[Congressional Record Volume 144, Number 81 (Friday, June 19, 1998)]
[Senate]
[Pages S6694-S6696]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




        SENATOR LOTT'S PROPOSED HEALTH UNANIMOUS CONSENT REQUEST

  Mr. KENNEDY. Mr. President, I hope very much that in the coming days, 
we will be able to begin debate in the full Senate on another major 
issue of vital importance to the country--the reforms needed in our 
health care system to end the abuses by HMOs and health insurance 
companies. Critical decisions on health care should be made by doctors 
and their patients, not by insurance industry accountants. It is long 
past time for Congress to act to protect patients and end these abuses. 
We face a growing crisis of confidence in health care.
  A recent survey found that an astonishing 80 percent of Americans now 
believe that their quality of care is often compromised by their 
insurance plan to save money. And, too often, they are absolutely 
right.
  One reason for this concern is the explosive growth in managed care. 
In 1987, only 13 percent of privately insured Americans were enrolled 
in HMOs. Today 75 percent are in some form of managed care.
  This issue goes to the heart of health care and the fundamental 
doctor-patient relationship. At its best, managed care offers the 
opportunity to achieve greater efficiency and greater quality in health 
care.
  In too many cases, however, the priority has become greater profits, 
not greater health. HMOs and conventional insurance companies alike 
have abused the system by denying coverage for treatments that their 
customers need and that their premiums should have guaranteed.
  In California, a Kaiser Foundation study found that almost half of 
all patients reported a problem with their health plan. Substantial 
numbers reported that the plan's actions caused unnecessary pain and 
suffering, delayed recovery, or even resulted in permanent 
disabilities.
  Projected to the national level, these results indicate that 30 
million Americans develop additional health problems because of their 
plan's abusive practices--and a shocking 11 million develop permanent 
disabilities.
  The dishonor roll of those victimized by insurance company abuse 
grows every day. A baby loses his hands and feet because his parents 
believe they have to take him to a distant emergency room rather than 
the one close to their home.
  A Senate aide suffers a devastating stoke, which might have been far 
milder if her HMO had not refused to send her to an emergency room. The 
HMO now even refuses to pay for her wheelchair.
  A woman is forced to undergo a mastectomy as an outpatient, against 
her doctor's recommendation. She is sent home in pain, with tubes still 
dangling from her body.
  A doctor is denied future referrals under a managed car plan, because 
he told a patient about an expensive treatment that could save her 
life.
  The parents of a child suffering from a rare cancer are told that 
life-saving surgery should be performed by an unqualified doctor who 
happens to be on the plan's list, rather than by a specialist at the 
nearby cancer center equipped to perform the operation.
  A San Diego paraplegic asks for referral to a rehabilitation 
specialist. Her HMO refuses, and she develops a severe pressure wound 
that a rehabilitation specialist would have routinely checked and 
treated. She is forced to undergo surgery, and is hospitalized for a 
year with round-the-clock nursing care.
  A child suffers a severe shoulder dislocation in a gym class. Frantic 
school officials make repeated calls to her HMO for authorization to 
call an ambulance. The accident has cut off the flow of blood to her 
arm. Fortunately, a mother who was also an emergency room physician was 
there and was able to give immediate treatment. Otherwise, the child 
might have lost her arm.
  The list of these abuses goes on and on.
  Many of us in Congress have offered legislation to end these abuses.
  Our proposal is a common sense program that guarantees the American 
people the fundamental protections that every good insurance company 
already provides, and that every American who pays insurance premiums 
deserves to have when serious illness strikes.
  But the Republican Leadership's position on these protections is to 
protect the insurance industry instead of protecting patients. They 
know that they can't do that in the light of day before the American 
people. So their strategy has been to work behind closed doors to kill 
the bill. Keep it bottled up in committee. No markup. No floor vote. 
Delay, deny, and obfuscate--and hope the clock runs out.
  And while the Republican Leadership keeps the bill bottled up, they 
call on the insurance companies and their right-wing allies to use 
their vast resources to manipulate public opinion. The National Journal 
reported in November that ``a coalition of business groups, 
corporations, and health care associations is planning a $1 million-
plus public relations and grass roots blitz to derail new legislation 
calling for increased regulation of health

[[Page S6695]]

plans.'' Just a few weeks ago, it was reported that the special 
interest opponents have now spent more than $3 million to defeat our 
common sense proposals.
  According to the Washington Post of November 5 last year, ``Three 
years after they killed President Clinton's massive health plan, 
Republican leaders in Congress have embarked on a crusade to block a 
new generation of federal efforts aimed at regulating the quality of 
medical care Americans receive.''
  The article goes on to report that members of the antireform 
coalition were invited to what was billed as the first in a Series of 
Briefings for Republican Staff Members. ``Clinton Care Returns: The 
Trojan Horse Strategy.'' That is what the invitation said to the 
briefing, sponsored by Senate Majority Leader Trent Lott and Senate 
Majority Whip Don Nickles--``Clinton Care Returns: The Trojan Horse 
Strategy.''
  It is obvious that the Senate Republican leadership is no friend of 
health reform.
  According to a memo from one of the participants in the briefing, 
``The message we are getting from House and Senate leadership is that 
we are in a war and we need to start fighting like we are in a war.'' 
It went on to say, ``Republican leadership is now engaged on this issue 
and is issuing strong directives to all players in the insurance and 
employer community to get activated.'' Their message: ``Get off your 
butts; get out your wallets.''
  The special interests have responded. They are now pouring millions 
of dollars into a PR campaign to confuse and intimidate patients, and 
they are pouring hundreds of thousands of dollars into Republican 
campaign committees.
  One of the directives the GOP leadership gave to their anti-reform 
coalition was to ``write the definitive piece of paper trashing all 
these bills''--trashing all these bills. It apparently did not matter 
to the Republican leadership what was actually in the bills--they were 
all to be trashed.
  Willis Gradison, the head of the Health Insurance Association of 
America, was asked in an interview published in the Rocky Mountain News 
to sum up the coalition's strategy. According to the article, Mr. 
Gradison replied, ``There's a lot to be said for `just say no.' '' The 
author of the article goes on to report that, ``At a strategy session 
last month called by a top aide to Senator Don Nickles, Gradison 
advised Republicans to avoid taking public positions that could draw 
fire during the election campaign. Opponents will rely on Republican 
leaders in both chambers to keep managed care legislation bottled up in 
committee.''
  So there you have it. Keep patient protections bottled up. Order your 
special interest friends to ``get off their butts and get out their 
wallets.'' Deliver a massive campaign of misinformation and 
disinformation. Just say yes to the special interests--and just say no 
to the American people.
  We saw the results of that strategy in the Senate yesterday when the 
Republicans put the interests of the tobacco companies ahead of the 
interests of the American children. Next, it is good medical care for 
American families that will be sacrificed on the altar of special 
interest profits, if the Republican leadership has its way.
  But those leaders are feeling the heat. Yesterday, the Republican 
leader tried a new tactic to try to persuade the American people that 
he is not trying to block managed care reform. But the tactic was 
another transparent attempt to dodge full and fair debate on this 
important issue of health reform.
  The Republican leader proposed an agreement under which the Senate 
could potentially take up our legislation, which is called the 
Patients' Bill of Rights. But the proposal is clearly not defined to 
allow a fair debate or give American families the protections they 
need. Instead, it is designed to give Republican Senators yet one more 
excuse for not taking up this critical legislation.
  First, it puts off action for several more weeks, even though time is 
clearly running out in this session of Congress, even though the 
American people have already been waiting for more than a year for 
action, even though every day we delay, more abuses take place and more 
patients suffer needless pain and illness.
  Next, the agreement proposed by the Republican leader would let him 
bring up any health care bill at all--not a hint of what that could be. 
Yet he would limit Democrats to offering the text of S. 1891, as 
introduced, without revisions. The Republican leader is not even 
proposing that we bring up the complete Patients' Bill of Rights, which 
is S. 1890. Instead, he wants us to offer a companion bill that does 
not provide patients with the right to hold health plans accountable 
for medical decisions that result in injury or death. It does not 
provide protections for those who buy health insurance on their own, 
without assistance from an employer. It is not the real Patients' Bill 
of Rights.

  In addition, the proposed agreement asks for a vote ``on or in 
relation to'' the unnamed Republican bill and the Democratic 
substitute. Again, a Trojan horse. This does not guarantee a clear vote 
or final action. The Republican leadership could meet this requirement 
by simply having procedural votes--on cloture, a point of order, or 
motion to table. Under this proposal, the American people will never 
find out where the Senate stands on patient protections.
  Adding insult to injury, the proposal further states that even if we 
win a vote--even if we win a vote--he reserves the right to kill the 
bill by returning it to the Senate calendar after the vote.
  This is what his proposal says:

       . . . and following those votes, it be in order for the 
     majority leader to return the legislation to the calendar.

  So even if we win the vote, this gives the authority to the majority 
leader to send it back to the calendar. Generally, if you win the vote 
around here on a piece of legislation, it goes to the House of 
Representatives, or if it has been in the House of Representatives, it 
goes to the President of the United States. That is the way you 
legislate--but not under the proposal of the Republican leadership, and 
not on the issue of the Patients' Bill of Rights, which he continues to 
refuse to schedule in this session of the Congress.
  This is bizarre, Mr. President. I know he announced it at a press 
conference, rather than sharing it with the Democratic leader and those 
who have been involved in the issue, which is generally the process and 
procedure. I don't know whether he thought that by issuing it at a 
press conference he would be able to flummox the American people into 
thinking he was really doing something, in order for the majority 
leader to return the legislation to the calendar.
  So after we debate for weeks, he is instructing the Democrats which 
bill to bring up, while he is keeping open his options. He is saying 
that any vote that is in relation to it, any vote at all, will answer 
the requirements of the proposal; and if we win the final vote, he can 
still put the legislation right back on the calendar.
  Mr. President, that is not even the end of it. Finally, the proposed 
agreement states that no other health care proposal--no bills, no 
amendments--can be considered this year on the issue. No health care 
proposal--none. This could even preclude further consideration of 
tobacco legislation.
  This is what it says, Mr. President:

       Finally, I ask unanimous consent that it not be in order to 
     offer any legislation, motion, or amendment relative to 
     health care prior to the initiation of this agreement, and 
     following the execution of the agreement, it not be in order 
     to offer any legislation, motion, or amendment relative to 
     health care for the remainder of the 105th Congress.

  I ask unanimous consent that the text of this unanimous consent 
request be printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                          Health Care Consent

       I ask unanimous consent that prior to the August recess, 
     the majority leader, after notification of the minority 
     leader, shall turn to the consideration of a bill to be 
     introduced by the majority leader, or his designee, regarding 
     Health Care.
       I further ask that the Senate proceed to its immediate 
     consideration and following the reporting by the clerk, 
     Senator Daschle or his designee be recognized to offer as a 
     substitute the text of S. 1891, as introduced on March 31, 
     1998.
       I further ask that during the consideration of the Health 
     Care issue, it be in order for members to offer Health Care 
     amendments in the first and second degree.

[[Page S6696]]

       I further ask unanimous consent that the chair not 
     entertain a motion to adjourn or recess for the August recess 
     prior to a vote on or in relation to the majority leader's 
     bill and the minority leader's amendment, and following those 
     votes, it be in order for the majority leader, to return the 
     legislation to the calendar.
       Finally, I ask unanimous consent that it not be in order to 
     offer any legislation, motion or amendment relative to Health 
     Care prior to the initiation of this agreement, and following 
     the execution of the agreement, it not be in order to offer 
     any legislation, motion or amendment relative to Health Care 
     for the remainder of the 105th Congress.

  Mr. KENNEDY. So you can't offer anything to do with the health care 
of the American people prior to this, or after this, or after the 
Republican leader puts this proposal back on the calendar to shelve it. 
In other words, the Republican leadership says to the Senate of the 
United States: You can't deal with anything affecting the health care 
of the American people for the rest of this Congress.
  Come on, Mr. President. Come on, Mr. President. This is just the day 
after the Republican leadership tried to sink the tobacco bill. Now 
they are out there trying to deny us the opportunity to debate one of 
the most important health care bills that is before the American 
people.

  Mr. President, it is just unbelievable to me to think that the 
majority leader's proposal was going to be considered in good faith by 
our Democratic leader, or by any Member--not just leadership--by any 
Member. We are all equals in this body.
  Those who are interested in health care ought to be concerned when a 
proposal is put forward to muzzle the U.S. Senate on health care. What 
does the Republican leadership fear? What do they fear about a full and 
open debate on the Patients' Bill of Rights? What do they fear in a 
debate about trying to give an opportunity for the Senate to express 
itself to permit our uninsured citizens between the ages of 55 and 64 
to be able to buy into the Medicare system? What do they fear about 
having an open and full debate on that issue, if the individuals are 
going to pay full premiums? What do they have to fear about the 
possibility of requiring that companies of 50 or more employees have 
some requirement to provide health care for their employees? Can't we 
have a debate on that issue? Can't we have a rollcall on that issue?
  Some will agree. Some will differ. Let the American people make a 
judgment about how their representatives stand. No, no, not if the 
majority leader, on behalf of the Republicans, have their way.
  This proposal says ``not be in order to offer any legislation, 
motion, or amendment relative to health care prior to the initiation of 
the agreement,'' which is sometime just before the August recess, for 
the next several weeks, and for the rest of this session following 
completion of this proposed agreement. If we were to proceed with it, 
we would be absolutely curtailed from any kind of effort to try to 
address health care for the American people. This could even preclude 
further consideration of tobacco legislation, or proposals to extend 
health insurance to uninsured Americans between the ages of 55 and 64, 
or improvements in Medicare package for senior citizens, or 
appropriations for the National Institutes of Health and other health 
programs, or legislation on the privacy of medical records--the list 
goes on and on.

  Many of us believe that as we move on into the millennium, it is 
going to be the millennium of the life sciences with extraordinary 
scientific breakthroughs. And the Republican leader wants to silence us 
from having some opportunity to debate that priority?
  Mr. President, it prohibits consideration of any legislation dealing 
with the problems of the privacy of our medical records, and the 
dangers that exist in terms of the proliferation of medical records. 
There are enormously important issues relating to the privacy of 
medical records that Republicans and Democrats have tried to address. 
But we are foreclosed from any opportunity to consider that under this 
proposal.
  Mr. President, it often takes, as we all know, many votes to pass 
legislation important to American families. Rarely can we do so on the 
first attempt. These arbitrary, unfair restrictions serve only to 
strengthen the power of the special interests. We have heard where 
those special interests are. We understand what they are doing at the 
present time--raising millions of dollars, and going on with these 
distortions and misrepresentations.
  The networks were hardly quiet after the tobacco industry was able to 
disrupt the kind of successful conclusion of legislation here in the 
U.S. Senate that would protect our children. The airwaves are polluted 
again with distortions and millions of dollars in trying to do a 
similar job on the Patients' Bill of Rights. They are not going to 
succeed in either one, Mr. President.
  It is said that you can fool some of the people all of the time, all 
of the people some of the time, but not all of the people all of the 
time.
  This unanimous consent request isn't going to fool any of the people 
any of the time. The American people want patient protections. They 
deserve them and know parliamentary maneuvers. No public relations 
campaign is going to allow the Republican leadership to avoid 
responsibility if this Congress does not pass strong HMO reform 
legislation this year.

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