[Congressional Record Volume 144, Number 61 (Thursday, May 14, 1998)]
[Senate]
[Pages S4875-S4876]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                    THE FIGHT AGAINST BREAST CANCER

  Mr. D'AMATO. Mr. President, I see the Senator from California on the 
floor and I would like to give her whatever part of my time that might 
be left because this is in regard to legislation that I think is so 
important. It is important for the psychology of the women of America 
who, unfortunately, will be diagnosed with breast cancer. It is 
important in their medical treatment. It is important to their 
families. It is important to the community. It is important to let 
people know we are serious in our battle to win the fight against 
breast cancer and to see that those who are diagnosed get the proper 
treatment and don't have some medical plan or medical director who says 
that--as a result of the ERISA laws passed more than 20 years ago--we 
don't have to provide you basic coverage; we don't have to say that 
reconstructive surgery is covered. And, indeed, we have had plans today 
in America where millions of women face being denied basic coverage as 
it relates to cancer and its treatment and the reconstructive surgery 
that is necessary.
  On January 30, 1997, Senator Feinstein and myself, along with a dozen 
or more colleagues--now 21--introduced the Women's Health and Cancer 
Rights Act. We have amended that and, indeed, put some provisions 
aside, and we have reduced it to two main parts. No. 1, no bean 
counter, no statistician can set an arbitrary limit on the length of 
time that a woman takes after a medical procedure for breast cancer. 
Some plans limit her stay to 24 hours. Imagine that. If there are 
complications, it is too bad. She and her family then have to pay for 
any longer stay. That is unconscionable. The decision in terms of the 
length of stay should be predicated upon the needs of that patient. 
That determination should be made according to the medical necessity 
and by her physician, not some bean counter who arbitrarily looks at a 
policy and says, ``We won't pay for more than 24 hours.'' We say that 
decision should be made as the medical necessity requires.

  The second major provision of that bill is that reconstructive 
surgery will not be treated as something optional or cosmetic. Let me 
refer to the case of a young woman. This past February, not that long 
ago, her doctor called me. Dr. Wider of Long Island said to me, ``Janet 
Franquet, a 31-year-old woman, needs a radical mastectomy. When I 
contacted her medical plan, the medical director said that they would 
not

[[Page S4876]]

authorize payment for reconstructive surgery.'' Here is a young woman, 
31 years of age. I called the director of that plan, Dr. Hodos, and I 
said to him, ``How could you be saying that this is not necessary?'' He 
said, ``Replacement of a breast is not medically necessary and not 
covered under the plan.'' Then he said, ``This is not a bodily function 
and therefore cannot and should not be replaced.''
  That is not an isolated case, Mr. President. The women of America--
our mothers, daughters, sisters, neighbors, friends--should know that 
they are covered.
  Let me tell you something. The sorry history of this legislation is 
that, in spite of Senator Feinstein, myself, Senator Snowe, and I think 
every woman Senator who signed on to support this bill--I have 
colleagues who say we should not legislate by body part. Imagine that. 
We should not mandate that. You are right, we should not have to 
mandate it. But the situation requires that. Then we get others who 
say, oh, no, we are not going to let you have a vote on this bill until 
or unless you let us have a vote on some other legislation. What 
nonsense--to hold the women of America captive.
  Senator Feinstein and I, and a number of colleagues, have decided 
that we will bring this legislation up and offer it as an amendment on 
every piece of legislation that goes through here that is vital, where 
there is a bipartisan interest in seeing this pass. We are going to put 
it on. Indeed, at some point in time, we may hold this assembly 
hostage.
  When the wheels slow down--understand, it is almost a year and a half 
now we have been trying to get this vote. I don't want people saying we 
are attempting to work our will against the majority. We backed down on 
the education bill; we took it off the IRS reform bill. We introduced 
this bill on January 30, 1997, 14 months ago. We brought it up during 
the consideration of IRS reform. We lost in committee. We got six 
votes. We brought it up again. In terms of the package that has just 
gone by, we brought it up and it was rejected 6 to 6 during the A+ 
education bill. We brought it up on the IRS bill during committee and 
we lost 8 to 10. We brought it up again today and we won 11 to 9. It is 
on the tobacco bill and it will be coming to this floor.
  When people say ``what relevance,'' we are talking about the health 
of American women. Indeed, I am prepared to offer it as an amendment to 
the defense bill, because we spend defense funds, as Senator Feinstein 
says, for cancer research and the defense of the families, and the 
women of America should not be shelved by partisan considerations or 
some ideological philosophy that says we can't have mandates. We have 
mandates every day. And some of the same people who voted against this 
bill vote for mandates every day. That is nonsense. It is too bad we 
need this.

  So this has been reported out 11 to 9 and will be on the tobacco 
bill. I thank the 11 members on the Finance Committee who voted for it. 
But understand, this Senator is serious. We are going to continue until 
this ``win'' turns into a real win and America's women do not have to 
be held hostage any longer.
  I yield the floor.

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