[Congressional Record Volume 144, Number 105 (Thursday, July 30, 1998)]
[Senate]
[Pages S9346-S9350]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                        PATIENTS' BILL OF RIGHTS

  Mr. KENNEDY. Mr. President, as we begin the August recess, the 
American people should understand that the Republican leadership is 
still bent on blocking meaningful HMO reform. I believe that Senator 
Lott owes it to Congress and the American people to schedule a full and 
fair debate as the Senate's first order of business when we return in 
September, but he has refused to do so and continues to hide behind the 
unreasonable restrictions on fair guidelines for the Senate's debate.
  The Republican leadership in Congress deserves the failing grades it 
is getting for fumbling the issue on HMO reform. At least since last 
January when the press reports began noting that Oscar-winning actress 
Helen Hunt in ``As Good as it Gets,'' who electrified audiences with 
her attack on HMOs, it has been clear that a tidal wave of support is 
building to end the managed care abuses and stop HMOs from profiting in 
ways that jeopardize patients' health or their very lives.
  The GOP's HMO line of defense continues to be to block any strong 
legislation, refuse to allow fair debate, and to give the HMO industry 
antireform TV ads a chance to bite. The genie is out of the bottle, and 
that cynical strategy will fail. If the majority leader has not already 
done so, I urge him to see the film during the recess. I have a 
videotape of the film here. I ask a page to deliver it to the majority 
leader.
  I urge the leader to see the film in a theater so he can judge the 
audience reaction and be more convinced of the genuine public outrage 
that exists over the abuses of HMOs and managed care. It is long past 
time for the Congress to end these abuses. Too often, the managed care 
is mismanaged care. No amount of distortion or smokescreens by 
insurance companies or GOP campaign ads can change the facts. A real 
Patients' Bill of Rights can stop these abuses. Let's pass it now 
before more patients have to suffer.
  All we want is a chance, in the time-honored tradition and the 
regular order of this body, to present a full and complete debate on 
this issue. We have had 5 days of debate and discussion on agriculture, 
with 55 amendments. We have

[[Page S9347]]

had 6 days of debate on the defense authorization, with 105 amendments. 
We have had 7 days of debate on the budget, with over 100 amendments. 
We are entitled to an opportunity for a full and fair debate. If there 
are provisions to be included in the Daschle bill, we would like to 
hear about them and what the objectives are. We believe that this 
debate offers the best opportunity to make sure that we are going to 
have the doctors and patients make decisions and not the insurance 
companies. That is the central and fundamental issue that we ought to 
be debating. We are going to continue to press this issue until we have 
that debate.
  The Senate Republican leadership plan is not a bill of rights--it's a 
bill of wrongs. It cannot withstand a full and fair debate on the floor 
of the Senate. Its supporters know that--so they are refusing to bring 
it up for full debate, or at least agree on a fair number of 
amendments.
  The goal of the Republican leadership and their friends in the 
insurance industry is to prevent legislation this year, or to pass only 
a minimalist bill so weak that it would be worse than no bill at all. 
The initial Republican strategy--the stonewall strategy--lasted for 
more than a year. But it broke down last month in the face of 
overwhelming public demand for action.
  Their minimalist approach pays lip service to reform without the 
reality of reform. They refuse to let the Senate debate it, because 
they know their plan is more loophole than law.
  The Republican record of delay and denial is clear. Congressman 
Dingell and I first introduced patient protection legislation 17 months 
ago--on February 25, 1997.
  Senator Daschle introduced the Patients' Bill of Rights four months 
ago--on March 31, 1998.
  We have repeatedly asked for committee action or consideration by the 
full Senate of this important legislation, but the Republican 
leadership has repeatedly said ``no.''
  Now, they know they can no longer just say ``no.'' So the Leadership 
is trying the next best thing. Instead of bringing up the bill for full 
and fair debate, they have offered up a series of phony consent 
agreements that they know are unacceptable. They don't want a full 
debate with an opportunity to amend their Patient Bill of Wrongs, 
because they believe that the less the American people know about their 
sham proposals, the better they will be able to protect their friends 
in the health insurance industry.
  In fact, the Republican leadership has gone to extraordinary lengths 
in the past six weeks to prevent a full debate on HMO reform.
  On June 18, Senator Lott proposed to bring up the bill, but on terms 
that made a mockery of legislative process.
   That proposal would have allowed the Senate to start debate on HMO 
reform, but Senator Lott would have been permitted to pull the bill 
down at any time, and the Senate would have been barred from 
considering it further for the rest of the year. So if Senator Lott did 
not like the direction the bill was headed, he could withdraw it and 
tie the Senate's hands on HMO reform for the remainder of the year.
  On June 23, 43 Democratic Senators wrote to Senator Lott to urge him 
to allow a full debate and votes on the merits of the Patients' Bill of 
Rights before the August recess.
  In response, on June 24, Senator Lott simply repeated his earlier 
unacceptable offer.
  On June 25, Senator Daschle proposed an agreement under which Senator 
Lott would bring up a Republican health care bill by July 6, Senator 
Daschle could offer the Democratic Patients' Bill of Rights, and other 
Senators could offer only amendments relevant to the HMO reform issue. 
We would not allow amendments on any other subject--just those relevant 
to the Patients' Bill of Rights.
  However, Senator Lott rejected this offer. And on June 26, he offered 
once again an agreement that allowed Senator Lott to withdraw the 
legislation at any time, and bar any further consideration of any 
health care legislation for the remainder of the year.
  On July 15, after a long silence, Senator Lott made yet another 
offer. This time he proposed an agreement that allowed for no 
amendments. He could bring up his bill. We could bring up ours. And 
that is it. It would be all or nothing. The American people would be 
denied votes on specific issues.
  No vote on whether all Americans should be covered, or just one-third 
as the Republicans propose.
  No vote on whether there should be genuine access to emergency room 
care.
  No vote on whether patients should have access to the specialists 
they need when they are seriously ill.
  No vote on whether doctors should be free to give the medical advice 
they feel is appropriate, without fear of being fired by the HMO.
  No vote on whether patients with cancer or Alzheimer's disease or 
other illnesses should have access to clinical trials after 
conventional treatments fail.
  No vote on whether patients in the middle of a course of treatment 
can keep their doctor if their health plan drops the doctor from the 
network, or the employer changes health plans.
  No vote on whether patients should have meaningful independent review 
of plan decisions--or whether health plans should continue to be judge 
and jury.
  No vote on whether the special health needs of persons with 
disabilities, and women, and children should be met.
  No vote on whether health plans should be held responsible for 
decisions that kill or injure patients.
  The list goes on and on.
  But the Republican Leadership just wants an all-or-nothing vote on 
their plan and our plan. They don't want a genuine debate on patient 
protection. They don't want to be held accountable by the American 
people for defending industry profits instead of patients. They want to 
gag the Senate, and allow HMOs to continue to gag doctors.
  On July 16, Senator Daschle proposed that we agree on a limited 
number of amendments--20 per side, directly related to the legislation, 
not on extraneous issues.
  This offer by Senator Daschle reflects the best traditions of the 
Senate. It is consistent with the conditions under which we have 
debated many major legislative proposals in the Senate this year.
  We had 7 days of debate on the budget resolution, and considered 105 
amendments. Two of those were offered by Senator Nickles.
  We had 6 days of debate on the defense authorization bill, and 
considered 150 amendments. Two of those were offered by Senator Lott, 
and he cosponsored 10 others.
  We had 8 days of debate on IRS reform, and considered 13 amendments.
  We had 17 days of debate on tobacco legislation--a bill we never 
completed--and considered 18 amendments.
  We had 5 days of debate on the Agriculture Appropriations bill and 55 
amendments.
  Senator Lott has said to reporters that Democrats might be able to 
offer 3 or 4 amendments. But that means we would have to decide which 
issues of concern to the American people are debated, and which are 
discarded. Do we debate access to emergency rooms, but put aside all 
concerns about access to specialists? Do we offer an amendment to 
ensure that all Americans are covered by the legislation, and not just 
the one-third the Republican plan proposes, but put aside access to 
clinical trials that could save lives?
  This debate should not be an unfair choice. We agree that the number 
of amendments should be limited. But the number should be large enough 
to accommodate the large number of legitimate issues that need to be 
debated as part of this important reform.
  If the Republican leaders are serious about fair debate, they know 
how to do it. We do it every day in the Senate, and we should do it 
now. If they are serious about passing meaningful patient protection 
legislation, they should call up the bill now. All we have asked for is 
20 amendments per side. It will take at least 20 amendments to even 
begin to remedy the major defects in the Republican proposal.
  Since the Republican leadership plan was introduced a week ago, we 
have held meetings and forums with doctors, nurses and patients to 
explore the critical issues that must be addressed if a Patients' Bill 
of Rights is to be worthy of its name.
  In each case, doctors, nurses and patients have reached the same 
conclusions. The abuses by HMOs and managed care are pervasive in our 
health

[[Page S9348]]

system. Every doctor and patient knows that, too often, managed care is 
mismanaged care. Every doctor and patient knows that medical decisions 
that should be made by doctors and patients are being made by insurance 
company accountants. Every doctor and patient knows that profits, not 
patient care, have become the priority of too many health insurance 
companies.
  The message in each of these forums from doctors, nurses and patients 
has been the same. Pass the Patients' Bill of Rights. Reject the 
Republican leadership plan. It leaves out too many critical 
protections. It leaves out too many patients. Even the protections it 
claims to offer have too many loopholes. It is a plan to protect 
industry profits, not patients.
  One of the aspects of their legislation that the Republican 
leadership likes to tout is its alleged protections for women. As part 
of their ongoing disinformation campaign about their legislation, they 
even had a press conference this morning to proclaim the benefits of 
their legislation for women. But no credible organization representing 
women endorses their bill--because their so-called protections for 
women are a sham.
  Nowhere is the difference between the bipartisan Patients' Bill of 
Rights and the Republican Bill of Wrongs more evident than on the issue 
of protecting women's health. The Republican leadership bill leaves out 
most key patient protections. Even the protections it does include are 
more cosmetic than real. And even those cosmetic protections are 
limited to fewer than one-third of the privately insured patients who 
need help.
  We held a forum yesterday afternoon during which leading 
organizations for women released a letter urging Senators to support 
the Patients' Bill of Rights and to reject the Republican leadership 
bill. The letter is signed by more than 30 women's groups, who 
represent millions of women in communities across the country.
  Last Friday, we heard from Diane Bergin of College Park, MD. She has 
ovarian cancer, and is currently enrolled in a clinical trial. She 
eloquently described the need for plans to cover such trials and the 
importance of having access to specialty care. Diane is a vivid example 
of the promise of such therapies and the need to see that patients have 
genuine access to specialists.
  Women need to know that they will receive the benefits covered by 
their plan and recommended by their treating physician--without being 
over-ruled by insurance company accountants.
  Women need to know that they can choose their gynecologist to be 
their primary care physician.
  Women need to know that they will never have to drive past the 
nearest emergency room, because a more distant hospital is part of 
their managed care plan.
  Women with mental illness need to know that they will have access to 
psychiatrists, psychologists and other mental health professionals.
  Women with ovarian cancer--like Diane Bergin--or other life-
threatening conditions need to know that their health plan will let 
them participate in clinical trials by covering routine costs of such 
care.
  Women whose plans provide pharmaceutical benefits need to know that 
they will have access to drugs that are not on the plan's list.
  Women need to know that they will have access to a quick and 
independent appeal if their plan overrules their doctor.
  Women need to know that they have a genuine remedy when plan abuses 
result in injury or death.
  The Patients' Bill of Rights guarantees these rights to all women 
with private health insurance. The Republican plan guarantees none of 
them.
  In fact, the closer you look at the Republican bill, the worse it 
looks. They claim to provide protections for patients who seek 
emergency room care. But the American College of Emergency Physicians 
has denounced their proposal as a sham.
  They claim to provide independent third party appeal, but Consumer's 
Union analyzed their proposal and called it ``woefully inadequate and 
far from independent.''
  Virtually every protection they claim to have included turns out to 
fail the truth-in-advertising test--and the protections they have left 
out are a dishonor roll of insurance industry abuses.
  Part of democracy is accountability. We have votes in the Senate to 
pass or defeat bills. We have votes on amendments to improve bills. We 
record these votes, because we are elected by the people of our states 
to represent them. The people have a right to know where we stand on 
important issues.
  I ask the Republican leader why he doesn't want the American people 
to know where members of the Senate stand on whether protections for 
patients should apply to all 161 million privately insured Americans--
or leave more than 100 million out.
  I ask the Republican leader why he doesn't want the American people 
to know where members of the Senate stand on allowing a sick child with 
cancer to have access to a specialist to treat his disease.
  I ask the Republican leader why he doesn't want a vote on whether 
doctors and patients, not accountants, should make medical decisions.
  I ask the Republican leader why he doesn't want a vote on whether 
doctors who stand up for their patients should be protected from 
retaliation by insurance companies.
  I ask the Republican leader why he doesn't want a vote on whether 
patients should have access to the nearest emergency room when 
immediate medical treatment means the difference between life and 
death.
  I ask the Republican leader why he doesn't want a vote on whether HMO 
decisions to deny patients the care they need should be subject to 
timely and independent review by an impartial third party.
  I ask the Republican leader why he doesn't want a vote on whether 
patients with deadly diseases that no conventional treatment can help 
should have access to clinical trials that offer them the hope of cure 
or improvement.
  I ask the Republican leader why he doesn't want a vote to insist on 
accountability for health plans when they kill or injure patients.
  Each of those votes will address a critical weakness in the 
Republican plan. It is obvious why the Republican leader does not want 
Democrats to offer these amendments. He wants to keep the Republican 
bill weak, so that it will protect profits instead of patients. He 
thinks that he can hold Republican Senators for one vote in favor of a 
bad bill, but he cannot keep them together on vote after vote that will 
show who stands with patients--and who stands with HMOs.
  The President will not sign--and the Senate should not pass--a bill 
that is a fig leaf over continued HMO abuses.
  If the Senate has a full and fair debate in full view of the American 
people, needed patient protections will pass--and that is what the 
Republican leadership is trying to avoid.
  The House Republican plan is so flawed that President Clinton has 
already sent a strong veto message. But the Senate Republican plan is 
even weaker than the House Republican plan--it's ``Gingrich Lite.'' We 
know we can do better, and we will do better if we have a fair 
opportunity for full debate.
  The Senate Republican plan protects industry profits instead of 
protecting patients. It is so riddled with loopholes that it's a 
license for continued abuse. It allows insurance company accountants to 
continue to make medical decisions, not doctors and patients. Patients 
with cancer, heart disease, or other serious illnesses will not have 
timely access to specialists and the treatment they need. Managed care 
plans are immunized from liability for abuses that injure or even kill 
a patient. No other industry in America has this immunity--and the 
managed care industry doesn't deserve it either.
  Just as managed care plans gag their doctors, the Republican 
leadership wants to gag the Senate. Just as insurance companies delay 
and deny care, the Republican leadership is trying to delay and deny 
meaningful reform. Just as health plans want to avoid being held 
accountable when they kill or injure a patient, the Republican 
leadership wants to avoid being held accountable for killing patient 
protection legislation.
  Yesterday, Senator Chafee offered a proposal that is a major 
improvement over the Senate Republican leadership

[[Page S9349]]

plan, and it provides significant patient protections. But it lacks 
many of the most important protections in our Patients' Bill of Rights.
  Key provisions omitted in the Chafee plan include the lack of needed 
protection for breast cancer patients from drive-through mastectomies 
and access to reconstructive surgery--the lack of fair opportunities 
for patients to join health plans allowing them to go to the physician 
or specialist of their choice--the lack of protection for health 
professionals who point out problems in the quality of care provided by 
health plans or facilities--and the lack of adequate remedies for 
patients injuries or killed by HMO abuses.
  All of these reforms are needed, and all of them are strongly 
supported by an unprecedented alliance of physicians, nurses, patients, 
and working families.
  Despite these significant gaps, the Chafee plan shows that the wall 
of opposition by Senate Republicans to genuine reform is continuing to 
crack, and it shows that at least some Republicans in the Senate are 
serious about reform. Now is the time for the Republican leadership to 
respond. As the Chafee plan shows, their industry profit protection 
plan is becoming less and less tenable with each passing day. The 
American people demand action, but the Republican leadership still 
refuses to bring patient protection legislation to the floor for full 
debate and action.
  The Republican Leadership in Congress deserves the failing grades 
it's getting for fumbling the issue of HMO reform. At least since last 
January--when press reports began noting that Oscar-winning actress 
Helen Hunt in the movie ``As Good As It Gets'' was electrifying 
audiences with her attack on her HMO--it has been clear that a tidal 
wave of support is building to end managed care abuses and stop HMOs 
from profiteering in ways that jeopardizing patients' health or their 
very lives.
  The GOP-HMO line of defense continues to be to block any legislation, 
refuse to allow fair debate, and give the HMO industry's anti-reform TV 
ads a chance to bite. But the genie is out of the bottle, and that 
cynical strategy will fail.
  It's time for Congress to end the abuses of patients and physicians 
by HMOs and managed care health plans. Too often, managed care is mis-
managed care. No amount of distortions or smokescreens by insurance 
companies can change the facts. A real Patients' Bill of Rights can 
stop these abuses. Let's pass it now, before more patients have to 
suffer.
  Mr. President, I ask unanimous consent that two articles on the film 
``As Good As It Gets'' be printed in the Record. The first is a March 
29 Boston Globe column by Ellen Goodman. The second is a January 12 
article in the St. Louis Post-Dispatch, which to my knowledge is the 
first report of the extraordinary impact of the film on the HMO debate, 
and which mentions State Representative Thomas Holbrook of Belleville, 
Missouri as the first elected official to recognize this impact.
  There being no objection, the articles were ordered to be printed in 
the Record, as follows:

                [From The Boston Globe, March 29, 1998]

                           (By Ellen Goodman)

                          The HMO Horror Show

       Too bad they don't have a Oscar for the Single Best Line in 
     a movie. A zeitgeist award for the sentence you want to 
     freeze-frame, the magical moment when Hollywood fantasy meets 
     daily life, with they get it absolutely right.
       Helen Hunt and Jack Nicholson picked up a couple of statues 
     last week for Best Actress and Best Actor in ``As Good as It 
     Gets.'' But the Best Line prize belongs to the scribbler who 
     put a string of ungenteel words in Hunt's mouth. When the 
     distraught mother gave her opinion about the managed medical 
     attention being given her asthmatic son, she exploded: ``F---
     --- HMO B------ Pieces of S---!''
       At this outburst--with none of the expletives deleted--
     audiences all over America spontaneously burst out in 
     applause. It was one of those moments when you know the tide 
     has turned.
       HMOs have become the new expletive--undeleted. Managed-care 
     companies are rapidly replacing tobacco companies as 
     corporate demons. Indeed, if you watch ``The Rainmaker,'' the 
     HMOs are taking the place of the Russkies as the bad guys. As 
     Ronald Glasser, a Minneapolis pediatrician, HMO critic, and 
     moviegoer who was downing popcorn when the audience roared at 
     Hunt, exclaims, ``I looked around and said, `My God, the 
     people are way ahead of the politicians on this.' ''
       A few years ago, the public saw doctors as rich 
     professionals who overcharged on Tuesday and played golf on 
     Wednesday. The weakness in the system was cost control--or 
     cost out of control.
       Now doctors and consumers are becoming allies on the same 
     side, fighting the HMOs, hassling the 800 numbers, trapped in 
     a medical system we suspect is being run by accountants. The 
     weakness in the system is trust. Or rather, mistrust.
       It is an astonishingly swift transformation. Bob Blendon, 
     who polls health care issues at Harvard's School of Public 
     Health, is about to publish a study of the consumer backlash 
     that confirms Helen Hunt's less professorial opinion. His 
     survey of surveys proves, he says, that ``we have changed the 
     whole politics of the health field. Essentially patients and 
     doctors have come together in a new class of exploited 
     people.''
       On the one hand, polls show that most Americans are 
     satisfied with their own health care plans. On the other 
     hand, they favor some type of government regulation.
       These two views seem contradictory, but the backlash is 
     based on the widespread anxiety about what happens if they 
     get sick. ``People have come to believe,'' says Blendon, 
     ``that these plans won't do the right thing for them when 
     they are very sick.''
       There isn't yet much objective research to show how often 
     health care is refused, or how often the hassles and hurdles 
     have lethal consequences. The backlash is driven by horror 
     stories of health care plans that won't pay for emergency 
     care, by anecdotes of cancer referrals denied or delayed, by 
     firsthand stories about a mother, a sister, a neighbor, a 
     friend.
       We have gotten the big picture as well. About 15 percent of 
     the population accounts for 80 percent of the medical bills. 
     In the phrase Glasser used in the March issue of Harper's, 
     HMOs are ``a Ponzi scheme'' in which the premiums have to 
     keep ahead of claims.
       But the backlash scenario presents the HMOs with a dilemma. 
     On the one hand, employers and employees may choose a system 
     based on how it treats the very ill. On the other hand, HMOs 
     want to enroll the very healthy.
       In general, managed-care companies have shown the public 
     relations skills of Ken Starr. In the past year or so, we've 
     had reports of outpatient breast surgery and drive-through 
     deliveries. All we've seen in return is HMO defensiveness.
       Now politicians who read the papers and go to the movies 
     are playing catch-up. There have been about 1,000 bills in 
     state legislatures to protect the consumers from the 
     managers.
       In Washington, Congress is still dithering around with 
     various forms of a patients' bill of rights, with Republican 
     leadership trying to stall, duck, and weave. But it is 
     getting pushed closer to a law that would provide for an 
     external appeal to those denied care, access to emergency 
     room, and an ombudsman program.
       As for the HMO's those folks who brought us Harry and 
     Louise are now warning us about Frankenstein. The latest ads 
     say, ``Washington: Be careful how you play doctor, you might 
     mandate a monster.''
       A monster? It's the unmandated, unregulated system that has 
     now produced the horror movie running in everybody's head. 
     Any way you look at health care, even in a darkened theater, 
     this is not as good as it gets.
                                  ____


          [From the St. Louis Post-Dispatch, January 12, 1998]

HMOS May Highlight Hot Topics in Legislature; Bills Would Target Myriad 
                        of Patients' Complaints

       State Rep. Thomas Holbrook, D-Beltsville, got a preview of 
     what may lie ahead in this year's Illinois legislative 
     session when he saw the new Jack Nicholson movie, ``As Good 
     As It Gets.''
       In one scene, co-star Helen Hunt, playing the mother of a 
     chronically ill boy, spouts vulgarity about a health 
     maintenance organization that is refusing to give her son the 
     treatment he needs.
       ``She starts railing on this HMO, and people in the theater 
     actually stood up and started applauding,'' Holbrook recalled 
     last week. ``When's the last time you saw that happen in a 
     theater? That's not an undercurrent, it's a tidal wave.''
       Proposals to make HMOs more user-friendly to consumers are 
     among the major issues likely to face Illinois legislators 
     when the year's legislative session opens Wednesday.
       Other potential topics include clamping more restrictions 
     on the campaign and contracting practices of state 
     politicians; continued controversy over hog farm waste; 
     discussions of new transportation projects in the Metro East 
     area; and minor adjustments to the major education funding 
     changes passed into law last year.
       Technically, this year is the second half of a two-year 
     legislative session. By legislative rule in Illinois, 
     legislators in the second, even-numbered years are supposed 
     to consider only budgetary matters and emergency issues.
       That has historically been among the most ignored rules in 
     state government, especially since even-numbered years are 
     also election years. And, with the Senate and House under 
     opposing parties--and with the House, especially, under a 
     razor-thin Democratic majority--much of the debate this year 
     is likely to be partisan and acrimonious.

[[Page S9350]]

       Most legislators predict there will be few concrete changes 
     on the books after the dust clears.
       ``There's no question there will be election-generated 
     bills . . . but it will just be window-dressing,'' said Rep. 
     Kurt Granberg, D-Carlyle. ``Mainly, I think it's going to be 
     a budget year.''


   among this year's likely topics of debate in the legislature: hmos

       The House last year passed several bills that would have 
     regulated how HMOs deal with their patients and member 
     doctors. Most of that legislation has remained stalled in the 
     Senate but could be called up again through the end of this 
     year.
       One measure, labeled the ``Patient Bill of Rights'' by its 
     supporters, would require that insurance companies provide 
     certain information to patients, would set up a formalized 
     grievance process and would make other changes to the HMO 
     industry.
       ``There seems to be a real ground swell about this,'' said 
     Holbrook, a co-sponsor of the bill. HMO expenses and alleged 
     lack of responsiveness to patients have ``become such a 
     glaring atrocity.''
       Not everyone agrees with that assessment. But even 
     Republican Senate President James ``Pate'' Philip of Wood 
     Dale, who has prevented most HMO-related legislation in the 
     past year from coming up for a Senate vote, is likely to open 
     the subject to debate this year.
       ``We're going to find out what's out there,'' in the way of 
     legislation, said Patty Schuh, Philip's spokeswoman. ``This 
     is an issue that hits everyone.''
       Propoents of the changes believe public frustration will 
     work in their favor in an election year.
       ``That truly has a chance at moving forward,'' said Rep. 
     Jay Hoffman, D-Collinsville. ``I see bipartisan support.''

  Mr. INOUYE addressed the Chair.
  The PRESIDING OFFICER. The Senator from Hawaii is recognized.
  Mr. INOUYE. Mr. President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. ABRAHAM. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.

                          ____________________