[Congressional Record Volume 144, Number 118 (Wednesday, September 9, 1998)]
[Senate]
[Pages S10094-S10099]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




         CONSUMER BANKRUPTCY PROTECTION ACT--MOTION TO PROCEED

  The Senate continued with the consideration of the motion.
  Mr. KENNEDY addressed the Chair.
  The PRESIDING OFFICER (Mr. Coats). The Senator from Massachusetts.
  Mr. KENNEDY. Mr. President, as I understand the parliamentary 
situation, we are in the post-cloture period, which allocates up to one 
hour to each Member of the Senate. Am I correct?
  The PRESIDING OFFICER. The Senator is correct.
  Mr. KENNEDY. Mr. President, I yield myself such time as I might use.
  Mr. President, we have just a few moments ago decided as a Senate to 
consider the bankruptcy legislation that was reported out of the 
Judiciary Committee a few weeks ago. I mentioned at the time that this 
measure was being considered by the leadership, that I had hoped we 
would have the opportunity at the time that the leadership was 
considering calling up the bankruptcy legislation to consider other 
legislation that had been pending for some period of time.
  The legislation that I was hoping would be considered is the 
Patients' Bill of Rights. It has been introduced by the Democratic 
leader, Senator Daschle, and supported by a number of us. Or, 
alternatively, I had hoped that the Senate would have been able to 
accept the proposal of the minority leader, Senator Daschle, that we 
would lay down before the Senate the Republican managed care proposal 
that passed the House of Representatives in July. This would have 
provided us with an opportunity to debate an issue that is enormously 
important to families in this country.
  I mentioned before, the bankruptcy legislation deals with 1,200,000 
people or occasions in this country per year. The Patients' Bill of 
Rights, however, affects 160 million Americans. The concerns that these 
families have are very real and very powerful.
  Time and again, we hear of insurance company abuses that cripple or 
kill patients in states around the country. Yet, the response of the 
Republican leadership has been, well, you can either take it or leave 
it. That's it. Take the alternative that is advanced by the Republican 
leadership--which allows one vote on Senator Daschle's bill, one vote 
on the Republican bill, and perhaps three other amendments, but no more 
than those amendments in number that are designated by the majority 
leader--or leave it and do nothing. Mr. President, this proposal 
effectively gags the Senate from having full debate and discussion on 
this legislation. But, we have been told that was the position of the 
leadership and that was what we were going to be stuck with.
  Mr. President, this is unsatisfactory because it excludes the 
opportunity to debate the major differences that exist between the 
Republicans and the Democrats on the issues of health care.
  I have here before me a comparison of each of the patient protection 
bills--the proposal that has been advanced by the Republicans, and also 
the Patients' Bill of Rights proposal introduced by the Democrats. At 
the heart of this debate is a very simple concept: Are medical 
professionals, the doctors and nurses, going to make the health care 
decisions that affect patients? Or are

[[Page S10095]]

insurance company accountants going to make those judgments and make 
those decisions, which is the case in too many instances in our country 
today? We believe that in all of these circumstances medical decisions 
ought to be made by the health professionals who have been trained, 
qualified, and certified to be able to deal with the health care 
challenges that will affect our families in this country.
  We believe there should be a prohibition on gag practices; access to 
emergency rooms when there is a need for services, which is not 
guaranteed in too many instances today; access to the Ob/Gyn providers; 
the ability to keep your doctor; and guaranteed access to the 
specialists, including out-of-network providers, when those needs are 
important.
  We believe that there should be standing referrals to specialists or 
that specialists should be allowed to act as primary care providers 
when that is important for particular patients, such as cancer 
patients, or persons with disabilities or HIV; the ability to have 
access to doctor-prescribed drugs when the various formularies override 
a physician's decision; and access to clinical trials, which are 
absolutely essential for patients who have life-threatening 
conditions--such as breast cancer-- that have failed to respond to 
conventional therapies. The failure to promote and cover routine costs 
for participation in these clinical trials is something that the Senate 
ought to make some judgment and decision about.
  The interesting point about clinical trials is that it really is not 
more costly to the HMOs, because the drug and biotechnology companies 
or the government continue to assume the burden for the 
experimentation. The HMOs are simply asked to shoulder their fair share 
of the routine costs that the patient would incur anyway. So it really 
is not costly to the HMOs to guarantee this access to clinical trials. 
We ought to have the opportunity to debate that here on the floor of 
the U.S. Senate.
  We ought to be able to ensure there is going to be protection for 
patient advocacy, and that we are going to have information on plan 
quality. People need to understand which plans present themselves to be 
quality plans, and which do not. And, perhaps most importantly, there 
should be a clear right to a timely and independent appeal process and 
the ability to hold health plans accountable for their actions. These 
are the areas of public policy that we ought to have an opportunity to 
debate and discuss.
  We have not heard from the Republican leadership what particular 
aspect of this list, which basically includes the President's 
reservations about the Republican proposal, that they object to. All 
they say is: We are not going to debate it. We are not going to discuss 
it. You can get one amendment, two amendments, three amendments, but we 
are just not going to tie the Senate up to debate these particular 
measures, even though these are the items which have been embraced by 
not just Members of the U.S. Senate but by nearly 190 organizations 
across this country that represent--who? Represent the Congress? The 
Senate? No. They represent the doctors, represent the nurses, represent 
the researchers, represent the patients and consumers.
  Nearly every single major and minor consumer group has effectively 
endorsed the proposal that we have advanced, and we have not heard of a 
single group that has endorsed or embraced the Republican proposal--not 
one. Not one. They do not have a single group--doctors or patients or 
nurses or health delivery professionals--that endorses their proposal. 
All of them endorse ours. Yet we are told by the Republican leadership 
that you are going to be denied the opportunity to even raise these 
issues in an orderly way, to have debate and discussion and an outcome 
decided on the floor of the U.S. Senate.
  These are the areas that need to be discussed. These are the gaps in 
the Republican bill. Some of them probably could be worked on through 
an agreement--not a great number. But they certainly are the ones that 
have been mentioned and identified by the health professionals in this 
country that are essential if we are going to provide quality health 
care for the American people. And we are denied this. We are being 
stonewalled, those of us who believe the patients' interests should be 
advanced. The Republican leadership have closed us out. They say, ``No. 
No.''
  They don't mind getting consideration for the bankruptcy bill. They 
don't say we will take the bankruptcy bill up, but there are only X 
number of amendments. No. They just went ahead and scheduled the 
bankruptcy bill, which, interestingly, is supported by major financial 
institutions and credit companies that have spent over $50 million in 
support of the legislation. Whom does that bill protect? It protects 
the banking and the financial interests over, I believe, the interests 
of the consumers. So we have seen that legislation that protects big 
business is on the fast track, and the legislation that protects 
patients and families is being denied the floor of the U.S. Senate for 
debate and discussion.
  I do not think, in the remaining time that we are here, outside of 
the various appropriations bills, there is any piece of legislation 
that is more important than this legislation. But we have been in a 
constant position now, for week after week after week, month after 
month after month.
  We were denied the opportunity to get even a markup in the relevant 
committee, in the Human Resources Committee. We were denied an 
opportunity to consider this as an amendment on other legislation. We 
have been denied the opportunity to have a full debate and discussion. 
We are told, ``You take it or leave it. You take the three-amendment 
strategy or you just do not get any debate or discussion.'' That is not 
satisfactory. Although the leadership has been able to prevent us from 
the opportunity of having that kind of debate and discussion up to this 
period of time, they will not be successful in denying us the chance to 
have the kind of debate that we need in order to protect the consumers 
of this country.
  So I think we have, again, missed an extraordinarily important 
opportunity to do the public business, to do the people's business, to 
try to do something about the quality of health care for the American 
people. We here this evening would like to give the assurance to the 
American people, as the leader has, as our Democratic leader has, that 
we will have the opportunity one way or the other to have consideration 
of this legislation before we adjourn. We should be able to do it in 
the way in which we deal with important legislation, where we call the 
legislation up and move toward the consideration of these various 
amendments, trying to work through a timeframe to get the final 
resolution. The Democratic leader even indicated that we were prepared 
to deal with these issues at nighttime, at 6 o'clock tonight, 6 o'clock 
in the evening. There is no reason in the world that the Senate of the 
United States should not work tonight, from 6 o'clock to 10 o'clock, 
for the next 4 hours, debating these particular issues, and do so 
tomorrow night, too. We could have done it last night as well. There is 
no reason, no reason in the world. If we believe this legislation is 
important, why aren't we here debating this issue tonight? What is so 
important, in terms of Members' schedules, that we are not debating or 
discussing this?
  I have been in the Senate for a period of time and we have had 
evening sessions. We have had two-track sessions many, many times. At 
this time in the session when there is important legislation to 
consider, Senator Daschle has proposed that to the majority leader, 
saying, 6 o'clock this evening, why aren't we out here considering and 
debating these issues tonight for 3 or 4 hours and having resolution of 
those? But we have been told no, we cannot do that either. We cannot 
take the time this evening or tomorrow evening, or Friday evening, or 
next week, or any of the evenings of next week to try to deal with the 
issues on the Patients' Bill of Rights--no. We are told we will not do 
it. You are not entitled to have that kind of debate and discussion. 
Evidently, the public interest with regard to health care will not be 
considered by the Republican leadership.
  So we will be forced, as the leader pointed out, to take the 
extraordinary steps that can be taken from a parliamentary point of 
view to move ahead and consider this at another time. We will continue 
to press the leadership for that consideration, because we believe that 
this issue is of such overpowering importance to children, to women, to 
grandparents, to

[[Page S10096]]

members of the family, and it is essential that we deal with it. And we 
will, as our leader has pointed out.
  Now, we are told, as we are moving towards the consideration of the 
bankruptcy legislation, we will have a cloture motion filed so we will 
not be able to have debate on various amendments that are relevant to 
the issue at hand. They may not fall within the particular framework of 
the technical provisions of the cloture motion. So we are facing the 
prospect of another cloture vote coming up on this Friday.
  I am hopeful that we will be able to consider, on that particular 
piece of legislation, a modest increase in the minimum wage. But we are 
told that the leadership will not permit a debate or discussion on any 
increase in the minimum wage.
  I have been asked why we should consider having an amendment on 
increasing the minimum wage on this legislation. I have been asked, 
what is its relevancy to bankruptcy? The fact of the matter is that the 
average wage of people filing for bankruptcy is just over $17,000 a 
year. One of the principal reasons that individuals file bankruptcy is 
because their income has declined--their purchasing power has been 
reduced. No one in this Nation has seen a greater decline in their 
purchasing power than minimum wage workers.
  Mr. President, I have here a chart that reviews where the minimum 
wage has been in the past 40 years.
  As we can see, the real value of the minimum wage went up to $6, and 
then to $6.50, until it reached $7.38 in the mid to late 1960s. Again, 
it bounced up and down through the 1970s at about $6 or slightly above. 
Then we saw a continued decline down to $4.34 in 1989. We saw an 
increase again in 1991 and then the increases in 1996 and 1997 which 
brought it up to $5.15.
  The proposal I have made will increase the minimum wage in two 
stages--50 cents on January 1, 1999 and 50 cents on January 1, 2000. 
That will bring the nominal value of the minimum wage to $6.15, but the 
real value, because of inflation, will be only $5.76.
  Even if this body accepted the increase in the minimum wage, we would 
still be well below the historical value of the minimum wage for some 
20 years in the 1960s and 1970s. These individuals on the lower rung of 
the economic ladder, the men and women who work 40 hours a week, 52 
weeks of the year, hard-working men and women trying to provide for 
their families--they will still be earning well below what the minimum 
wage was worth for more than 20 years.
  This issue is a woman's issue, because 60 percent of all minimum-wage 
workers are women. It is a children's issue, because many, many of 
those women are single moms and, therefore, their income is going to 
dictate what they can provide for their children. It is a family issue.
  I will always remember the witness who described what an increase in 
the minimum wage would mean to her. She said, ``It is very simple, 
Senator, we will only have to work two jobs now instead of three.'' 
Only two jobs instead of three. What that means is increasing the 
ability of those parents to spend time with their children, increasing 
the ability of those parents to take a little time and work with their 
children on homework. The additional money may allow them to take their 
child to a ball game. Maybe they can afford a birthday present. Maybe 
they can afford to take a child out to dinner, or even see a movie. Of 
course, a vacation is completely out of reach--it is not even being 
considered.
  This is what I mean when I talk about family issues. We hear a great 
deal of discussion about family issues and about family values. The 
minimum wage is a family value. It is a working family value. It is 
saying to someone who works 40 hours a week, 52 weeks of the year that 
we are going to honor their work, and that in the United States of 
America working people are not going to live in poverty. These are 
family values.
  We are going to hear, Mr. President, when we get a chance to debate 
this--and I can understand why the Republican leadership does not want 
to permit us to debate it--we are going to hear that we don't need to 
have an increase in the minimum wage. The market will take care of 
these workers. If we do increase the minimum wage, opponents will claim 
it will add to inflation and unemployment. This is against the 
background of the most extraordinary economic growth in the history of 
this country, with the greatest prosperity, the lowest inflation, the 
lowest unemployment in a generation. We will hear, ``We can't afford 
it; we're going to lose jobs.'' We will hear that from Members of 
Congress who have experienced an increase in their own salary of more 
than $3,000 only last year.
  We will hear, ``We just can't afford to do that for working 
Americans.'' It is the working Americans, the working poor who have 
fallen further and further behind in their purchasing power--further 
behind than any group in our society.
  I think some of us remember those wonderful charts Secretary Reich 
used to present at the Joint Economic Committee when he talked about 
the five different economic groups and what has happened in the postwar 
period from 1947 right up to 1979. And it showed that the wage rates of 
these groups increased at similar rates. Incomes of those at the lower 
rungs went up in percentages as high as if not higher than those at the 
highest levels. This is not true any more. It is the top 1 percent, the 
top 5 percent, the top 20 percent. Their incomes are going up through 
the roof. Those at the lower end have been going right down through the 
cellar. This is an issue that we have an opportunity to do something 
about.

  Mr. President, I want to take a moment to answer some of the 
arguments that will be made with regard to an increase in the minimum 
wage, of what that means in terms of inflation. When we debate this 
issue, I will review some of the statements that our friends and 
colleagues made during those final hours of the 1996 debate about the 
effect on inflation and unemployment of the increase. These were the 
most extraordinary statements. I will not take the time of the Senate 
to go through them now, but they are just so out of touch with reality 
that it really is extraordinary.
  Raising the minimum wage does not fuel inflation. This chart shows 
what the inflation rate was per month during the year or two before the 
increase in 1996. The rate of inflation was relatively flat between 
February of 1996 and October 1996. It was pretty flat--it held fairly 
steady at three-tenths of 1 percent per month.
  The minimum wage increased to $4.75, and look what happened to 
inflation. The rate stayed steady. In October 1996, the inflation rate 
was maintained at three-tenths of 1 percent. Inflation declined in 
December 1996, and then went up and down slightly between January and 
September 1997.
  Then the minimum wage increased in September 1997 to $5.15. Here we 
see the continued decline of inflation. In June of 1998 the inflation 
rate was one-tenth of 1 percent. This chart puts the lie to claims that 
the minimum wage increase added to the rate of inflation in the United 
States.
  I believe that the overwhelming power of this argument comes from 
notions of basic fairness and justice. But if the opponents are going 
to claim that increasing the minimum wage will increase inflation, let 
us look at what happened over the period of the last two increases, 
going back to October 1996 and then the increase in September 1997.
  Mr. President, I would like to consider at the other argument that is 
made in opposition. That is the claim that raising the minimum wage 
causes unemployment to rise.
  Opponents always say, ``If you increase the minimum wage, you're 
going to see a rise in unemployment.'' I will come to teenage 
unemployment in a minute. Unemployment overall declined dramatically 
since the minimum wage increased in October 1996.
  And then, after the minimum wage increased again in September 1997, 
unemployment continued to drop. Now we are at 4.5 percent unemployment, 
which is virtually the lowest unemployment level in a generation. Since 
1996, the nation has experienced the lowest rate of inflation and the 
lowest rate of inflation in a generation.
  So you cannot make the argument, Mr. President, that if we increase 
the minimum wage, it will add to the rate of inflation or add to the 
rate of unemployment.

[[Page S10097]]

  Mr. President, what is always said is, ``Well, all right, you don't 
really understand it. It is teenagers, teenage unemployment. They are 
the ones who really get squeezed.'' Let us look at teen unemployment, 
ages 16 to 19, over this same period. Before the minimum wage increase, 
you had some 16 percent teenage unemployment in 1996. Since the 1996 
and 1997 increases, it has dropped to 15 percent unemployment. The fact 
of the matter is, Mr. President, that about a quarter of those who earn 
the minimum wage are teenagers. Many of those teenagers are trying to 
go out and work their way through their first or second year of 
community college. They are teenagers. These kids, in many instances, 
are the ones who are trying to earn in order to continue their 
education. They need that increase as well.
  So, Mr. President, this chart makes the point that the total 
unemployment for teenagers is down.
  Mr. President, the greatest opposition to this has come from the 
retail industry. But retail employment has grown by leaps and bounds 
over this period. It is growing 31 percent faster. Before the minimum 
wage increased, from September 1995 to September 1996--394,000 new 
retail jobs were added. The minimum wage increased in October 1996, and 
then again in September 1997.
  This is a 1-year period before the minimum wage went up. From 
September to September, 394,000 new retail jobs were added. Then in the 
11 months after the increase took effect, 517,000 new jobs were added. 
This is very dramatic growth.
  The point about it is, Mr. President, that there is not a valid 
economic argument to be made. I wish we had the opportunity to engage 
in that debate on the floor of the U.S. Senate with those who are 
opposed to the increase because they claim they are concerned about 
teenage unemployment, about inflation and about the effect on people 
who work in retail stores and will lose their jobs. The facts belie 
those claims.
  Mr. President, we are talking about individuals who are still earning 
$2,900 below the poverty level for a family of three.
  What will this $1 an hour increase mean to minimum wage workers? It 
would buy almost 7 months of groceries. $1 an hour may not mean much to 
many in this country. Certainly, it doesn't mean a lot to the people 
who saw the stock market go up 370 points yesterday, gain over $1 
trillion in value in one day. Of course, all of us are glad to have 
seen the stock market go up these past few days.
  $1 an hour might not make so much difference to those who are 
investing in the stock market, but it represents about 7 months of 
groceries to an average family of four. It buys about 8 months of rent 
for that family. It pays three-fourths of a year's tuition and fees at 
a community college. It is a matter of enormous importance and it is a 
matter of critical need for working families.
  When you come right down to it, this issue is really about dignity. 
It is about dignity for individuals who can pay their bills. It is 
about dignity for people who don't have to go on welfare. It is the 
dignity of a family knowing they will not have their electricity or 
their water turned off because they can't pay the bill. Raising the 
minimum wage is really about dignity. It is about a sense of pride. It 
is the way parents look at children and the way children look at 
parents. This is an issue of fairness, an issue of whether we as a 
society honor work, for people who will work and want to work; those 
people who are the child-care helpers, the teachers' aides in our 
schools.
  We talk a great deal about education. Teachers' aides are important. 
Many of them earn the minimum wage. We talk about the importance of 
Medicare and Medicaid and making sure that our parents are going to be 
able to live in dignity. Much of that dignity is provided for by health 
aides who earn the minimum wage. The men and women who clean office 
buildings at nighttime, by and large, are minimum-wage earners. These 
are people who have a sense of dignity and pride in themselves, as they 
should.
  This is an issue of fundamental fairness. In the past, this body has 
responded. It has responded at other times when the minimum wage has 
sunk this low. It has responded with Republican and Democratic 
leadership, with Republican Presidents and Democratic Presidents, 
alike. But we are now being told by the Republican leadership that we 
are going to be denied the opportunity even to address this issue on 
the floor of the U.S. Senate. We are told, ``We will not give you the 
time.'' We will not have that debate tonight, here in the U.S. Senate, 
and vote at 10 o'clock tonight.
  What is more important to the 12 million Americans who would benefit 
from an increase than a debate this evening and a vote at 10 o'clock 
tonight? I can understand that many of my Republican colleagues don't 
want to vote on this issue. But that isn't a good enough reason. We are 
sent here to make choices. This is a choice that ought to be made in 
the light of day, or even in the evening, but it ought to be made here 
on the floor of the U.S. Senate. Parliamentary tricks should not be 
used to deny us the opportunity to address it. This is not a 
complicated issue, involving constitutional questions. This is a simple 
issue of fairness and justice. The Members of this body know it. The 
Members of this body understand it. We don't need any more hearings on 
this issue.
  People know what this issue is all about. It is simple and plain: 
Here in the U.S. Senate, are we going to take steps that will guarantee 
some fairness to American workers who need that increase and have been 
falling further and further behind? Are we going to say, as a society, 
that we are all going to move together, that we have a sense of common 
purpose and common direction? Will we make sure that our fellow 
citizens can participate in this extraordinary economic expansion? Or 
are we going to say, no, we will let you stay out there in the cold, we 
won't even debate any kind of increase? Sure, you are providing for 
your kids, but we will not even permit the U.S. Senate the opportunity 
to debate this and vote on this, up or down; up or down.
  Mr. President, that is why this issue is so important. I believe it 
is one of fundamental fairness. It is a defining issue. It has been a 
defining issue at other times, and it is at this time. I am hopeful 
that we could have a time to debate this issue. We are not interested 
in prolonged debate and discussion. As I mentioned, we would settle for 
a reasonable period of time to debate this and have a vote. It is not a 
complex issue. We are going to continue to pursue it because we believe 
it is right and it is just and it is fair. Those are values which I 
think most of us were sent here to uphold in the U.S. Senate.
  How much time remains?
  The PRESIDING OFFICER. The Senator has used 41 minutes 50 seconds.
  Mr. KENNEDY. I reserve the remainder of my time.
  Mr. REED. Mr. President, I ask unanimous consent to be recognized to 
use such time as I may consume with respect to bankruptcy reform.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. REED. Mr. President, today we have voted to move to consideration 
of the Bankruptcy Act. One of the sad but true causes of so many 
bankruptcies of families throughout this country is the fact that they 
are overwhelmed by medical bills. Now, this is obvious when it comes to 
those people without insurance, because for those people, getting sick 
in America not only means being ill, it also very often means going 
broke.
  But one of the other aspects that is startling to so many is that 
many families with insurance, particularly health maintenance 
organization insurance, find themselves in similar situations where the 
insurance they paid for, they thought they bargained for, evaporates 
when they actually have a health care crisis.
  That is why it is so very, very important to engage in a thorough 
debate and legislative action with respect to the Patients' Bill of 
Rights. I join all of my colleagues in issuing a challenge to the 
leadership of this body to bring up the Patients' Bill of Rights so we 
can debate it, we can consider it, and hopefully we can pass it.
  Indeed, we should be here tonight debating this worthy measure, or 
the minimum wage, as my colleague from Massachusetts, Senator Kennedy, 
has suggested, because that is truly the people's business. When I go 
back to Rhode Island, people are concerned about many things, but they 
are most

[[Page S10098]]

concerned about the status of the health care and about whether or not 
working families in my State and across this country can provide for 
themselves.
  The Patients' Bill of Rights, the legislation that we should be 
debating tonight, is about applying fair rules of the game to health 
care. When it comes to health care, consumers should get the health 
care they pay for and they should get it when they need it. But sadly, 
this is not always the case. In many cases, it is the exception to the 
rule. It is time for this Congress to accept the President's challenge 
and pass legislation to enact guarantees for quality health care in 
this country and important consumer protections.
  The Patients' Bill of Rights introduced by Democratic leader Daschle, 
protects patients' rights, while the opposing version introduced by 
Senator Lott and Senator Nickles leaves too many loopholes and does not 
provide adequate protections for consumers. By addressing only self-
funded, non-ERISA plans, the Lott-Nickles bill excludes 113 million 
Americans from the protections that are necessary, and, indeed, if you 
follow the logic of their bill, if a portion of Americans need 
protection in their health care plan, if a portion of Americans need 
these protections from insurance companies that are too much oriented 
toward the bottom line and not quality health care, why should all 
Americans in private health care plans not have these protections?

  That is what the Daschle bill does. It would provide coverage for all 
161 million Americans who aren't privately insured. This bill submitted 
by Leader Daschle provides full protection to patients, including, for 
example, access to specialists, pediatric specialists for children, 
coverage for emergency services, an internal and an independent 
external appeals process, and allowing patients to hold health plans 
accountable in court.
  All of these protections are important to the health and well-being 
of all Americans. And all of these protections deserve full debate and 
consideration on the floor of the U.S. Senate. Now, an offer of a 
single vote on the bill with an extremely limited opportunity for 
amendments is not the full, vigorous debate that this issue requires--
in fact, that this issue demands. The health care of the American 
people is too important to try to squeeze in between other issues here 
on the floor of the Senate. I think we should move today to bring up 
this legislation, debate it vigorously, pass it and send it forward. 
Our colleagues in the other body have done so. Now the challenge is 
with this body to move forward deliberately and purposefully to pass 
protections that will ensure quality health care and access to all 
Americans.
  There is a particular aspect of this debate that I am extremely 
interested in, which is ensuring that there are adequate protections in 
managed care plans for children. Too often, children are ignored in the 
preparation of these plans. Too often, pediatric illnesses are 
relegated to just another variation of adult illnesses. Too often, 
children are just seen through these lenses as smaller adults when, in 
fact, pediatric care is a very specialized part of the health care 
delivery system. And too often, parents discover that what they bargain 
for and what they thought they had in terms of protections evaporate 
when their child is ill.
  Earlier this year I introduced my own legislation that would ensure 
that children are not left out of this great debate about managed care, 
that children would, in fact, be the focal point of very specific 
procedures within managed care plans, that there would be access to 
pediatric specialists. A family could choose a pediatrician as a 
primary care provider, and pediatric specialists would evaluate 
outcomes relative to children. In working with the pediatric hospitals 
and with the American Academy of Pediatrics, I have come to understand 
the very specialized care that is necessary to deliver such care to 
children. Without such care, illnesses that may have been treated 
successfully and cheaply in children become traumatic and complicated 
illnesses that are more expensive and more threatening to the health of 
this child and later to that adult.
  My words are less compelling than the words of the people in my home 
State of Rhode Island who have dealt with this health care morass. A 
few weeks ago, I had the opportunity to share a podium with Dr. Karen 
LaMorge. She detailed the problems she had in getting adequate health 
care for her father and the fact that the insurance company would not 
provide a second opinion, and they would not make easy referrals to 
specialists. One of the great ironies of her story is that Dr. LaMorge 
is a podiatrist and, in fact, a member of the professional panels of 
this particular HMO. Now, she, a skilled professional, a provider 
herself, cannot easily and quickly get adequate care for her father.

  What happens to the average citizen who confronts this morass of 
regulations and rules and consents and approvals and daily calls and 
tracking down people to give the right approval? It becomes a daunting 
experience. Many, many Americans simply get exhausted trying to get 
basic health care for their families and themselves. Some give up. 
Others press on, enduring huge costs in time, efforts and energy. That 
is not the way our health care system should operate.
  With the Patients' Bill of Rights, we will go a long way toward 
ensuring that it doesn't operate that way, that there is an opportunity 
for high-quality care that is accessible and, indeed, also affordable, 
because, frankly, there is a lot of money being spent by these health 
care plans on administrators and bureaucrats. Maybe more could be 
directed to health care and to the American citizens.
  There is a particular aspect of this which I find particularly 
compelling, and I mentioned it before; that is, the aspect of pediatric 
health care. A few weeks ago, I had the opportunity to visit the 
Hassenfeld Children's Cancer Center at New York University Hospital in 
New York City. There I saw the care they are giving to dying children. 
I heard from the frontline professionals, the social workers, nurses, 
doctors, about the daily frustrations they face and endure in trying to 
get adequate care for these children from HMOs. The idea that they 
would spend days trying to get hospice care for a child who is dying, 
the idea that they would have to get daily approval and reapprovals for 
a course of treatment that is clear and obvious and has been prescribed 
is just an example of the state of this system, which is, in many 
respects, a crisis for so many families in this country.
  We can do better. We must do better. But we can only do that if we 
have the will. We must bring this legislation to the floor. We must 
bring this legislation to this floor promptly. There are few days left, 
but in those days it is our obligation to serve the interests of the 
American people. At the top of their list is a more rational, more 
appropriate health care system. We are within striking distance of 
that, if we just act.
  As I mentioned before, the other body has acted. It is our 
responsibility, our turn to step up to the plate and to get a greater 
hit than even Mark McGwire, because this hit will ensure that every 
family in America has good access to health care and will help that 
process to continue along. We should stay here tonight and every night 
and not simply make speeches with respect to this underlying bankruptcy 
bill, but actively debating and actively voting on, in a robust, wide-
open debate, HMO protections for the people of America. As Senator 
Kennedy suggested, we should also take up the minimum wage because 
that, too, is a way to address the real problems that face America.
  I hope that our resolution tonight would be to take up these 
measures, debate them fairly and honestly, and to vote and give the 
American people what they so desperately want and deserve--a health 
care system that works for them, and for those low-income working 
Americans a decent wage which will lift them out of poverty. I hope we 
do that. Certainly I think I and my colleagues will continue to urge 
that action on this Senate, and hopefully these words will take heart 
and take hold.

  Mr. President, I reserve the remainder of my time and yield the 
floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER (Mr. Brownback). The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. ROTH. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.

[[Page S10099]]

  The PRESIDING OFFICER. Without objection, it is so ordered.
  The Senator from Delaware is recognized.
  Mr. ROTH. I thank the Chair.
  (The remarks of Mr. Roth pertaining to the introduction of S. 2453 
are located in today's Record under ``Statements on Introduced Bills 
and Joint Resolutions.'')
  Mr. ROTH. Mr. President, I yield back the floor.
  Mr. DASCHLE addressed the Chair.
  The PRESIDING OFFICER. The Democratic leader.

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