[Congressional Record Volume 144, Number 98 (Tuesday, July 21, 1998)]
[Senate]
[Pages S8638-S8639]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                         THE HEALTH CARE DEBATE

  Mr. GRAMM. Mr. President, while we are waiting for someone to come 
over with an amendment, I want to say something about health care and 
about the health care debate. As long as I have been in the Senate, the 
minority party has always sought to have the opportunity to have an up-
or-down vote on their alternatives. Senator Kennedy has now for months 
demanded that he have an opportunity to offer his proposal to remake 
the American health care system.
  We on the majority side of the aisle have spent tremendous amounts of 
time putting together our proposal to strengthen patients' rights to 
empower consumers----
  Mr. BYRD. Mr. President, may we have order in the Senate?
  The PRESIDING OFFICER. The Senator is correct. The Senator from Texas 
deserves to be heard. Will Members please take their conversations off 
the floor?
  Mr. GRAMM. I thank the Senator from West Virginia, and I thank the 
Chair.
  Mr. President, on this side of the aisle, we have spent a tremendous 
amount of time, individual Members' time--not just the time of our 
staffs--in putting together our bill to promote patients' rights, to 
get the gatekeepers of Health Maintenance Organizations out of the 
examining rooms where medical care is being provided in America.
  We now have a situation where we have Senator Kennedy's proposal, 
which is strongly supported by our Democratic colleagues, and we have 
our proposal, which is strongly supported by our Republican colleagues. 
What we have sought to do since we have a limited number of legislative 
days--we have many appropriations bills to pass--is to try to reach an 
agreement where we would allow something that majorities normally do 
not do under the Senate rules, and that is to allow the minority to 
have an up-or-down vote on their so-called Patients' Bill of Rights. 
Then, if they are unsuccessful, to have an up-or-down vote on our bill, 
and if we are successful, that would be the bill.
  We now find that our colleagues say, ``No; we want 20 amendments,'' 
or, ``We want 10 amendments.'' I wanted to explain to my colleagues why 
I am going to object to any unanimous consent request that does not 
allow us to simply have the two choices. It is unusual in the sense 
that someone would object to narrowing down amendments, so I would like 
to explain my concern.
  First of all, I don't think it is unreasonable, given our legislative 
schedule, to say to those who have a health care bill that we are going 
to give them an up-or-down vote on their bill. I don't think that is 
unreasonable. Obviously, a unanimous consent request alters the basic 
procedures of the Senate, and any Senator has the right to object to 
doing that.
  Secondly, I am not interested in amending Senator Kennedy's bill. I 
don't want to try to change his bill. I want him to write the best bill 
he can write to try to improve our health care system and enhance the 
rights of health care consumers, and I don't have any interest in 
amending his bill.
  Now, let me tell you why I don't have any interest in Senator Kennedy 
and others amending our bill. I have not forgotten that the Senator 
from Massachusetts and many of the supporters of the Kennedy bill 5 
years ago were for a Government-run HMO, the Clinton health care bill. 
I have not forgotten that the President was not only in favor of the 
Government taking over and running the health care system 5 years ago; 
within the past year he has said that he had not changed his objective 
in having a Government-run system but that he was now simply trying to 
implement it piece by piece.
  Here is the problem this late in the legislative session of getting 
into endless amendments on the two bills: Not only do we not have time 
to do it, but we have a very unequal situation. Let me explain, and I 
will try to do it briefly so we can get on with this bill.
  I am not interested, and I don't believe anyone on our side of the 
aisle is interested, in amending the Kennedy bill. I believe that we 
have a better bill. I think he ought to write the best bill he can, we 
will write the best bill we can, and then, with the limited time we 
have, give people a choice. But there is an additional problem here, 
and the problem is the unequal situation we are in.
  I desperately do not want to do anything to destroy the private 
practice of medicine in America. I don't believe that a Government-run 
system is the best system. In offering amendments and writing our bill, 
we are constrained in that we don't want to do anything that is going 
to drive up costs, cost millions of American families their health 
insurance, and ultimately force people into a Government-run HMO.
  It appears that many of our colleagues, including the author of the 
Democratic alternative, support a Government-run HMO, support a 
Government takeover, so that while we are constrained in amendments 
that we can offer by our desire to be certain that we don't end up 
killing off private medicine, many on the other side of the aisle seem 
to believe that private medicine should be killed off so that we can 
have a system that they sincerely believe will work better, and that is 
a system where the Government would run health care in America.
  The best analogy, interestingly enough, is biblical. Some of my 
colleagues will remember the story in the Bible about the two women who 
had infants. While they slept, one infant died, and the lady whose 
child had died got up and took the dead baby and put the dead baby by 
the mother of the living baby and took the living baby herself. When 
the mother woke up and saw the dead child, she realized it was not her 
child.
  To make a long biblical story short, the women appeared before King 
Solomon. Solomon, being wise, asked that a sword be brought. He 
suggested that since there was no way that anybody other than the two 
mothers would know whose child was really alive, that he would take the 
sword and divide the child. When he proposed that this be done, the 
real mother, of course, as all of us remember from our schooldays and 
reading the story in the Bible, the real mother said, ``No; give her 
the

[[Page S8639]]

child.'' The woman who was not the real mother said, ``No; divide the 
child.'' Solomon, of course, then knew who the real mother was, gave 
her the child, and the people were awed by his wisdom.
  Here is our problem. We are debating over a child on the health care 
bill, and the child is the private practice of medicine in America. The 
child is a viable system run in the private sector by doctors and 
nurses and hospitals that are not run by the Government, but we are in 
an unequal debate because many on the other side seem to want that 
system to die so that we can have a Government-run system.
  Under those circumstances, to simply have endless amendments would 
not serve any purpose, given not only the limited amount of time we 
have, but also because, more importantly, it puts us at a disadvantage 
because we have no interest in offering amendments that would drive up 
cost, kill off private health insurance, and leave people uninsured, 
whereas those who really believe that you first have to prove that the 
private health care sector cannot work and therefore you must have a 
Government-run system would view such an amendment exercise potentially 
as a step toward improving the health care system.
  I simply state to my colleagues while this negotiating is going on, I 
will certainly support, and do support, a unanimous consent request 
where Senator Kennedy and those who support him write the very best 
proposal they can write to strengthen patients' rights. We have 
written--and if we come up with better ideas, we will incorporate 
them--the best bill we can write that we believe achieves those 
objectives. Let's give Senator Kennedy and those who support him an up-
or-down, freestanding vote, unamended, to put before the Senate his 
best proposal, and let us vote yea or nay. Then give us an opportunity 
to put our bill--our best proposal--in front of the Senate and vote yea 
or nay.

  But I am not interested in allowing amendments where one side of the 
debate can view it as positive to kill off the private sector of 
medicine in America and whereas those of us who believe that its 
survival is critical to quality medicine in America would be forever 
disadvantaged in that debate.
  So I want to call on those who have for 6 months said to us: ``The 
No. 1 issue in the country is patients' rights. Give us an opportunity 
to vote on our bill.'' I want to call on them to bring their bill to 
the floor of the Senate and let us vote on it. Let us vote up or down. 
We will not amend Senator Kennedy's bill. If he has reached legislative 
perfection, at least in terms of what he thinks he can pass, then let 
us vote on it. And then let us vote on our bill.
  But I intend to object to any unanimous consent request that would 
have the effect I've described. I hope that reason will prevail and we 
will have an up-or-down vote on the two alternatives. Those who want a 
bill, I do not see how they could view that as being an unfair 
proposal. It is a proposal that 6 months ago I would think that the 
minority would have jumped at.
  Today, they want the ability to have 20 amendments. They do not want 
to set a calendar time limit. That process could go on and on and on. I 
do not have any desire to amend their bill. We want an opportunity to 
vote on ours. Let the Senate choose. I think it would be the right way 
to go about it, and the only way we can be successful in the end.
  I yield the floor.
  Several Senators addressed the Chair.
  The PRESIDING OFFICER. The Senator from New Hampshire.
  Mr. GREGG. Mr. President, we are going to have a lot of time to 
debate health care. I suspect the Senator from Kentucky may want to 
respond to the Senator.
  Mr. FORD. Thirty seconds.
  The Senator from Texas said time and time again that we were 
destroying the medical system. With the AMA and 170 medical 
organizations in this country for our particular bill, I do not believe 
there is any indication that we are trying to destroy the medical 
profession in this country.
  Several Senators addressed the Chair.
  Mr. GREGG. Reclaiming my time.
  Mr. FORD. I said 30 seconds.
  Mr. GRAMM. Will the Senator yield?
  Mr. GREGG. Did the Senator from Kentucky get his 30 seconds?
  The PRESIDING OFFICER. The Senator from Kentucky used 18 seconds.
  Mr. GRAMM. Will the Senator yield----
  Mr. GREGG. I would like to move on with the bill, to be quite honest 
with you. I will yield the floor, but I hope we can move to the 
completion of this bill.
  The Senator from Arizona has been waiting, along with the Senator 
from Utah, to get an amendment completed that we worked on for a few 
hours here. It would be nice if we could wrap that up. Then, if you 
want to come back to the health care debate, that is great.
  I ask unanimous consent that the next Member to be recognized be the 
Senator from Arizona.
  The PRESIDING OFFICER. Is there objection?
  Mr. GRAMM. I object and suggest the absence of a quorum.
  The PRESIDING OFFICER. Is there objection to the request?
  Mr. HATCH. Could I ask the distinguished Senator from Texas to 
withhold his objection? This should not----
  Mr. GRAMM. Mr. President, I withhold. I withhold my suggestion of the 
absence of a quorum.
  The PRESIDING OFFICER. The Senator from New Hampshire has asked for 
unanimous consent. Is there objection?
  Mr. GREGG. I withdraw the unanimous consent request.
  Mr. HATCH addressed the Chair.
  The PRESIDING OFFICER. Does the Senator from New Hampshire yield the 
floor?
  Mr. GREGG. I yield the floor.
  Mr. HATCH. Will the Senator yield 30 seconds to me?
  Mr. GRAMM addressed the Chair.
  The PRESIDING OFFICER. The Senator from Texas.
  Mr. GRAMM. I will be 20 seconds. If the Senator has support, if he 
has a good bill, let us bring it before the Senate and vote on it.
  Mr. FORD. In my strategy and not yours.
  Mr. GRAMM. If we are going to have a unanimous consent request, we 
have to have the agreement of the Members. And I am not going to agree 
to that particular process.
  I yield the floor.
  Mr. McCAINN addressed the Chair.
  The PRESIDING OFFICER. The Senator from Arizona.

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