[Congressional Record Volume 144, Number 83 (Tuesday, June 23, 1998)]
[Senate]
[Pages S6886-S6889]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




          STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

      By Mr. AKAKA (for himself, Mr. Inouye, Mr. Levin, Ms. Moseley-
        Braun, Ms. Landrieu, and Mr. Kennedy):
  S. 2202. A bill to amend the Animal Welfare Act to ensure that all 
dogs and cats used by research facilities are obtained legally; to the 
Committee on Agriculture, Nutrition, and Forestry.


               the pet protection and safety act of 1998

 Mr. AKAKA. Mr. President, today I am introducing the Pet 
Protection and Safety Act of 1998, a bill to close a serious loophole 
in the Animal Welfare Act.
  Congress passed the Animal Welfare Act over 30 years ago to stop the 
mistreatment of animals and to prevent the sale of family pets for 
laboratory experiments. Despite the Animal Welfare Act's well-meaning 
intentions and the enforcement efforts of the Department of 
Agriculture, the Act routinely fails to provide pets and pet owners 
with reliable protection against the actions of USDA-licensed Class B 
animal dealers, also known as ``random source'' dealers.
  Medical research is an invaluable weapon in the battle against 
disease. New drugs and surgical techniques offer promise in the fight 
against AIDS, cancer, and a host of life-threatening diseases. Animal 
research has been, and continues to be, fundamental to advancements in 
medicine. I am not here to argue whether animals should or should not 
be used in research; rather, I am addressing the unethical practice of 
selling stolen pets and stray animals to research facilities.
  There are less than 40 ``random source'' animal dealers operating 
throughout the country who acquire tens of thousands of dogs and cats. 
Many of these animals are family pets, acquired by so-called 
``bunchers'' who resort to theft and deception as they collect animals 
and sell them to Class B dealers. ``Bunchers'' often respond to ``free 
pet to a good home'' advertisements, tricking animal owners into giving 
away their pets by posing as someone interested in adopting the dog or 
cat. Random source dealers are known to keep hundreds of animals at a 
time in squalid conditions, providing them with little food or water. 
The mistreated animals often pass through several hands and across 
state lines before they are eventually sold by a random source dealer 
to a research laboratory for $200 to $500 each.
  Mr. President, the use of animals in research is subject to 
legitimate criticism because of the fraud, theft, and abuse that I have 
just described. Dr. Robert Whitney, former director of the Office of 
Animal Care and Use at the National Institutes of Health echoed this 
sentiment when he stated, ``The continued existence of these virtually 
unregulatable Class B dealers erodes the public confidence in our 
commitment to appropriate procurement, care, and use of animals in the 
important research to better the health of both humans and animals.'' 
While I doubt that laboratories intentionally seek out stolen or 
fraudulently obtained dogs and cats as research subjects, the fact 
remains that these animals end up in research laboratories--and little 
is being done to stop it. Mr. President, it is clear to most observers, 
including animal welfare organizations around the country, that this 
problem persists because of random source animal dealers.
  The Pet Protection and Safety Act strengthens the Animal Welfare Act 
by prohibiting the use of random source animal dealers as suppliers of 
dogs and cats to research laboratories. At the same time, The Pet 
Protection and Safety Act preserves the integrity of animal research by 
encouraging research laboratories to obtain animals from legitimate 
sources that comply with the Animal Welfare Act. Legitimate sources are 
USDA-licensed Class A dealers or breeders; municipal pounds that choose 
to release dogs and cats for research purposes; legitimate pet owners 
who want to donate their animals to research; and private and federal 
facilities that breed their own animals. These four sources are capable 
of supplying millions of animals for research, far more cats and dogs 
than are required by current laboratory demand. Furthermore, at least 
in the case of using municipal pounds, research laboratories could save 
money since pound animals cost only a few dollars compared to $200 and 
$500 per animal charged by random animal dealers. The National 
Institutes of Health, in an effort to curb abuse and deception, has 
already adopted policies against the acquisition of dogs and cats from 
random source dealers.
  The Pet Protection and Safety Act also reduces the Department of 
Agriculture's regulatory burden by allowing the Department to use its 
resources more efficiently and effectively. Each year, hundreds of 
thousands of dollars are spent on regulating 40 random source dealers. 
To combat any future violations of the Animal Welfare Act, the Pet 
Protection and Safety Act increases the penalties under the Act to a 
minimum of $1,000 per violation.
                                 ______
                                 
      By Mr. LEAHY:
  S. 2207. A bill to amend the Clayton Act to enhance the authority of 
the Attorney General to prevent certain mergers and acquisitions that 
would unreasonably limit competition; to the Committee on the 
Judiciary.


                   antitrust improvements act of 1998

 Mr. LEAHY. Mr. President, I know that consumers are becoming 
more and more concerned about the merger mania that has hit the United 
States--they see the potential for higher prices to consumers and 
poorer service as industries become far more concentrated in fewer 
hands.
  I am also concerned about this trend, particularly when mergers take 
place between incumbent monopolies. Specifically, the mergers among 
Regional Bell Operating Companies, which continue to have a virtual 
strangle-hold on the local telephone loop, pose the greatest threat to 
healthy competition in the telecommunications industry.
  Indeed, incumbent telephone companies still control over 99% of the 
local residential telephone markets. In other words, new entrants have 
captured less than 1% of local residential phone service.
  The Telecommunications Act's promise of competition was a sales pitch 
that has not materialized to benefit American consumers. Instead of 
competition, we see entrenchment, mega-mergers, consolidation and the 
divvying up of markets. Even Edward Whitacre, Jr., the Chairman and 
Chief Executive Officer of SBC Communications, testified several weeks 
ago before the Antitrust Subcommittee that ``The Act promised 
competition that has not come.''
  At a recent judiciary committee hearing on mergers, Alan Greenspan 
acknowledged that the Act has not lived up to its promises of lower 
consumer costs and more competition.
  Since passage of this law, Southwestern Bell has merged with PacTel 
into SBC Corporation, and Bell Atlantic has merged with NYNEX. Now, SBC 
Corporation is seeking to purchase Ameritech. What once had been seven 
separate local monopolies will soon be

[[Page S6887]]

four, with the possibility of more on the horizon. One of my home state 
newspapers--the Rutland Daily Herald--commented in an editorial that, 
``It might even seem as if Ma Bell's corpse is coming back to life.''
  I voted against the Telecommunications Act because I did not believe 
it was sufficiently procompetitive. I raised a number of concerns as 
that Act was being considered by the Senate. I said in my floor 
statement on the day the new law passed:

       Mega-mergers between telecommunications giants, such as the 
     rumored merger between NYNEX and Bell Atlantic, or the 
     gigantic network mergers now underway, raise obvious concerns 
     about concentrating control in a few gigantic companies of 
     both the content and means of distributing the information 
     and entertainment American consumers receive. Competition, 
     not concentration, is the surest way to assure lower prices 
     and greater choices for consumers. Rigorous oversight and 
     enforcement by our antitrust agencies is more important than 
     ever to insure that such mega-mergers do not harm consumers.

  I am very concerned that this concentration of ownership in the 
telecommunications industry is currently proceeding faster than the 
growth of competition. We are seeing old monopolies getting bigger and 
expanding their reach.
  Upon completion of all the proposed mergers among the Bell companies, 
most of the local telephone lines in the country will be concentrated 
in the hands of three to four companies. This will affect not only the 
millions of people who depend on the companies involved for both basic 
telephone service and increasingly for an array of advanced 
telecommunications services, but also competition in the entire 
industry. The Consumers Union recently testified before the Judiciary 
Committee's Antitrust Subcommittee that the mergers between Regional 
Bell Operating Companies could lead to even more mega-mergers within 
this industry.
  I know personally that at my farm in Vermont and here at my office in 
the District of Columbia and at my home in Virginia, I still have only 
one choice for dial-tone and local telephone service. That ``choice'' 
is the Bell operating company or no service at all. The current mantra 
of the industry seems to be ``one-stop shopping.'' But if that stop is 
at a monopoly that is not competing on price and service, I do not 
think it is the kind of ``one-stop shopping'' consumers want.

  I have been concerned that the distraction of these huge mergers 
serve only to complicate and delay the companies' compliance with their 
obligations under the Telecommunications Act to open their networks. 
That is not good for competition in the local loop. Consolidation is 
taking precedence over competition. We need to reverse that priority, 
and make opening up the local loop the focus of the energies of the 
Bell Operating Companies. Then consolidation, if it happens, would not 
pose the current risk of creating additional barriers to effective 
competition.
  Big is not necessarily bad. But the Justice Department in the late 
1970's worked overtime to divide up the old Ma Bell to assure more 
competition and provide customers with better service at lower rates. 
It is ironic that the Telecommunications Act, which was touted as the 
way to increase competition, is having the reverse effect instead of 
promoting consolidation among telephone companies.
  Before all the pieces of Ma Bell are put together again, Congress 
should revisit the Telecommunications Act. To ensure competition among 
Bell Operating Companies and long distance and other companies, as 
contemplated by passage of this law, we need clearer guidelines and 
better incentives. Specifically, we should ensure that Bell Operating 
Companies do not gain more concentrated control over huge percentages 
of the telephone access lines of this country through mergers, but only 
through robust competition.
  As the Consumers Union recently testified, ``If Congress really wants 
to bring broad-based competition to telecommunications markets, it must 
rewrite the Telecommunications Act, giving antitrust and regulatory 
authorities more tools to eliminate the most persistent pockets of 
telephone and cable monopoly power.''
  Today I am introducing antitrust legislation that will bar future 
mergers between Bell Operating Companies or GTE, unless the federal 
requirements for opening the local loop to competition have been 
satisfied in at least half of the access lines in each State. I look 
forward to working with my colleagues on this legislation to make the 
Telecommunications Act live up to some of its promise.
  The bill provides that a ``large local telephone company'' may not 
merge with another large local telephone company unless the Attorney 
General finds that the merger will promote competition for telephone 
exchange services and exchange access services. Also, before a merger 
can take place the Federal Communications Commission must find that 
each large local telephone company has for at least one-half of the 
access lines in each State served by such carrier, of which as least 
one-half are residential access lines, fully implemented the 
requirements of sections 251 and 252 of the Communications Act of 1934.
  The bill requires that each large local telephone company that wishes 
to merge with another must file an application with the Attorney 
General and the FCC. A review of these applications will be subject to 
the same time limits set under the Hart-Scott-Rodino Antitrust 
Improvements Act of 1976.
  The bill also provides that nothing in this Act shall be construed to 
modify, impair, or supersede the applicability of the antitrust laws of 
the United States, or any authority of the Federal Communications 
Commission, or any authority of the States with respect to mergers and 
acquisitions of large local telephone companies.
  The bill is effective on enactment and has no retroactive effect. It 
is enforceable by the Attorney General in federal district courts.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 2207

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Antitrust Improvements Act 
     of 1998''.

     SEC. 2. PURPOSE.

       The purpose of this Act is to enhance the authority of the 
     Attorney General to prevent certain mergers and acquisitions 
     that would unreasonably limit competition in the 
     telecommunications industry in any case in which certain 
     Federal requirements that would enhance competition are not 
     met.

     SEC. 3. RESTRAINT OF TRADE.

       The Clayton Act (15 U.S.C. 12 et seq.) is amended by adding 
     at the end the following new section:

     ``SEC. 27. RESTRAINT OF TRADE REGARDING TELECOMMUNICATIONS.

       ``(a) Large Local Telephone Company Defined.--In this 
     section, the term `large local telephone company' means a 
     local telephone company that, as of the date of a proposed 
     merger or acquisition covered by this section, serves more 
     than 5 percent of the telephone access lines in the United 
     States.
       ``(b) Restraint of Trade Regarding Telecommunications.--
     Notwithstanding any other provision of law, a large local 
     telephone company, including any affiliate of such a company, 
     shall not merge with or acquire a controlling interest in 
     another large local telephone company unless--
       ``(1) the Attorney General finds that the proposed merger 
     or acquisition will promote competition for telephone 
     exchange services and exchange access services; and
       ``(2) the Federal Communications Commission finds that each 
     large local telephone company that is a party to the proposed 
     merger or acquisition, with respect to at least \1/2\ of the 
     access lines in each State served by that company, of which 
     at least \1/2\ are residential access lines, has fully 
     implemented the requirements of sections 251 and 252 of the 
     Communications Act of 1934 (47 U.S.C. 251, 252), including 
     the regulations of the Commission and of the States that 
     implement those requirements.
       ``(c) Report of the Attorney General.--Not later than 10 
     days after the Attorney General makes a finding described in 
     subsection (b)(1), the Attorney General shall submit to the 
     Committee on the Judiciary of the Senate and the Committee on 
     the Judiciary of the House of Representatives a report on the 
     finding, including an analysis of the effect of the merger or 
     acquisition on competition in the United States 
     telecommunications industry.
       ``(d) Application Process.--
       ``(1) In general.--Each large local telephone company or 
     affiliate of a large local telephone company proposing to 
     merge with or acquire a controlling interest in another large 
     local telephone company shall file an application with both 
     the Attorney General and the Federal Communications 
     Commission, on the same day.
       ``(2) Decisions.--The Attorney General and the Federal 
     Communications Commission

[[Page S6888]]

     shall issue a decision regarding the application within the 
     time period applicable to review of mergers under section 7A 
     of this Act.
       ``(e) Jurisdiction of the United States Courts.--
       ``(1) In general.--The district courts of the United States 
     are vested with jurisdiction to prevent and restrain any 
     mergers or acquisitions described in subsection (d) that are 
     inconsistent with a finding under subsection (b) (1) or (2).
       ``(2) Actions.--The Attorney General may institute 
     proceedings in any district court of the United States in the 
     district in which the defendant resides or is found or has an 
     agent and that court shall order such injunctive, and other 
     relief, as may be appropriate if--
       ``(A) the Attorney General makes a finding that a proposed 
     merger or acquisition described in subsection (d) does not 
     meet the applicable condition under subsection (b)(1); or
       ``(B) the Federal Communications Commission makes a finding 
     that 1 or more of the parties to the merger or acquisition 
     referred to in subsection (b)(2) do not meet the requirements 
     specified in that subsection.''.

     SEC. 4. PRESERVATION OF EXISTING AUTHORITIES.

       (a) In General.--Nothing in this Act or the amendments made 
     by this Act shall be construed to modify, impair, or 
     supersede the applicability of the antitrust laws, or any 
     authority of the Federal Communications Commission under the 
     Communications Act of 1934 (47 U.S.C. 151 et seq.), with 
     respect to mergers, acquisitions, and affiliations of large 
     incumbent local exchange carriers.
       (b) Antitrust Laws Defined.--In this section, the term 
     ``antitrust laws'' has the meaning given that term in the 
     first section of the Clayton Act (15 U.S.C. 12).

     SEC. 5. APPLICABILITY.

       This Act and the amendments made by this Act shall apply to 
     a merger or acquisition of a controlling interest of a large 
     local telephone company (as that term is defined in section 
     27 of the Clayton Act, as added by section 3 of this Act), 
     occurring on or after the date of enactment of this 
     Act.
                                 ______
                                 
      By Mr. FRIST:
  S. 2208. A bill to amend title IX of the Public Health Service Act to 
revise and extend the Agency for Healthcare Policy and Research; to the 
Committee on Labor and Human Resources.


               HEALTHCARE QUALITY ENHANCEMENT ACT OF 1998

  Mr. FRIST. Mr. President, I rise today to advocate better healthcare 
for Americans and to introduce legislation strengthening the scientific 
foundation of healthcare quality improvement efforts. Let me make a few 
introductory comments before summarizing the ``Healthcare Quality 
Enhancement Act of 1998.''
  First, I want to make it clear: all patients deserve better 
healthcare quality, not just HMO enrollees as recent discussions have 
most frequently focused on regarding consumer protections.
  All Americans deserve better healthcare. We need healthcare quality 
improvement that reaches everybody through better healthcare plans, 
tertiary care centers, fee-for-service solo practices, and all other 
kinds of patient care.
  We should not wait for another movie like the one titled ``As Good as 
It Gets'' to talk about healthcare quality for 70% percent of employees 
and 86% of Medicare beneficiaries who are not traditional-HMO 
enrollees.
  Quality of care fundamentally rests on the achievements of biomedical 
research. We all know that sound science is the best way to improve 
quality in patient care. All components of the outcome of healthcare 
can be effectively improved by statistically valid science: health 
status can be turned around by transplantation when someone's life is 
in jeopardy due to a diseased organ; social functioning can be improved 
by shock wave lithotripsy that leads to faster recovery; and patient 
satisfaction can be better when children with moderate or severe asthma 
get proper anti-inflammatory treatment.
  While being amazed by the promise of new scientific achievements, few 
patients realize the implications of abundant and growing production in 
biomedical research.
  Over the past 20 years, the number of articles indexed annually in 
the Medline database of the National Library of Medicine nearly 
doubled.
  Randomized clinical trials are considered sources of the highest 
quality evidence on the value of a new intervention. Over the past two 
decades, the number of clinical trials in my own field of cardiology 
have increased five-fold.
  In health services research, 10 times more clinical trials are 
published today than 20 years ago (e.g., clinical trials comparing 
inpatient care with outpatient care, trials of physician profiling and 
other information interventions).
  But we are falling short in our success to disseminate our findings 
and influence practice behavior.
  In spite of all these scientific achievements, we cannot further 
build up biomedical research production for the next millennium if our 
network for sharing it with practitioners remains on a nineteenth's 
century level.
  The landmark Early Treatment Diabetic Retinopathy Study was published 
in 1985. This randomized controlled clinical trial validated a 
scientific achievement almost a decade earlier. The American Diabetes 
Association published its eye care guidelines for patients with 
diabetes mellitus in 1988. Today, the national rate for annual diabetic 
eye exam is still only 38.4%.
  There are more scientific discoveries than ever before, but practical 
introduction of new scientific discoveries does not seem to be much 
faster today than it was more than 100 years ago. We need to close the 
gap between what we know and what we do in healthcare. That requires a 
federal role in sharing information about what works to improve 
quality.
  All Americans want better healthcare and the federal government must 
respond by offering helpful information on quality, channeling 
scientific evidence to clinicians, and investing in research on 
improving health services.
  For this reason, today I am introducing legislation to establish the 
``Agency for Healthcare Quality'' which builds on the platform of the 
current Agency for Healthcare Policy and Research, but refocuses it on 
quality to become the central figure in our efforts to improve the 
quality of healthcare.
  Healthcare quality is a matter of personal preference--it means 
different things to different people. We all remember when healthcare 
quality became a political showdown, the low back pain guidelines 
backfired because they were viewed as an attempt to mandate ``cook 
book'' medicine, and the Agency for Healthcare Policy and Research had 
a near death experience.
  Over the past three years, since I first came to the United States 
Senate, I have looked very closely at this agency. The Subcommittee on 
Public Health and Safety, which I chair, has held three hearings to 
invite public input on this agency. As a result, this legislation 
responds to many of the past criticisms of the agency. This legislation 
will take AHCPR--under a new name--to new heights and will establish it 
as the center of healthcare quality research for the country.

  The new Agency for Healthcare Quality will:
  1. promote quality by sharing information. While proven medical 
advances are made daily, patients are waiting too long to benefit from 
these discoveries. We must get the science to the people by better 
sharing of information and more effective dissemination. In addition, 
the Agency will develop evidence-rating systems to help people in 
judging the quality of science.
  2. build public-private partnerships to advance and share true 
quality measures. Quality means different things to different people. 
In collaboration with the private sector, the Agency shall conduct 
research that can figure out what quality really means to patients and 
to clinicians, how to measure quality, and what actions can improve the 
outcome of healthcare.
  3. report annually on the state of quality, and cost, of the nation's 
healthcare. Americans want to know if they receive good quality 
healthcare. But compared to what? Statistically accurate, sample-based 
national surveys will efficiently provide reliable and affordable data 
--without excessive, overly intrusive, and potentially destructive 
mandatory reporting requirements.
  4. aggressively support improved information systems for health 
quality. Currently, quality measurement too often requires manual chart 
reviews for such simple data as frequency of procedures, infection 
rates, or other complications. Improved computer systems will advance 
quality scoring and facilitate quality-based decision-making in patient 
treatment.

[[Page S6889]]

  5. support primary care research, and address issues of access in 
underserved areas. While most policy discussions this year are 
targeting managed care, quality improvement is just as important to the 
solo private practitioner. The Agency's authority is expanded to 
support healthcare improvement in all types of office practice--not 
just managed care. The agency shall specifically address quality in 
rural and other undeserved areas by advancing telemedicine services 
which share clinical expertise with more patients.
  6. facilitate innovation in patient care with streamlined evaluation 
and assessment of new technologies. Patients should benefit from proven 
breakthrough technologies sooner, while inefficient methods should be 
phased out faster. Today, manufacturers and distributors of new 
technologies face major hurdles in trying to secure coverage. The 
Medicare technology committee has been particularly criticized for its 
process. Criteria are unclear, delays are long, and decisions are 
unpredictable. The Agency will be accessible to both private and public 
entities for technology assessments and will share information on 
assessment methodologies.
  7. coordinate quality improvement efforts of the government. Most of 
the many federal healthcare programs today support some kind of health 
services research and conduct various quality improvement projects. The 
Agency shall coordinate these many initiatives to avoid disjointed, 
uncoordinated, or duplicative efforts.
  In summary, we need to practice, not just publish, better patient 
care. We all want to see better quality.
  Real improvement can come from progress in health sciences, from 
promoting innovation in patient care, and from better practical 
application of new scientific advances. The Agency for Healthcare 
Quality will focus on overall improvement in healthcare and enable us 
to judge the quality of care we receive.
  Americans want better healthcare and the federal government shall 
respond by offering helpful information on quality, channeling 
scientific evidence to clinicians, and investing in research on 
improving health services.
  Mr. President the ``Healthcare Quality Enhancement Act of 1998'' will 
reduce the gap between what we know and what we do in healthcare. The 
refocused Agency for Healthcare Quality is the right step forward and I 
urge my colleagues to support this legislation to improve healthcare 
for all Americans.

                          ____________________