. The Senator from Minnesota.
  Mr. WELLSTONE. Mr. President, I have an amendment I would send to the 
desk on behalf of myself and Senator McCain.
  The PRESIDING OFFICER. Is there objection to setting aside the 
pending amendment?
  Mr. WELLSTONE. I ask unanimous consent the pending amendment be set 
aside.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                           Amendment No. 1074

 (Purpose: To provide for the establishment of a program for research 
           and training with respect to Parkinson's disease)

  The PRESIDING OFFICER. The clerk will report the amendment.
  The assistant legislative clerk read as follows:

       The Senator from Minnesota [Mr. Wellstone], for himself, 
     Mr. McCain, Mr. Craig, Mr. Burns, Mr. Durbin, Mr. Ford, Mr. 
     D'Amato, Mr. Breaux, Ms. Moseley-Braun, Mr. Santorum, Mr. 
     Johnson, Ms. Snowe, Mr. Reid, Mr. Hollings, Mr. Torricelli, 
     Mr. Faircloth, Mr. Levin, Mr. Lautenberg, Mr. Hatch, and Mr. 
     Bryan, proposes an amendment numbered 1074.

  Mr. WELLSTONE. Mr. President, I ask unanimous consent that the 
reading of the amendment be dispensed with.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The amendment is as follows:

       At the appropriate place, insert the following:

     SEC.    . PARKINSON'S DISEASE RESEARCH.

       (a) Short Title.--This section may be cited as the ``Morris 
     K. Udall Parkinson's Research Act of 1997''.
       (b) Finding and Purpose.--
       (1) Finding.--Congress finds that to take full advantage of 
     the tremendous potential for finding a cure or effective 
     treatment, the Federal investment in Parkinson's must be 
     expanded, as well as the coordination strengthened among the 
     National Institutes of Health research institutes.
       (2) Purpose.--It is the purpose of this section to provide 
     for the expansion and coordination of research regarding 
     Parkinson's, and to improve care and assistance for afflicted 
     individuals and their family caregivers.
       (c) Parkinson's Research.--Part B of title IV of the Public 
     Health Service Act (42 U.S.C. et seq.) is amended by adding 
     at the end the following:


                         ``parkinson's disease

       ``Sec. 409B. (a) In General.--The Director of NIH shall 
     establish a program for the conduct and support of research 
     and training with respect to Parkinson's disease (subject to 
     the extent of amounts appropriated under subsection (e)).
       ``(b) Inter-Institute Coordination.--
       ``(1) In general.--The Director of NIH shall provide for 
     the coordination of the program established under subsection 
     (a) among all of the national research institutes conducting 
     Parkinson's research.
       ``(2) Conference.--Coordination under paragraph (1) shall 
     include the convening of a research planning conference not 
     less frequently than once every 2 years. Each such conference 
     shall prepare and submit to the Committee on Appropriations 
     and the Committee on Labor and Human Resources of the Senate 
     and the Committee on Appropriations and the Committee on 
     Commerce of the House of Representatives a report concerning 
     the conference.
       ``(c) Morris K. Udall Research Centers.--
       ``(1) In general.--The Director of NIH shall award Core 
     Center Grants to encourage the development of innovative 
     multidisciplinary research and provide training concerning 
     Parkinson's. The Director shall award not more than 10 Core 
     Center Grants and designate each center funded under such 
     grants as a Morris K. Udall Center for Research on 
     Parkinson's Disease.
       ``(2) Requirements.--
       ``(A) In general.--With respect to Parkinson's, each center 
     assisted under this subsection shall--
       ``(i) use the facilities of a single institution or a 
     consortium of cooperating institutions, and meet such 
     qualifications as may be prescribed by the Director of the 
     NIH; and
       ``(ii) conduct basic and clinical research.
       ``(B) Discretionary requirements--With respect to 
     Parkinson's, each center assisted under this subsection may--
       ``(i) conduct training programs for scientists and health 
     professionals;
       ``(ii) conduct programs to provide information and 
     continuing education to health professionals;
       ``(iii) conduct programs for the dissemination of 
     information to the public;
       ``(iv) separately or in collaboration with other centers, 
     establish a nationwide data system derived from patient 
     populations with Parkinson's, and where possible, comparing 
     relevant data involving general populations;
       ``(v) separately or in collaboration with other centers, 
     establish a Parkinson's Disease Information Clearinghouse to 
     facilitate and enhance knowledge and understanding of 
     Parkinson's disease; and
       ``(vi) separately or in collaboration with other centers, 
     establish a national education program that fosters a 
     national focus on Parkinson's and the care of those with 
     Parkinson's.
       ``(3) Stipends regarding training programs.--A center may 
     use funds provided under paragraph (1) to provide stipends 
     for scientists and health professionals enrolled in training 
     programs under paragraph (2)(B).
       ``(4) Duration of support.--Support of a center under this 
     subsection may be for a period not exceeding five years. Such 
     period may be extended by the Director of NIH for one or more 
     additional periods of not more than five years if the 
     operations of such center have been reviewed by an 
     appropriate technical and scientific peer review group 
     established by the Director and if such group has recommended 
     to the Director that such period should be extended.
       ``(d) Morris K. Udall Awards for Excellence in Parkinson's 
     Disease Research.--The Director of NIH shall establish a 
     grant program to support investigators with a proven record 
     of excellence and innovation in Parkinson's research and who 
     demonstrate potential for significant future breakthroughs in 
     the understanding of the pathogensis, diagnosis, and 
     treatment of Parkinson's. Grants under this subsection shall 
     be available for a period of not to exceed 5 years.
       ``(e) Authorization of Appropriations.--For the purpose of 
     carrying out this section, there are authorized to be 
     appropriated $100,000,000 for fiscal year 1998, and such sums 
     as may be necessary for each of the fiscal years 1999 and 
     2000.''.

  Mr. WELLSTONE. Mr. President, I could talk at some length about this 
amendment, and I will not. I will just make a few introductory 
comments, and then my colleague, Senator McCain, will speak on this.
  We have, I believe, close to 66, or thereabouts, cosponsors. This 
amendment, which I am very proud to offer today, is really an amendment 
that is

[[Page S8712]]

named after Mo Udall, who was a very distinguished Representative in 
the House of Representatives and somebody that many people here have a 
great deal of love and respect for.
  This amendment would call for 10 Parkinson's research centers. This 
would be $100 million a year. The reason for this amendment is that 
Parkinson's disease is a devastating neurological disease. Probably my 
colleagues are very familiar with it. They may have had a loved one who 
suffered from it. I had two parents who suffered from Parkinson's 
disease.
  Mr. President, what happens with people with Parkinson's is that 
there is a tremendous problem with shaking, people have difficulty 
walking, and many people have really found it difficult to be, if you 
will, their own lobbyist. People have found it difficult to speak for 
themselves.
  But what has happened in the last several years is that there has 
been a wonderful group of people who have come here. The Udall family 
has been very, very important in this whole struggle. In addition, Joan 
Samuelson, with the Parkinson's Action Network, has been really 
critical to this. They have come here and I think have met with 
Senators, Democrats and Republicans alike. This is a bipartisan effort 
we have on the floor of the Senate. They have essentially said to all 
of us, ``Time is not on our side. We have the research that we can 
point to. It is such promising research. We are on the cuspis of major 
breakthroughs, but if we do not at least increase this funding for 
research for many of us, we really will not have that much of a 
future.''
  Mr. President, there are a million people in our country, men and 
women who struggle with Parkinson's disease. Up to now, we have been 
spending about $30 per person. It is a really shamefully low amount of 
money that we have spent. Very little has been invested.
  But now these men and women, this community, has come to the Nation's 
Capital. They have met with all of us, and they have made their case. I 
am very honored to offer this amendment with Senator McCain. I hope we 
will get very, very strong support.
  Mr. President, I ask unanimous consent to add as original cosponsors 
to this amendment Senator Craig, Senator Burns, Senator Durbin, Senator 
Ford, Senator D'Amato, Senator Breaux, Senator Moseley-Braun, Senator 
Santorum, Senator Johnson, Senator Snowe, Senator Harry Reid, Senator 
Hollings, Senator Torricelli, Senator Faircloth, Senator Levin, and 
Senator Lautenberg.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                    Amendment No. 1074, As Modified

  Mr. WELLSTONE. Mr. President, I ask unanimous consent to send a 
modification to the desk, along with the cosponsors.
  The PRESIDING OFFICER. The Senator has a right to modify his 
amendment, the yeas and nays not having been ordered.
  The amendment, as modified, is as follows:

       At the appropriate place, insert the following:

     SEC.   . PARKINSON'S DISEASE RESEARCH.

       (a) Short Title.--This section may be cited as the ``Morris 
     K. Udall Parkinson's Research Act of 1997''.
       (b) Finding and Purpose.--
       (1) Finding.--Congress finds that to take full advantage of 
     the tremendous potential for finding a cure or effective 
     treatment, the Federal investment in Parkinson's must be 
     expanded, as well as the coordination strengthened among the 
     National Institutes of Health research institutes.
       (2) Purpose.--It is the purpose of this section to provide 
     for the expansion and coordination of research regarding 
     Parkinson's, and to improve care and assistance for afflicted 
     individuals and their family caregivers.
       (c) Parkinson's Research.--Part B of title IV of the Public 
     Health Service Act (42 U.S.C. 284 et seq.) is amended by 
     adding at the end the following:


                         ``parkinson's disease

       ``Sec. 409B. (a) In General.--The Director of NIH shall 
     establish a program for the conduct and support of research 
     and training with respect to Parkinson's disease (subject to 
     the extent of amounts appropriated under subsection (e)).
       ``(b) Inter-Institute Coordination.--
       ``(1) In general.--The Director of NIH shall provide for 
     the coordination of the program established under subsection 
     (a) among all of the national research institutes conducting 
     Parkinson's research.
       ``(2) Conference.--Coordination under paragraph (1) shall 
     include the convening of a research planning conference not 
     less frequently than once every 2 years. Each such conference 
     shall prepare and submit to the Committee on Appropriations 
     and the Committee on Labor and Human Resources of the Senate 
     and the Committee on Appropriations and the Committee on 
     Commerce of the House of Representatives a report concerning 
     the conference.
       ``(c) Morris K. Udall Research Centers.--
       ``(1) In general.--The Director of NIH shall award Core 
     Center Grants to encourage the development of innovative 
     multidisciplinary research and provide training concerning 
     Parkinson's. The Director shall award not more than 10 Core 
     Center Grants and designate each center funded under such 
     grants as a Morris K. Udall Center for Research on 
     Parkinson's Disease.
       ``(2) Requirements.--
       ``(A) In general.--With respect to Parkinson's, each center 
     assisted under this subsection shall--
       ``(i) use the facilities of a single institution or a 
     consortium of cooperating institutions, and meet such 
     qualifications as may be prescribed by the Director of the 
     NIH; and
       ``(ii) conduct basic and clinical research.
       ``(B) Discretionary requirements.--With respect to 
     Parkinson's, each center assisted under this subsection may--
       ``(i) conduct training programs for scientists and health 
     professionals;
       ``(ii) conduct programs to provide information and 
     continuing education to health professionals;
       ``(iii) conduct programs for the dissemination of 
     information to the public;
       ``(iv) separately or in collaboration with other centers, 
     establish a nationwide data system derived from patient 
     populations with Parkinson's, and where possible, comparing 
     relevant data involving general populations;
       ``(v) separately or in collaboration with other centers, 
     establish a Parkinson's Disease Information Clearinghouse to 
     facilitate and enhance knowledge and understanding of 
     Parkinson's disease; and
       ``(vi) separately or in collaboration with other centers, 
     establish a national education program that fosters a 
     national focus on Parkinson's and the care of those with 
     Parkinson's.
       ``(3) Stipends regarding training programs.--A center may 
     use funds provided under paragraph (1) to provide stipends 
     for scientists and health professionals enrolled in training 
     programs under paragraph (2)(B).
       ``(4) Duration of support.--Support of a center under this 
     subsection may be for a period not exceeding five years. Such 
     period may be extended by the Director of NIH for one or more 
     additional periods of not more than five years if the 
     operations of such center have been reviewed by an 
     appropriate technical and scientific peer review group 
     established by the Director and if such group has recommended 
     to the Director that such period should be extended.
       ``(d) Morris K. Udall Awards for Excellence in Parkinson's 
     Disease Research.--The Director of NIH shall establish a 
     grant program to support investigators with a proven record 
     of excellence and innovation in Parkinson's research and who 
     demonstrate potential for significant future breakthroughs in 
     the understanding of the pathogenesis, diagnosis, and 
     treatment of Parkinson's. Grants under this subsection shall 
     be available for a period of not to exceed 5 years.
       ``(e) Authorization of Appropriations.--For the purpose of 
     carrying out this section and section 301 and title IV of The 
     Public Health Service Act with respect to direct Parkinson's 
     disease research, there are authorized to be appropriated a 
     total of $100,000,000 for fiscal year 1998, and such sums as 
     may be necessary for each of the fiscal years 1999 and 2000.

  Mr. WELLSTONE. I defer to my colleague from Arizona, and I thank him 
for his--I am not going to use the word ``leadership'' because many 
people always talk about Senator McCain's leadership--but for his 
emotional and personal involvement. He is a Senator who is very 
connected to people. I thank him for all of his work. I hope we will 
get a good, strong vote.
  Mr. McCAIN addressed the Chair.
  The PRESIDING OFFICER. The Senator from Arizona.
  Mr. McCAIN. Mr. President, I thank my friend from Minnesota. He is a 
man of great spirit, a man of great commitment. When the Senator from 
Minnesota gets involved in an issue, he is heard from. I believe his 
involvement in this issue is important and, indeed, critical. I don't 
think it is inappropriate to mention that the life of the Senator from 
Minnesota has been touched in the most graphic and dramatic fashion by 
this disease we are discussing today. I thank the Senator from 
Minnesota.
  Mr. President, I support Senator Wellstone's amendment. Scientists 
have made tremendous new discoveries and progress in regard to 
Parkinson's disease, which clearly illustrates how close we are to 
finding a cure and treatment for this deadly disease. According to a 
wide array of experts, we

[[Page S8713]]

are on the verge of substantial, groundbreaking scientific discoveries 
in the next few years regarding the cause and potential cure of 
Parkinson's disease.
  The most recent scientific discovery of a gene abnormality that 
causes some cases of Parkinson's disease has provided researchers with 
a powerful new tool for understanding Parkinson's disease. This is the 
kind of breakthrough that makes a strong case for ensuring adequate 
funding for Parkinson's research.
  I don't come to the floor very often on a situation like this, but 
there is a gross inequity here and one that needs rectification. I find 
it gravely disturbing that despite the significant progress scientists 
are making in the field of Parkinson's, the National Institutes of 
Health continuously fail to provide an appropriate amount of funding 
for Parkinson's research, which is why the Senator from Minnesota and I 
are here.
  During fiscal year 1996, the National Institutes of Health spent $32 
million for direct Parkinson's research. That is about $32 for each of 
the approximately 1 million Parkinson's patients--$32 for each of the 
approximately 1 million Parkinson's patients. Compare this to the 
$2,143 per AIDS victim; $338 per cancer victim; or $200 per breast 
cancer victim; or $81 per Alzheimer's victim; $74 per heart disease 
victim, not including the additional funding just adopted as an 
amendment to this bill.
  Obviously, funding for Parkinson's research is grossly inadequate 
compared to support which other diseases receive at NIH. By failing to 
provide scientists with adequate funding, we are potentially letting a 
cure for this dreadful disease slip further and further into the 
future. This amendment will ensure that our scientific researchers have 
available the necessary funding and support to proceed as quickly as 
possible to combat Parkinson's.
  Mr. President, the Senator from Minnesota has described what this 
legislation would do, including the establishment of 10 Morris K. Udall 
Centers for Research on Parkinson's Disease throughout the Nation, 
create a national Parkinson's disease clearinghouse and other things.
  Approximately 1 million Americans are afflicted with Parkinson's 
disease. Parkinson's is a debilitating, degenerative disease which is 
caused when nerve centers in an individual's brain lose their ability 
to regulate body movements. People afflicted by this disease experience 
tremors, loss of balance and repeated falls, loss of memory, confusion 
and depression. Ultimately, this disease results in total incapacity of 
an individual, including the inability to speak. This disease knows no 
boundaries, does not discriminate and strikes without warning.
  This amendment is supported by the National Parkinson's Foundation, 
the American Parkinson's Disease Association and Parkinson's Action 
Network. These organizations, as well as many other individuals 
involved in grassroots support activities, have worked long and hard to 
achieve widespread support for this authorization bill in both the 
House and Senate.
  The Mo Udall Parkinson's Research and Education Act, which is the 
basis for this amendment, has 64 cosponsors in the Senate and 
approximately 240 cosponsors in the House. Mr. President, we cannot 
afford to lose this opportunity to continue the momentous progress in 
finding the cause for a cure for this terrible illness. On behalf of 
the millions of Americans afflicted with Parkinson's and their families 
and friends, I urge my colleagues to support this measure.
  Mr. President, I ask unanimous consent that Senator Hatch be added as 
an original cosponsor of the amendment.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. McCAIN. Mr. President, finally, I would like to thank the people 
that I mentioned earlier--the National Parkinson's Foundation, the 
American Parkinson's Disease Association, and Parkinson's Action 
Network. Without the help of these organizations, we would not be here 
today.
  Finally, I know sometimes amendments have a tendency to be dropped in 
conference. The Senator from Minnesota and I feel very strongly about 
this amendment, and that is why we feel it is necessary that we have a 
rollcall vote on this issue. I hope that the managers of the bill will 
see the way clear to preserve this amendment in conference, as it is 
supported by, as I mentioned, now 65 of our colleagues in the Senate 
and over 240 Members of the House.
  Mr. President, I ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There is a sufficient second.
  The yeas and nays were ordered.
  Mr. McCAIN. I yield the floor.
  Mr. WELLSTONE addressed the Chair.
  The PRESIDING OFFICER. The Senator from Minnesota.
  Mr. WELLSTONE. Mr. President, I want to add one final word to what my 
colleague, Senator McCain, has had to say. Above and beyond the 
organizations that Senator McCain recognized for their fine work, and 
above and beyond Mo Udall, this amendment comes from legislation which, 
as I said, is really named after Mo Udall, for reasons I don't need to 
explain to any colleague. I also would like to thank, but I want to do 
this carefully, Muhammad Ali, who has been very courageous, and I use 
that word carefully. Muhammad Ali struggles with Parkinson's, and he 
could have chosen to have had the world or the country have only seen 
him as he was when he was in his prime as a boxer. Instead, he has been 
very public, very visible and a very, very strong advocate, not just 
for himself but for many, many other people.
  Mr. President, I say to my colleagues, and I know that my colleague 
from Indiana is going to have a second-degree amendment which I think 
really adds strength to this and he has some very thoughtful and 
important questions to raise or comments to make, but I am going to end 
on a personal note. I want to say to everybody here that we really do 
need to have a strong vote, and we need to keep this in conference.
  When Senator McCain was talking about this disorder and what it does 
to people, I remember when L-Dopa, the first drug, came out. My father 
was in the original pilot group. For a while, L-Dopa helped, but then 
it reached the point where it did not. With my father, Leon Wellstone, 
at the very end, he not only could not walk, and he was a writer and 
his hand would shake and he could not type, but, in addition, he could 
not even speak.
  It can be so ravaging to people. It can be so devastating. The reason 
we have brought this amendment to the floor is that it is an equity 
question. So precious little has been invested in Parkinson's research 
at the very time when there is such potential for big breakthroughs.
  I want to make it clear to everybody that we have had the Parkinson's 
community come here to Washington, and they have come year after year 
for the last 3 or 4 years that they have been working on this. Each 
time, we make progress, and then at the very end, for some reason, they 
get shut out.
  So I make a plea to people on the basis of please vote for this 
funding. It is just a matter of elementary fairness and justice. It is 
just a matter of equity. Please don't shut people out. I just don't 
want to see people who have been so courageous and who have come here 
and have struggled so hard not be successful in this Senate and in this 
House of Representatives. We have to pass this legislation. It really 
would be a wonderful vote, and it really would make a huge difference 
in the lives of many of our neighbors and many of our friends who are 
men and women of enormous worth and enormous dignity and enormous 
substance. Nothing I say is said out of pity, it is said out of respect 
for the dignity of people. I just would like to say one more time, I 
hope we will get a huge vote for this amendment. I yield the floor.
  Mr. SPECTER addressed the Chair.
  The PRESIDING OFFICER. The Senator from Pennsylvania.
  Mr. SPECTER. Mr. President, this amendment to provide a statutory 
program for research and training with respect to Parkinson's, I think, 
is well founded.
  We have worked within the subcommittee to increase the funding for 
the National Institute of Neurological Disorders and Stroke which 
included language in the Senate report highlighting the importance of 
further activity on Parkinson's disease research. And the activities of 
the sponsors of

[[Page S8714]]

this amendment, whom I commend, will direct greater intensive effort on 
Parkinson's, which is a horrible disease. It has afflicted many, many 
people.
  With the enactment of this amendment, I think we will be taking a 
firm stand to show the emphasis that the Senate, hopefully, ultimately 
the full Congress, will place on additional research and resources 
being directed against Parkinson's.
  There is a great deal that could be said. We have a number of other 
amendments, so I will limit my comments to those brief remarks.
  Mr. HARKIN addressed the Chair.
  The PRESIDING OFFICER. The Senator from Iowa.
  Mr. HARKIN. I want to concur with what the chairman just said about 
this amendment. Obviously, all of us are very concerned about the lack 
of, shall we say, appropriate funding levels for research into the 
causes and interventions and cures of Parkinson's disease. This is 
something that I have been very close to for the last several years. I 
know that both Senator McCain and Senator Wellstone have been leaders 
on this issue in the Senate. And I congratulate them and commend them 
for their leadership on the issue of proper funding for Parkinson's 
research.
  There have been some recent breakthroughs in the causes of 
Parkinson's, some recent breakthroughs in genetic tracing, some recent 
breakthroughs in possible interventions, early interventions for those 
who are detected early with the onset of Parkinson's disease.
  This is a quantum increase. It is not out of bounds. Certainly the 
incidents of Parkinson's disease in this country and around the globe 
warrants the type of investment in research that the amendment 
anticipates. It remains to be seen whether or not we can accommodate 
this huge increase within the confines of the conference. I can assure 
the authors of the amendment that this Senator, and I am sure that 
Senator Specter, will do what we can to maintain this type of a level 
for Parkinson's research. What the disposition will be on the House 
side, obviously, we have no control over that. But I want to commend 
both Senator McCain and Senator Wellstone for their leadership on this 
issue and hope that we can do what we can in conference to keep the 
funding level up for Parkinson's research.
  I yield the floor.
  Mr. COATS addressed the Chair.
  The PRESIDING OFFICER. The Senator from Indiana.
  Mr. COATS. Mr. President, I want to add my support to this. I have 
been a supporter of additional funds for Parkinson's. But in the 
process of all of this, and serving on the committee, I have raised, on 
a number of occasions, my concerns that we are making decisions about 
which diseases, which research centers at NIH receive the funds. We are 
making that decision, I think, in well-intended ways, in ways that we 
hope will direct funds to provide breakthroughs and better research and 
hopefully cures for some of these diseases, yet I have been concerned 
we are doing it on a piecemeal basis.
  I am concerned that those organizations which have the greatest 
lobbying clout, who have been able to contact the most Senators or 
Congressmen, the ones who have generated the most support at home or 
who are best organized have become those that are rewarded by passage 
of legislation like this, and that those who do not have the lobbying 
expertise, the lobbying clout, do not have the same kind of friends in 
Congress that others have and end up being shorted. As a consequence, 
we are making decisions on the basis of anecdotal evidence--and some 
scientific evidence--but on the basis of political decisions as much as 
scientific decisions.
  Medical research is a complicated field. NIH is a wonderful 
organization that attempts to direct funds in ways that will ensure 
that research dollars are going into those areas where the best results 
can be obtained. And yet, in my visits to NIH, and talking with a 
number of people out there, and my observation of the process here, it 
is clear that those funds are not always directed in the most 
expeditious manner, not always directed in ways that provide the most 
hope in terms of finding breakthroughs and in finding cures.
  Having said that, there is no question that Parkinson's research over 
the years has been shorted. In 1994, it had a funding rate of $26 per 
patient, the lowest of all the major diseases, yet it affects one 
million or more Americans. Its direct funding in 1994 was only $26 
million, the lowest dollar number of all the major diseases.
  So I think it is important that we recognize that here is a 
debilitating disease that affects a million or more Americans, that has 
had a personal impact on many of us and our families, that has 
generated a very effective organization that supports research, 
increased funding for research, but at the same time I think we have to 
acknowledge or we should acknowledge and recognize that this is not the 
best way to go about allocating funds for research at NIH, that the 
lobby group that is the most effective or the Members who are in the 
best position to direct the funds because of their committee positions 
or whatever, that is not the way that we ought to be allocating 
research dollars.

  We ought to be doing it on a meritorious basis, one that is supported 
by medical science, one that receives the recommendation of independent 
researchers or an independent body or medical experts that certainly 
have more expertise in this area than we do. I say that because if you 
look at the list of diseases and the centers and the way we fund those, 
there is clearly an imbalance. We clearly are directing funds to areas 
where research is unnecessary or is duplicated. We clearly are not 
directing funds to areas where we need research.
  I have discussed this with NIH officials. I have been told--and will 
not quote any names--but I have been told by people who are in a 
position to know, they are duplicating and in some cases tripling the 
amount of funds going into the same research simply because they are 
directed by the Congress to fund that specific disease. And, of course, 
any duplication or triplication or every excess dollar that has to be 
spent because it is politically directed to be spent and not medically 
necessary or scientifically required and going to meritorious studies 
is a dollar that does not go into some other research, whether it is 
direct research or indirect research, that could offer potentially 
life-saving breakthroughs in other diseases.
  Just an example or two. All of us have heard about Parkinson's, and 
we are going to increase Parkinson's here. And I am going to support 
that increase. I will say this. This is the last specific research 
dollar increase that I am going to support until we have an outside 
organization that can give us some recommendations as to how to 
allocate our money. This ``disease of the month'' or who has the best 
lobby or who has the most influential friends in Congress is not the 
way that we ought to be directing research funds. But I have been a 
long-time supporter of Parkinson's.
  They have made their case. But I have told them I am not going to 
continue on this basis. I will support the bill this year, but I am 
going to be adding shortly an amendment that Senator Frist will speak 
to, of which I would like to add him as a cosponsor, which will 
initiate this study so that we would have a report so that in next 
year's appropriations process we have before us the information we need 
in order to make rational decisions, meritorious decisions rather than 
just simply political decisions. I don't mean just simply political 
decisions, but decisions that are not wholly supported by medical 
science.
  Very few people have heard of polycystic kidney disease, PKD. I had 
not heard of it until I was visited by a friend of mine who introduced 
me to the disease. PKD receives a ridiculously low appropriation, and 
yet PKD is a disease that affects 500,000 Americans. It affects their 
kidneys in a way that they do not function. And yet, as a Government, 
because kidney dialysis is covered under Medicaid and Medicare, we 
spend untold millions of dollars in paying the bills for kidney 
dialysis when we provide virtually nothing for research in an area 
where some amazing advances are possible, according to the medical 
researchers, that can eliminate this disease and save the taxpayer 
literally billions of dollars.
  But because PKD is something that has not generated a huge lobbying 
effort, does not have influential friends in Congress in key positions, 
PKD continues to get the short end of the stick

[[Page S8715]]

in terms of research dollars. And yet, if there was ever an area where 
we ought to be directing research funds, if the medical science says we 
have an opportunity here to utilize these effectively and provide 
research, if there is ever an area that can free up funds that we can 
use for more research, in Parkinson's and other areas, or to help with 
the Medicare funding or Medicaid funding or Medicare funding, it ought 
to be in polycystic kidney disease, because the Government, we have 
agreed we are going to pay for transfusions on dialysis, we are going 
to pay for those out of Federal funds. And so year after year after 
year we pay billions of dollars to provide very costly and very 
difficult relief for people suffering from this disease, and yet we 
give them virtually nothing in terms of their research.
  As a consequence of all that, and through discussions we have had in 
committee with some NIH scientists and researchers, I think we are 
coming to a consensus here that we ought to initiate a process by which 
we can coordinate our research dollars in a way that it gives us an 
effective use of those dollars and gives us the best chance to provide 
the best research in the best ways.
  This amendment that I am going to offer shortly would require a 
comprehensive review of NIH and congressional policies and procedures 
for establishing priorities for research dollars. And that review has 
to be independent of the agency. The amendment requires that the agency 
contract with the Institute of Medicine, which I think is a highly 
respected and reputable institution, to conduct the study according to 
the statutory specifications, and requires a report to Congress within 
6 months so that the authorizing and the appropriating committees for 
next year's cycle will have that information before them before they 
make their decisions.
  It raises critical questions about how we ought to direct research 
dollars, talks about how much funding that would be appropriate, and 
the statutory changes that will be needed to change NIH policies and 
procedures.
  The Institute of Medicine is particularly directed to focus on the 
factors and criteria used by NIH to make disease funding allocations, 
to focus on the process by which the funding decisions are made, the 
mechanisms for public input and the impact of congressional statutory 
directives.
  Again, as I said, Dr. Olonow, from NIH, who testified before our 
committee, thought that this was an appropriate way to proceed. The 
funding is drawn from NIH's general administrative funds. None of these 
funds will come from existing research dollars. This amendment is not 
opposed by NIH. I think it will give us a means of making wiser 
decisions about how we appropriate dollars in the future.


                           Amendment No. 1075

 (Purpose: To provide for the conduct of a comprehensive, independent 
   study of National Institutes of Health research priority setting)

  Mr. COATS. Mr. President, I now offer this amendment by sending it to 
the desk, and ask unanimous consent that Senator Frist be added as an 
original cosponsor.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Is there objection to setting aside the pending amendments so the 
Coats amendment would be considered as a first-degree amendment?
  Mr. WELLSTONE. We have no objection.
  The PRESIDING OFFICER. Without objection, it is so ordered. The clerk 
will report the amendment.
  The legislative clerk read as follows:

       The Senator from Indiana [Mr. Coats], for himself and Mr. 
     Frist, proposes an amendment numbered 1075.

  Mr. COATS. Mr. President, I ask unanimous consent that further 
reading of the amendment be dispensed with.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The amendment is as follows:
       On page 49, after line 26, add the following:


    comprehensive independent study of nih research priority setting

       Sec.   . (a) Study by the Institute of Medicine.--Not later 
     than 30 days after the date of enactment of this Act, the 
     Secretary of Health and Human Services shall enter into a 
     contract with the Institute of Medicine to conduct a 
     comprehensive study of the policies and process used by the 
     National Institutes of Health to determine funding 
     allocations for biomedical research.
       (b) Matters To Be Assessed.--The study under subsection (a) 
     shall assess--
       (1) the factors or criteria used by the National Institutes 
     of Health to determine funding allocations for disease 
     research;
       (2) the process by which research funding decisions are 
     made;
       (3) the mechanisms for public input into the priority 
     setting process; and
       (4) the impact of statutory directives on research funding 
     decisions.
       (c) Report.--
       (1) In general.--Not later than 6 months after the date on 
     which the Secretary of Health and Human Services enters into 
     the contract under subsection (a), the Institute of Medicine 
     shall submit a report concerning the study to the Committee 
     on Labor and Human Resources and the Committee on 
     Appropriations of the Senate, and the Committee on Commerce 
     and the Committee on Appropriations of the House of 
     Representatives.
       (2) Requirement.--The report under paragraph (1) shall set 
     forth the findings, conclusions, and recommendations of the 
     Institute of Medicine for improvements in the National 
     Institutes of Health research funding policies and processes 
     and for any necessary congressional action.
       (d) Funding.--Of the amount appropriated in this title for 
     the National Institutes of Health, $300,000 shall be made 
     available for the study and report under this section.

  Mr. COATS. Mr. President, I appreciate the support and the efforts 
that Senator Wellstone has provided. We have discussed this matter on a 
number of occasions. He is, I believe, willing to accept the amendment 
and supports what we are trying to do.
  I know Senator Frist and maybe others would like to speak on the 
Coats amendment. I yield the floor.
  The PRESIDING OFFICER (Ms. Collins). The Senator from Minnesota.
  Mr. WELLSTONE. Madam President, could I add Senator Bryan as an 
original cosponsor of the Wellstone-McCain amendment.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. WELLSTONE. I thank my colleague from Indiana and also my 
colleague from Tennessee for their thoughtful and important amendment, 
and I thank them for their support.
  The PRESIDING OFFICER. The Senator from Tennessee is recognized.
  Mr. FRIST. I rise to commend my colleagues, Senators Wellstone and 
McCain, for their excellent leadership on this issue and their 
commitment to improving the lives of patients suffering from 
Parkinson's disease.
  I would like to recognize at this time the important efforts of all 
of the advocacy groups who have done such a wonderful job in educating 
people broadly, increasing the awareness about the devastation of this 
disease, and the continued need for research, and to the causes and to 
the treatments and to the eventual cure of Parkinson's disease. It is 
in large part due to these efforts, this broad effort at the grassroots 
level across this country that there has been increased focus on 
Parkinson's disease and Parkinson's research at the National Institutes 
of Health.
  I want to reiterate and support the words of my colleague from 
Indiana who has expressed some concern with regard to the process of 
how these decisions are made and are brought forward, and thus our 
amendment which he has put forward. As chair of the subcommittee on 
public health and safety that has jurisdiction over the majority of the 
public health agencies, including the National Institutes of Health, I 
must state today, because I believe we should not be placing 
authorizing legislation on an appropriations bill but should rather be 
considering this particular bill within the overall NIH reauthorization 
process.
  I, along with my fellow committee members, Senators Jeffords and 
Coats, have discussed at length the critical role our public health 
agencies play in improving the health and well being of American 
citizens. We have a strong commitment to push forward authorization 
legislation for each of the National Institutes of Health's vital 
programs, but we have to do this in a systematic way through a coherent 
process, one in which we would be able to give thoughtful review and 
comparative review to the programs that we establish.
  Thus, although I am very supportive of increasing funding in support 
for Parkinson's research, my preference very clearly would have been to 
work

[[Page S8716]]

with my colleague and to include this bill within our overall NIH 
reauthorization bill that would address the various concerns.
  I also want to reiterate what my colleague from Indiana has said, 
that we have to be very careful because once again we are falling into 
this risky area of establishing a precedent that once again we take a 
disease either of the week or of the month or of the year or in 
reflection or in response to a very strong advocacy group and react to 
that individual disease without consideration of this larger process.
  Every week people come to my office with multiple voices requesting 
more funds to be allocated to research in a variety of diseases. It 
might be heart disease, lung disease, kidney disease or pancreatic 
disease or neurological research. Again, each comes forward making a 
very strong case. As a physician, and as one who is empathetic and who 
has treated many of these diseases, my initial response is to say we 
should increase funding, and if we do increase funding we will find a 
cure, better treatment or relieve suffering.
  The problem is that is exactly the way the system works today. I am 
concerned that if we continue to appropriate as we are today, disease 
by disease, we are sending an inaccurate or wrong message to our 
patient groups. Therefore, we come in today with this amendment, to 
have a comprehensive study of talking, of discussing exactly how these 
decisions of prioritization, of research, should be made.
  As a physician and as a researcher, I understand the many, many 
complex factors that must be considered in determining the priorities 
for research and the enormous difficulty that exists in making 
decisions of heart disease versus lung disease versus renal disease 
versus pancreatic disease versus Parkinson's disease. Indeed, each of 
us in this Chamber, if you came and asked us, would have different 
priorities based on our own personal circumstances, who we know who has 
come to see us, who in our family has suffered from a particular 
disease, and then we are asked to turn around and vote on particular 
pieces of legislation to be supported by the available research 
dollars.
  My fellow members of the Senate Labor Committee and I have discussed 
the issue of the priority-setting process within the NIH in two 
hearings, one on May 1 and the other on July 24. In those hearings we 
engaged the various committee members in the dialog about the process 
at the National Institutes of Health regarding funding allocation 
decisions and what should be the appropriate congressional role in 
directing Federal biomedical research dollars. Our committee members 
have expressed concern, as again so well articulated by the Senator 
from Indiana, that Congress should take caution in micromanaging 
biomedical research by establishing legislative mandates for specific 
areas of research without a thorough comparative review of other 
diseases, of other interests.
  We have to be honest with ourselves that there is genuine 
disagreement among various constituencies about how NIH funds should be 
distributed among the various institutes and agencies at the NIH. 
Indeed, there has been much discussion over the need for increased 
Parkinson's research, and I recognize that disputes have taken place 
regarding over what the exact amount of research dollars currently 
spent on Parkinson's disease should be.
  As legislators, we have a responsibility, an obligation to the 
American people to assess the overall strategy, the overall system, the 
overall process of prioritizing our research dollars. We must do that 
to ensure the public trust in the decisionmaking process as the NIH 
addresses the health needs of the Nation.
  However, we must ensure that we are funding the best scientific 
opportunities through the appropriate process. I believe we all have 
the same goal, to use our resources in the very best way possible to 
reduce the burden of illness and human suffering. Our challenge is to 
figure out the system, the process, the path for best achieving that 
goal. I believe the best way to answer these questions is to ensure 
that the process at the NIH is working, that the public has a vote in 
that process.
  The amendment we are offering today supports a study to be undertaken 
by the Institute of Medicine of the National Academy of Science to 
conduct a comprehensive independent study of the policies and the 
processes used by the NIH to determine how they allocate funds for 
biomedical research. The study will look at those factors or criteria 
that are used to determine funding allocations for disease research, 
the process by which these research funding decisions are made, the 
mechanisms for public input into the priority-setting process, to make 
sure we hear from the public, and lastly, the impact of the statutory 
directives on research funding decisions.
  The report of the study will set forth the findings and the 
recommendations and the conclusions of the Institute of Medicine for 
improvements in this process, and the Institute of Medicine will submit 
the report to both the Senate and the House authorizing committee and 
Appropriations Committees within 6 months.
  I believe this is the best way to address this challenge of 
prioritizing research. It is my goal that we ensure that the process 
and the policies at the NIH appropriately address funding allocation 
and research decisions. The scientific community is equipped to help 
set the Nation's research priorities.
  In conclusion, I again want to state my preference on the underlying 
amendment would have been to work with my colleagues in the Senate 
within the overall NIH reauthorization process to resolve the various 
issues rather than legislating on the appropriations bill today. 
However, I do support the underlying bill to support the increase in 
Parkinson's research, and I urge my colleagues to support our amendment 
to initiate this comprehensive independent study of NIH policies and 
processes for making funding decisions in the future.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Vermont is recognized.
  Mr. JEFFORDS. I speak in favor of the Coats amendment and I urge its 
adoption. I do have problems with the underlying amendment. On the 
other hand, I recognize that the large majority of Members desire to 
tell NIH what they should be doing with respect to Parkinson's disease. 
I also recognize it is a serious problem for those that have 
Parkinson's disease, and many of my friends across the country do so.
  I think the Coats amendment is an important addition to let NIH know 
that they have to at least be more forthcoming with respect to the 
processes they use in determining how they should expend the money in 
research. I, therefore, commend Senator Coats for bringing this to our 
attention, and as a way to prevent the need for amendments such as the 
underlying amendment as we move toward the future.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Pennsylvania is recognized.
  Mr. SPECTER. Parliamentary inquiry. What is the status of the pending 
issue before the Senate?
  The PRESIDING OFFICER. The pending question is the Coats amendment 
numbered 1075.
  Mr. SPECTER. Further inquiry, Madam President. Has the amendment 
offered by Senator McCain and Senator Wellstone been set aside?
  The PRESIDING OFFICER. It has been set aside.
  Mr. SPECTER. Madam President, the amendment offered by the 
distinguished Senator from Indiana is acceptable to this side of the 
aisle. It calls for a study which I think is well-founded, and we are 
prepared to accept it.
  I commend my colleague from Indiana for offering the amendment.
  The PRESIDING OFFICER. The question is on agreeing to amendment 
numbered 1075, offered by the Senator from Indiana.
  The amendment (No. 1075) was agreed to.
  Mr. SPECTER. Madam President, if we can proceed with sequencing, I 
have just discussed with the Senator from Indiana a subsequent 
amendment which he intends to offer and he is prepared to accept a 20-
minute time limit, equally divided, so we can proceed to a vote on that 
amendment in relatively short order.
  I believe we will have to get concurrence from my colleague, Senator 
Harkin.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.

[[Page S8717]]

  Mr. SPECTER. I ask unanimous consent that the order for the quorum 
call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. SPECTER. I think we will be able to work out a time agreement, 20 
minutes equally divided, but we have to check on the other side of the 
aisle.
  Why do we not proceed at this time, and then we will work on that 
time agreement. I suggest my colleague from Indiana proceed with his 10 
minutes at this time.
  Mr. COATS. If I could state to the Senator, before we have an 
agreement, why do I not just, while we are working on the agreement, 
why do I not begin? I could probably pretty much make my statement, and 
I might not need the full 10 minutes in the agreement. I will be glad 
to yield back. There are a certain amount of things I want to say. 
Until we hear from the other side----
  Mr. HARKIN. I think if we might, the Senator from Indiana would go 
ahead and make some remarks and at least at the beginning outline what 
his amendment is about. That will certainly alert offices. If we do not 
hear, in a decent amount of time, that some people are objecting to a 
time limit, we will go ahead with an agreement.
  Mr. SPECTER. I think that arrangement is acceptable.
  Why do we not proceed on that basis, with the Senator from Indiana 
proceeding with his argument, and we will try to solidify that time 
agreement as we hotline it or allow Members to know what we are doing 
generally.
  The PRESIDING OFFICER. The Senator from Indiana is recognized.
  Mr. COATS. The amendment I will offer, and I will hold offering it 
until such time as an agreement can be at least reached on the other 
side, this amendment is something that we have debated before. I think 
it is an important debate. I think it does not require that we make a 
lengthy debate because it has been discussed and debated.
  I want to make sure that each Senator is aware of a certain practice 
and the implications of that practice before they cast their final vote 
on the Parkinson's research or any other research that might involve 
the use of fetal tissue. The amendment says, briefly, notwithstanding 
any other provision of law, none of the amounts subject to the 
provisions of subsection (e) of the Morris K. Udall Parkinson's 
Research Act of 1997 may be expended for any research which utilizes 
human fetal tissues, cells, or organs obtained from a living or dead 
embryo or dead fetus during or after an induced abortion. The 
subsection does not apply to human fetal tissues, cells, or organs 
obtained from a spontaneous abortion or an ectopic pregnancy.
  We just debated, and I believe will vote tonight or tomorrow, and 
certainly it will pass and I will vote for it, the provision offered by 
the Senator from Minnesota to increase funding for Parkinson's 
research. I was pleased the Senate accepted the amendment I just 
offered to provide a study which will give us guidance in terms of how 
we can direct research funds in the future.
  But on the question of Parkinson's research, it is important that we 
address an issue that a lot of people do not like to talk about but it 
is an issue that I think is relevant and one that is important, and 
that is that in certain research--and I believe it is very limited 
research, and fortunately it is research that is much more limited than 
it was in the past because it has not shown that much promise--the 
implantation of human fetal tissue has been one of the means by which 
researchers have attempted to address the symptoms of Parkinson's 
disease.
  Now, from a practical standpoint it is important to understand that 
the amendment here only affects use of fetal tissue, the use of funds 
to provide fetal tissue research for Parkinson's disease. There are a 
number of other diseases, diabetes and others, that use fetal tissue 
research, and that is a subject for a separate time. This only applies 
to that particular section of the Udall bill and it simply says that 
funds that we will appropriate cannot be used for fetal tissue 
research. It does not affect research in other areas. It does not 
affect indirect research that affects Parkinson's.
  Frankly, I do not know that this should even be an issue in 
Parkinson's, and I cannot speak with scientific authority, but to the 
best of my knowledge fetal tissue research has held very little and is 
diminishing in importance in terms of Parkinson's research.
  The Parkinson's Action Network has issued a statement, and I will 
quote from that statement that says:

       Even those involved with fetal tissue research readily 
     acknowledge that the result of their research will not use 
     human fetal tissues. Current work is intended only to 
     demonstrate the capability. Ultimately, another source of 
     fetal material must be found.

  That is the statement from the Parkinson's Action Network.
  So we are not even talking about direct use here as a potential cure 
or alleviation of circumstances of Parkinson's. One of the reasons for 
that is that human tissue has consistently been found to be unsanitary 
or not fit for clinical use.
  Now, the good news is that there are other sources of tissue that 
have shown some promise that are not from induced abortions. There are 
xenografts, fetal pig tissue, that at this time and to my understanding 
are believed to be more useful than human tissue.
  There are human cell lines that are more promising sources of tissue 
than tissue derived from abortions. Genetically engineered cell 
research has shown significant promise. And tissue that is derived from 
miscarried pregnancies is now being utilized as a substitute for 
utilizing fetal tissue from induced abortions.
  So I want my colleagues to understand, we are not trying to impede 
significant research on Parkinson's from the limited amount of research 
that does come from fetal tissue. There are alternative means of 
obtaining tissue, whether it is animal tissue, whether it is human cell 
lines, whether genetically engineered, or whether it is actual fetal 
tissue, but fetal tissue obtained from miscarriages, from spontaneous 
abortions, which are miscarriages, but also from ectopic pregnancies.
  So there are alternatives to obtain the material necessary for this 
research.
  In addition, the research seems to be moving away from fetal tissue 
and even new tissue toward more promising areas of research in 
Parkinson's disease. Implanted brain stimulators work for some but 
obviously do not work for all. Surgical pallidotomies, proton therapy, 
genetic-based therapy--these are all alternatives to the fetal tissue 
research.
  So, therefore, just from a practical standpoint, regardless of how 
you feel about the ethical question, I think there is a real basis to 
avoid the controversy and to avoid the profound ethical questions and 
concerns that arise from the utilization of human fetal tissue through 
induced abortions.
  What are those ethical questions that we ought to be asking 
ourselves? Many of us in the Senate--I am included in this--either have 
parents, children, spouses, relatives, friends, or colleagues who have, 
unfortunately, incurred a neurological disease in which fetal tissue 
transplantation has offered some hope of treatment. So it is not a 
subject that we ought to lightly dismiss.
  I just outlined why I think in the area of Parkinson's research that 
it is really not even a major issue any more. But I think we have to 
address the question of the wrenching dilemma that it ought to pose--
that is posed--by the issue of human tissue research. Therefore, I 
think we ought to be searching for a path that serves both public 
health needs and concerns and the questions of moral principle, a path 
that offers hope for breakthroughs in research, for cures, for 
alleviating symptoms, but a path which also shows ethical insight.
  Scientific research does not occur in a moral vacuum. I think it has 
to be guided by something that is more than just practically possible 
or feasible research. It has to be guided by some ethical 
considerations that I think each of us need to ask ourselves.
  In this regard, the ethical questions, I believe, are the following:
  Question No. 1: Will the use of tissue from elective abortions create 
an irreversible economic and an institutional bond between abortion 
centers and biomedical science?
  Just think for a minute. If medical research becomes dependent on 
widespread abortion, a vested interest would clearly be created in a 
substantial uninterrupted flow of human fetal

[[Page S8718]]

tissue. Medical science would be dependent on continued legal abortion 
on demand. Does that create an ethical dilemma? I would argue that it 
does. The reason that it does is that there is no way that we could 
provide sufficient tissue from spontaneous abortions, miscarriages, or 
ectopic pregnancies because we know that if tissue transplants are the 
cure for diabetes, Parkinson's, Alzheimer's, and other neurological 
trauma, then we are talking about between 34 million and 20 million 
fetuses a year necessary to supply the need for the fetal tissue to 
address the problem.
  So just on this basis alone, it seems that we need to look at 
alternative ways to generate fetal tissue without elective abortions--
to look at cell cultures, use of animal tissue, and other research that 
I have just mentioned. We have an ethical nightmare, a potential 
ethical nightmare that we will face if we can't address ourselves to 
alternatives.
  Another question is: By what right is this fetal tissue obtained? 
Certainly the remains of the fetus in elective abortions are not 
donated in the traditional sense of the word. The fetus can't give 
consent. It is instead provided by the very people who have made the 
decision to end the life of the fetus. Can the person who ends the life 
be morally permitted to determine the use of the organs in the life 
that that person just ended?
  Mr. SPECTER. If the distinguished Senator will yield for a moment.
  Mr. COATS. I would be happy to yield to the Senator.
  Mr. SPECTER. Madam President, we have been checking with various 
Senators to see if we could reach a unanimous-consent agreement, and it 
now appears that we will not be able to make that determination very 
fast. Senators are waiting to find out what is going to happen with 
respect to the vote and we had earlier talked about stacked votes at 7. 
It now appears we cannot have stacked votes. So we will set the vote at 
7 o'clock by agreement with the other side of the aisle on the 
Wellstone-McCain, McCain-Wellstone amendment so we will at least 
proceed with that vote at that time, and by 7 we should be in a 
position to know what we will be able to do about a unanimous-consent 
agreement here and further scheduling.
  I thank my colleague from Indiana for yielding.
  The PRESIDING OFFICER. Does the Senator make a request that the vote 
occur at 7 p.m?
  Mr. COATS. Yes.
  The PRESIDING OFFICER. Is there objection?
  Mr. WELLSTONE. Madam Chair, I will not object, but might I inquire, 
the amendment that we have introduced, Wellstone-McCain, McCain-
Wellstone, this precludes a second-degree amendment, I gather. Is that 
correct?
  Mr. SPECTER. Madam President, parliamentary inquiry as to whether it 
precludes a second-degree amendment.
  The PRESIDING OFFICER. The present agreement would not preclude a 
second-degree amendment.
  Mr. WELLSTONE. Madam Chair, I ask unanimous consent that this vote at 
7 preclude a second-degree amendment.
  Mr. SPECTER. I agree with that modification, Madam President.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. COATS addressed the Chair.
  The PRESIDING OFFICER. The Senator from Indiana.
  Mr. COATS. Madam President, I regret that we were not able to obtain 
an agreement. I will finish my statement very shortly here and then 
offer the amendment. I certainly would agree to set it aside so that 
the Senator from Pennsylvania can continue with what other business he 
has. We obviously will have to address this issue in greater detail at 
another time, either later this evening or tomorrow.
  Mr. SPECTER. Madam President, I think it may still be possible to 
have a time agreement, but we could not get that determination. Rather 
than await that determination to get back-to-back votes, I decided we 
ought to get the vote set at 7 and perhaps we could have a time 
agreement entered into after that. We will decide when to have the 
vote, but perhaps we can have a time agreement. We have a great many 
amendments pending, and to the extent we can have limited time 
agreements, we ought to try to do that.
  I thank my colleague from Indiana.
  Mr. COATS addressed the Chair.
  The PRESIDING OFFICER. The Senator from Indiana is recognized.
  Mr. COATS. Let me return to the question of the ethical dilemma that 
is posed with utilization of fetal tissue in research. There is a broad 
ethical question that affects all neurological research or any research 
that utilizes human fetal tissue. I have tried to raise some of the 
questions that I think ought to give all of us pause before we sign off 
on the use of human fetal tissue in medical research.
  Does it create an irreversible economic and institutional bond been 
abortion centers and biomedical science? That is a legitimate question. 
Because if the cure or alleviation of symptoms for neurological 
diseases, diseases including Alzheimer's and Parkinson's and diabetes 
and other neurological trauma, is dependent on utilization of human 
fetal tissue, then we are talking about the need to supply fetal tissue 
patches or pieces from up to 20 million abortions, induced abortions a 
year. That poses a profound ethical question.
  Second, the question is, by what right will we obtain this fetal 
tissue? We obtain it with the consent of the very person who has made 
the decision to end the life of the fetus from which the fetal tissue 
will be derived. So there is no such thing as consent of the human 
species, the human being, the human person whose life is ended to 
provide the fetal tissue in the name of medical science.
  And is it really possible to separate the practice of abortion from 
its use in biomedical research? Are researchers merely using the 
results of abortion, or are they dictating its practice?
  There are real concerns about how fetal tissue is derived, how it is 
procured. A report issued by the University of Minnesota Center for 
Bioethics has stated that in Sweden, ``Doctors say they have obtained 
brain tissues with a forceps before the fetus was suctioned out of the 
mother. That raises the question of whether the fetus was killed by the 
harvesting of brain tissue or by abortion.''
  Janice Raymond, professor of women's studies and medical ethics at 
the University of Massachusetts, has testified that doctors are already 
altering the methods of abortion in order to get the tissue that they 
desire, and I quote from her.

       Doctors who are eager to get good tissue samples must put 
     women at additional risk of complication by altering the 
     methods of performing abortions and by extending the time it 
     takes to perform the conventional abortion procedure.

  Dorie Vawter of the Center for Bioethics at the University of 
Minnesota has reaffirmed this observation, noting that some clinics 
currently alter abortion methods for tissue harvesting--slowing down 
the abortion procedure, reducing the pressure of the suction machine, 
and increasing the size of dilation instruments, all practices which 
place women at additional risk.
  And so in the harvesting of human tissue, the human tissue has to be 
at a certain condition. I talked a few moments ago about how much of 
this tissue is unfit for effective use in Parkinson's research or other 
neurological research. And now we have testimony of people who are 
altering the procedures of obtaining the human fetal tissue so that the 
human fetal tissue is in a better condition for this research. But in 
doing so they place the health of the woman who is carrying the child, 
from whom the fetal tissue is derived, at greater health risk.
  And then I think we have to ask probably the most difficult of 
questions, and that is, are we encouraging abortion by covering it with 
a veneer of compassion?
  Dr. Kathleen Nolan, formerly of the Hastings Center, writes,

       Lifesaving cures resulting from the use of cadaveric 
     material might make abortion, and fetal death, seem less 
     tragic. Enhancing abortion's image could thus be expected to 
     undermine efforts to make it as little needed and little done 
     procedure as possible.

  This is a very real concern because often people come up to me and 
say: Why do you offer amendments? Why do you think that utilization of 
fetal tissue should be restricted to noninduced abortions, because it 
does so much good, it holds so much potential.
  Look at the ethical question involved. Is taking a life, is killing a

[[Page S8719]]

fetus in order to obtain material that is useful in providing research 
which offers promising health benefits to individuals, is that not one 
of the most profound ethical and moral questions that we have to face?
  And so I think when we look at a question like this, we clearly have 
to understand, as Stephen Post said,

       Ultimately, it is the specter of a society whose medical 
     institutions are inextricably bound up with elective abortion 
     and whose people come to believe that for their own health 
     they have every right to feed off the unborn, that gives 
     pause.

  Arthur Caplan of the University of Minnesota expresses these concerns 
in another way.

       This is the ultimate issue of generational justice. You're 
     not just asking for the pocketbooks of the young--you're 
     asking for their body parts.

  Now, fortunately, Madam President, we have alternatives available to 
us. I have listed those alternatives. In the case of Parkinson's, and 
that is the issue we are facing here--we will address the other issue 
at another time--but in the case of Parkinson's research, we are 
learning that fetal tissue research is of diminishing importance and of 
diminishing effectiveness.
  We are learning that there are more viable alternatives that hold far 
greater benefit and hope for breakthroughs in treating Parkinson's than 
fetal tissue. And so while I think it is appropriate that we are 
focusing on increasing funds for research in Parkinson's, I believe it 
is also appropriate that we place this most limited of restrictions on 
this research, both for practical reasons because it offers very little 
hope of any research breakthroughs and because this tissue can be 
obtained by other alternatives without taking human life, without 
inducing abortions. Fetal tissue cells from human fetuses can be 
obtained through miscarriages, spontaneous abortions, ectopic 
pregnancies, but the other forms of research, the xenografts from 
animal tissue, which are now being found to be more useful than human 
tissue, human cell lines, genetically engineered cells, and then all 
the other more promising means of research in Parkinson's, I think 
allow us to say that at least in this area we will not pursue and we do 
not need to pursue the utilization of human fetal tissue.


                           Amendment No. 1077

(Purpose: To prohibit the use of funds for research that utilizes human 
fetal tissue, cells, or organs that are obtained from a living or dead 
          embryo or fetus during or after an induced abortion)

  Mr. COATS. So with that, Madam President, I send my amendment to the 
desk and ask for its consideration with the understanding that it may 
be possible to enter into an agreement that would limit the time.
  The PRESIDING OFFICER. Is there objection to setting aside the 
pending amendment? Hearing no objection, it is so ordered.
  The clerk will report the amendment.
  The legislative clerk read as follows:

       The Senator from Indiana [Mr. Coats], for himself and Mr. 
     Nickles, proposes an amendment numbered 1077.

  Mr. COATS. Madam President, I ask unanimous consent that reading of 
the amendment be dispensed with.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The amendment is as follows:

       At the appropriate place, insert the following:
       Sec.   . Limitation on Use of Funds.--Notwithstanding any 
     other provisions of law, none of the amounts subject to the 
     provision of subsection (e) of the ``Morris K. Udall 
     Parkinson's Research Act of 1997'' may be expended for any 
     research that utilizes human fetal tissue, cells, or organs 
     that are obtained from a living or dead embryo or fetus 
     during or after an induced abortion. This subsection does not 
     apply to human fetal tissue, cells, or organs that are 
     obtained from a spontaneous abortion or an ectopic pregnancy.

  Mr. COATS. Madam President, I yield the floor.
  Mr. HARKIN. Madam President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  Mr. KENNEDY. Will the Senator withhold.
  Mr. HARKIN. I withdraw that.
  The PRESIDING OFFICER. The Senator from Massachusetts is recognized.


                         Privilege Of The Floor

  Mr. KENNEDY. Madam President, I ask unanimous consent that Susan 
Hammersten, a fellow in my office, be granted the privilege of the 
floor during the pending Labor, HHS appropriations bill.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. KENNEDY. Madam President, I strongly support the amendment that 
Senator McCain and Senator Wellstone have offered. More research is 
clearly needed if we are to conquer this debilitating disease that 
afflicts more than a million Americans.
  I strongly disagree, however, that this is an appropriate place to 
revisit the issue of fetal tissue research, and I urge the Senate to 
defeat the Coats amendment.
  The earlier ban on fetal research was lifted 4 years ago, and that 
action was deeply justified. The ban was lifted by the administration 
and Congress after careful consideration and exhaustive debate.
  Research involving fetal tissue holds the potential to provide 
tremendous advances in treatments and cures for a long list of 
debilitating conditions such as Parkinson's disease, Alzheimer's 
disease, Huntington's disease, diabetes, multiple sclerosis, epilepsy, 
blindness, leukemia, hemophilia, sickle cell anemia, spinal cord 
injuries, deficiencies of the immune system, birth defects, and certain 
conditions causing intractable pain. The list goes on and on.
  It is no wonder, then, that opposition to a ban on fetal tissue 
research is supported by a wide range of organizations dedicated to 
improving the health of Americans, including the Alzheimer's 
Association, the Epilepsy Foundation of America, the Cystic Fibrosis 
Foundation, the Parkinson's Disease Foundation, and the Society for 
Pediatric Research.
  Four years ago, Congress decided that the benefits of this research 
far outweighed the unsubstantiated fears and concerns that the need for 
fetal tissue would lead to increases in abortions. The vote in the 
Senate to lift the ban was a resounding 93 to 4.
  The bill enacted in 1993 established rigorous standards to safeguard 
against any possibility that fetal tissue research would influence 
individual decisions about abortion. Those safeguards are in place and 
they are working--and working well.
  A 1997 GAO study of the safeguards reports that ``the act's 
documentation requirements were met'' and that ``there have been no 
reported violations in the acquisition of human fetal tissue for use in 
transplantation.''
  The safeguards are working not just in research on Parkinson's 
disease, but in all research involving fetal tissue. It is irrational 
and inappropriate to revisit this debate by singling out research on 
Parkinson's disease for excessive restrictions.
  Since 1993, the NIH has awarded more than $23 million in grants for 
research involving the study, analysis, and use of human fetal tissue. 
The research that is being carried out today is producing effective 
solutions that can end the suffering associated with a wide variety of 
illnesses, and it makes no sense, no sense at all, to restrict it.
  One other point should be made. The research being conducted today 
with fetal tissue is also providing new techniques such as specialized 
cell lines and genetically engineered cells. In fact, the development 
of these new technologies may well eliminate the need for using fetal 
tissue for research purposes. Ironically, the best way to achieve the 
goal of the Coats amendment is to defeat the Coats amendment, and I 
urge the Senate to do so.
  My Republican colleagues have argued that women will decide to have 
an abortions in order to donate tissue for research.
  These claims are unfounded and uncorroborated. The substantial 
history of fetal tissue research--extending back at least 30 years to 
the development of the polio vaccine--shows no evidence--and no 
evidence has been presented here to the Senate this evening--that the 
results have encouraged abortion.
  American women for various personal and entirely unrelated reasons 
choose to have over 1 million legal abortions each year. These legal 
abortions will continue to be performed in the future, regardless of 
the extent of fetal tissue research.
  Congress enacted stringent safeguards to address this claim. No woman 
can know in advance if the remains from her abortion would or even

[[Page S8720]]

could be used for research purposes. A woman may not be approached for 
consent to donate the aborted tissue until after she has made the 
decision to have an abortion.
  Safeguards established by the NIH have eliminated any potential 
incentives for abuse. No profit can be derived from providing the 
tissue for research. No family member or friend can benefit from a 
woman's abortion. A woman may not designate who will be the recipient 
of the tissue.
  This issue has been reviewed and studied as to the effectiveness of 
the rules and regulations which have been established. It is 
effectively working and working well. This amendment would have an 
adverse impact in terms of the real potential for making significant 
progress in areas of research, and it would not be justified in terms 
of providing the kind of restrictions that are included in the Coats 
amendment. For that reason, I hope the Coats amendment will not be 
accepted.
  Madam President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. WELLSTONE. Madam President, I ask unanimous consent that the 
order for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                    Amendment No. 1074, as modified

  Mr. WELLSTONE. Madam President, on the Wellstone-McCain/McCain-
Wellstone amendment, I ask unanimous consent that Senator Boxer be 
added as a cosponsor.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. WELLSTONE. Madam President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. WELLSTONE. Madam President, I ask unanimous consent that the 
order for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. WELLSTONE. Mr. President, I ask unanimous consent that Senator 
Robb be listed as a cosponsor of the Wellstone-McCain / McCain-
Wellstone amendment.
  The PRESIDING OFFICER (Mr. Brownback). Without objection, it is so 
ordered.
  Mr. WELLSTONE. I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. WELLSTONE. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The question is on agreeing to amendment No. 1074, as modified. The 
yeas and nays have been ordered. The clerk will call the roll.
  The bill clerk called the roll.
  Mr. NICKLES. I announce that the Senator from Alaska [Mr. Murkowski] 
is necessarily absent.
  Mr. FORD. I announce that the Senator from Hawaii [Mr. Inouye] is 
necessarily absent.
  The result was announced--yeas 95, nays 3, as follows:

                      [Rollcall Vote No. 214 Leg.]

                                YEAS--95

     Abraham
     Akaka
     Allard
     Baucus
     Bennett
     Biden
     Bingaman
     Bond
     Boxer
     Breaux
     Brownback
     Bryan
     Bumpers
     Burns
     Byrd
     Campbell
     Chafee
     Cleland
     Coats
     Cochran
     Collins
     Conrad
     Coverdell
     Craig
     D'Amato
     Daschle
     DeWine
     Dodd
     Domenici
     Dorgan
     Durbin
     Faircloth
     Feingold
     Feinstein
     Ford
     Frist
     Glenn
     Gorton
     Graham
     Gramm
     Grams
     Grassley
     Gregg
     Hagel
     Harkin
     Hatch
     Helms
     Hollings
     Hutchinson
     Hutchison
     Inhofe
     Johnson
     Kempthorne
     Kennedy
     Kerrey
     Kerry
     Kohl
     Kyl
     Landrieu
     Lautenberg
     Leahy
     Levin
     Lieberman
     Lott
     Lugar
     Mack
     McCain
     McConnell
     Mikulski
     Moseley-Braun
     Moynihan
     Murray
     Nickles
     Reed
     Reid
     Robb
     Roberts
     Rockefeller
     Roth
     Santorum
     Sarbanes
     Sessions
     Shelby
     Smith (NH)
     Smith (OR)
     Snowe
     Specter
     Stevens
     Thomas
     Thompson
     Thurmond
     Torricelli
     Warner
     Wellstone
     Wyden

                                NAYS--3

     Ashcroft
     Enzi
     Jeffords

                             NOT VOTING--2

     Inouye
     Murkowski
       
  The amendment (No. 1074), as modified, was agreed to.
  Mr. WELLSTONE. I move to reconsider the vote.
  Mrs. FEINSTEIN. I move to lay that motion on the table.
  The motion to lay on the table was agreed to.
  Mr. CRAIG. Mr. President, each year a small portion of the Medicare 
budget is devoted to HCFA's Office of Research and Demonstrations for 
Activities that help guide Medicare policymaking on coverage, financing 
and other operational issues. This year the Appropriations Committee 
has approved $47 million for this purpose, an increase, of $3 million 
over the last year.
  The Appropriations Committee has urged the Secretary of Health and 
Human Services to use a portion of this research budget to conduct a 2-
year demonstration project on coverage of medical nutrition therapy by 
registered dietitians under Medicare part B. I would like to take this 
opportunity to reiterate my support for this project and to urge the 
Secretary to move expeditiously to initiate this program.
  Research has shown that medical nutrition therapy is an effective way 
to save health care dollars and improve patient outcomes. By reducing 
and shortening hospital admission, preventing and controlling medical 
complications and limiting the need for physician follow-up visits, 
medical nutrition therapy can lower the cost of treating a variety of 
diseases. Of particular note are the savings that have been documented 
for patients with diabetes and cardiovascular disease, two ailments 
that account for a staggering 60 percent of all Medicare expenditures.
  As we continue efforts to modernize and improve the Medicare Program, 
we should not overlook medical nutrition therapy as an important way to 
save program dollars and improve patient treatment options. A 
demonstration project in this area will help us understand how we can 
best integrate this important service into any future Medicare 
improvements.


                           amendment no. 1057

  Mr. MOYNIHAN. Mr. President, earlier today I voted to support Senator 
Harkin's amendment to fund the Food and Drug Administration's ``Youth 
Tobacco Initiative'' regulations. When this amendment was first offered 
on July 23, 1997, I voted to table it. I was concerned at that time 
that the offset was a tax; taxes fall under the jurisdiction of the 
Ways and Means and Finance Committees. I am pleased that Senator Harkin 
changed the offset so that I was able to vote for the amendment today. 
I am a strong supporter of the Food and Drug Administration's efforts 
to reduce the number of young people who begin smoking cigarettes each 
year. I believe that the money designated for that purpose today is 
crucial to the success of those efforts.
  The PRESIDING OFFICER. Who seeks recognition?
  Mr. WELLSTONE addressed the Chair.
  The PRESIDING OFFICER. The Senator from Minnesota.
  Mr. WELLSTONE. Mr. President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. LOTT. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.

                          ____________________