[Congressional Record Volume 145, Number 130 (Thursday, September 30, 1999)]
[Senate]
[Pages S11721-S11724]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




  DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND 
          RELATED AGENCIES APPROPRIATIONS ACT, 2000--Continued

  Mr. SPECTER. Mr. President, will the Senator from Nevada, Mr. Reid, 
give me his attention? We have a sense-of-the-Senate resolution to be 
offered by Senator Inhofe; and then we have 10 minutes for an amendment 
to be offered and then withdrawn. We need consent to set aside your 
amendment. Or perhaps you are ready to withdraw that amendment?


                     Amendment No. 1807, Withdrawn

  Mr. REID. I say to the manager of the bill, I have not received 
assurance yet that I will have a hearing. To expedite matters, I will 
agree to withdraw my amendment. But I want everyone to understand there 
is an amendment pending, a sense-of-the-Senate resolution, on the same 
issue. Rule XVI does not apply, of course, against my sense of the 
Senate. But in order to expedite matters, I withdraw my amendment. I 
will bring up, whenever we get back to this bill, my sense-of-the-
Senate resolution on the exact same material.
  Mr. SPECTER. I thank the Senator from Nevada.
  The PRESIDING OFFICER. Without objection, it is so ordered. The 
amendment is withdrawn.
  Mr. SPECTER. Then in our sequence, we have an amendment by the 
Senator from Oklahoma.
  Mr. INHOFE addressed the Chair.
  The PRESIDING OFFICER. The Senator from Oklahoma.


                           Amendment No. 1816

 (Purpose: To express the sense of the Senate regarding payments under 
   the prospective payment system for hospital outpatient department 
                  services under the medicare program)

  Mr. INHOFE. I have an amendment at the desk and I ask for its 
immediate consideration.
  The PRESIDING OFFICER. The clerk will report.
  The legislative clerk read as follows:

       The Senator from Oklahoma [Mr. Inhofe] proposes an 
     amendment numbered 1816.

  Mr. INHOFE. I ask unanimous consent reading of the amendment be 
dispensed with.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The amendment is as follows:

       At the appropriate place, insert the following:

     SEC. __. SENSE OF THE SENATE REGARDING PAYMENTS UNDER THE 
                   PROSPECTIVE PAYMENT SYSTEM FOR HOSPITAL 
                   OUTPATIENT DEPARTMENT SERVICES.

       (a) Findings.--The Senate finds the following:
       (1) The Balanced Budget Act of 1997, in order to achieve 
     the objective of balancing the Federal budget, provided for 
     the single largest change in the medicare program under title 
     XVIII of the Social Security Act

[[Page S11722]]

     (42 U.S.C. 1395 et seq.) since the inception of such program 
     in 1965.
       (2) Reliable, independent estimates now project that the 
     changes to the medicare program provided for in the Balanced 
     Budget Act of 1997 will result in the reduction of payments 
     to health care providers that greatly exceeds the level of 
     estimated reductions when such Act was enacted.
       (3) Congressional oversight has begun to reveal that these 
     greater-than-anticipated reductions in payments are harming 
     the ability of health care providers to maintain and deliver 
     high-quality health care services to beneficiaries under the 
     medicare program and to other individuals.
       (4) One of the key factors that has caused these greater-
     than-anticipated reductions in payments is the inappropriate 
     regulatory action taken by the Secretary in implementing the 
     provisions of the Balanced Budget Act of 1997.
       (5) The Secretary of Health and Human Services, contrary to 
     the direction of 77 Members of the Senate and 253 Members of 
     the House of Representatives (stated in letters to the 
     Secretary dated June 18, 1999, and September 14, 1999, 
     respectively), has persisted in interpreting the provisions 
     of the prospective payment system for hospital outpatient 
     department services under section 1833(t) of the Social 
     Security Act (42 U.S.C. 1395l(t)) in a manner that would 
     impose an unintended 5.7 percent across the board reduction 
     in payments under such system.
       (b) Sense of the Senate.--It is the sense of the Senate 
     that the Secretary of Health and Human Services should--
       (1) carry out congressional intent and cease its 
     inappropriate interpretation of the provisions of the 
     prospective payment system for hospital outpatient department 
     services under section 1833(t) of the Social Security Act (42 
     U.S.C. 1395l(t)); and
       (2) eliminate the unintended 5.7 percent across the board 
     reduction in payments under such system.


                    amendment no. 1816, as modified

  Mr. INHOFE. Mr. President, I ask unanimous consent to modify the 
amendment in accordance with the modification at the desk.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The amendment, as modified, is as follows:

       At the appropriate place, insert the following:

     SEC. __. SENSE OF THE SENATE REGARDING PAYMENTS UNDER THE 
                   PROSPECTIVE PAYMENT SYSTEM FOR HOSPITAL 
                   OUTPATIENT DEPARTMENT SERVICES.

       (a) Findings.--The Senate finds the following:
       (1) The Balanced Budget Act of 1997, in order to achieve 
     the objective of balancing the Federal budget, provided for 
     the single largest change in the medicare program under title 
     XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) 
     since the inception of such program in 1965.
       (2) Reliable, independent estimates now project that the 
     changes to the medicare program provided for in the Balanced 
     Budget Act of 1997 will result in the reduction of payments 
     to health care providers that greatly exceeds the level of 
     estimated reductions when such Act was enacted.
       (3) Congressional oversight has begun to reveal that these 
     greater-than-anticipated reductions in payments are harming 
     the ability of health care providers to maintain and deliver 
     high-quality health care services to beneficiaries under the 
     medicare program and to other individuals.
       (4) One of the key factors that has caused these greater-
     than-anticipated reductions in payments is the inappropriate 
     regulatory action taken by the Secretary in implementing the 
     provisions of the Balanced Budget Act of 1997.
       (5) The Secretary of Health and Human Services, contrary to 
     the direction of 77 Members of the Senate and 253 Members of 
     the House of Representatives (stated in letters to the 
     Secretary dated June 18, 1999, and September 14, 1999, 
     respectively), has persisted in interpreting the provisions 
     of the prospective payment system for hospital outpatient 
     department services under section 1833(t) of the Social 
     Security Act (42 U.S.C. 1395l(t)) in a manner that would 
     impose an unintended 5.7 percent across the board reduction 
     in payments under such system.
       (b) Sense of the Senate.--It is the sense of the Senate 
     that the Secretary of Health and Human Services should--
       (1) carry out congressional intent and cease its 
     inappropriate interpretation of the provisions of the 
     prospective payment system for hospital outpatient department 
     services under section 1833(t) of the Social Security Act (42 
     U.S.C. 1395l(t)).

  Mr. INHOFE. Mr. President, when the Balanced Budget Act of 1997 was 
passed, there was a misinterpretation by the Health Care Financing 
Administration of this bill--while it should have been revenue 
neutral--to have regular reductions in the amount of reimbursement that 
goes to hospitals, specifically a 5.7-percent reduction to 
reimbursement that would take place in July of the year 2000. This was 
not the intent of the Members of the Senate.
  I have a letter that has 77 signatures on it, including those of each 
Senator who is in the Chamber right now, stating that was not the 
intent. This is a sense-of-the-Senate resolution saying that was not 
the intent so we would not be having that 5.7-percent reduction in July 
of the year 2000.
  Mr. SPECTER addressed the Chair.
  The PRESIDING OFFICER. The Senator from Pennsylvania.
  Mr. SPECTER. Mr. President, I commend the Senator from Oklahoma for 
the sense-of-the-Senate resolution. I think it is meritorious. It has 
been cleared by the ranking member on the Democratic side.
  Mr. REID. We have not had a chance to clear this with our leader. I 
apologize to the manager of the bill. We have not cleared this with the 
leader, so I can't agree to it.
  Mr. INHOFE. Mr. President, if the Senator from Pennsylvania would 
yield?
  Mr. SPECTER. I do.
  Mr. INHOFE. I suggest to the Senator from Pennsylvania, both Senator 
Daschle and Senator Reid have signed the letter asking for this same 
thing we have in the sense of the Senate.
  Mr. REID. It is pretty persuasive.
  Mr. SPECTER. Do you want to check?
  Mr. REID. I withdraw our objection.
  The PRESIDING OFFICER. The question is on agreeing to the amendment, 
as modified.
  The amendment (No. 1816), as modified, was agreed to.
  Mr. REID. If I could have the floor for a second.
  I say to my friend from Oklahoma, that was one of the most persuasive 
arguments I have heard on the Senate floor.
  Mr. SPECTER. Mr. President, the final order of business this evening 
on the pending bill is an amendment to be offered by the Senator from 
Kansas, Mr. Brownback, for purposes of 10 minutes of discussion, and 
then it will be withdrawn. So I leave the floor in the hands of Senator 
Brownback for that 10-minute presentation and withdrawal.
  The PRESIDING OFFICER. The Senator from Kansas.


                           Amendment No. 1833

   (Purpose: To establish a task force of the Senate to address the 
                    societal crisis facing America)

  Mr. BROWNBACK. I call up an amendment at the desk numbered 1833 and 
ask for its immediate consideration.
  The PRESIDING OFFICER. The clerk will report.
  The legislative clerk read as follows:

       The Senator from Kansas [Mr. Brownback] proposes an 
     amendment numbered 1833.

  Mr. BROWNBACK. I ask unanimous consent reading of the amendment be 
dispensed with.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The amendment is as follows:

       At the end of the bill insert the following:

         TITLE __--TASK FORCE ON THE STATE OF AMERICAN SOCIETY

     SEC __01. ESTABLISHMENT OF THE TASK FORCE.

       (a) Establishment.--There is established a task force of 
     the Senate to be known as the Task Force on the State of 
     American Society (hereafter in this title referred to as the 
     ``task force'').
       (b) Purpose.--The purpose of the task force is--
       (1) to study the societal condition of America, 
     particularly in regard to children, youth, and families;
       (2) to make such findings as are warranted and appropriate, 
     including the impact that trends and developments have on the 
     broader society, particularly in regards to child well-being; 
     and
       (3) to study the causes and consequences of youth violence.
       (c) Task Force Procedure.--
       (1) In general.--Paragraphs 1, 2, 7(a) (2), and 10(a) of 
     rule XXVI of the Standing Rules of the Senate, and section 
     202 (i) of the Legislative Reorganization Act of 1946, shall 
     apply to the task force, except for the provisions relating 
     to the taking of depositions and the subpoena power.
       (2) Equal funding.--The majority and the minority staff of 
     the task force shall receive equal funding.
       (3) Quorums.--The task force is authorized to fix the 
     number of its members (but not less than one-third of its 
     entire membership) who shall constitute a quorum for the 
     transaction of such business as may be considered by the task 
     force. A majority of the task force will be required to issue 
     a report to the relevant committees, with a minority of the 
     task force afforded an opportunity to record its views in the 
     report.

     SEC. __02. MEMBERSHIP AND ORGANIZATION OF THE TASK FORCE.

       (a) Membership.--

[[Page S11723]]

       (1) In general.--The task force shall consist of 8 members 
     of the Senate--
       (A) 4 of whom shall be appointed by the President pro 
     tempore of the Senate from the majority party of the Senate 
     upon the recommendation of the Majority Leader of the Senate; 
     and
       (B) 4 of whom shall be appointed by the President pro 
     tempore of the Senate from the minority party of the Senate 
     upon the recommendation of the Minority Leader of the Senate.
       (2) Vacancies.--Vacancies in the membership of the task 
     force shall not affect the authority of the remaining members 
     to execute the functions of the task force and shall be 
     filled in the same manner as original appointments to it are 
     made.
       (b) Chairman.--The chairman of the task force shall be 
     selected by the Majority Leader of the Senate and the vice 
     chairman of the task force shall be selected by the Minority 
     Leader of the Senate. The vice chairman shall discharge such 
     responsibilities as the task force or the chairman may 
     assign.

     SEC. __03. AUTHORITY OF TASK FORCE.

       (a) In General.--For the purposes of this title, the task 
     force is authorized, in its discretion--
       (1) to make expenditures from the contingent fund of the 
     Senate;
       (2) to employ personnel;
       (3) to hold hearings;
       (4) to sit and act at any time or place during the 
     sessions, recesses, and adjourned periods of the Senate;
       (5) to procure the services of individual consultations or 
     organizations thereof, in accordance with the provisions of 
     section 202(i) of the Legislative Reorganization Act of 1946; 
     and
       (6) with the prior consent of the Government department or 
     agency concerned and the Committee on Rules and 
     Administration, to use on a nonreimbursable basis the 
     services of personnel of any such department or agency.
       (b) Other Committee Staff.--At the joint request of the 
     chairman and vice-chairman of the task force, the chairman 
     and the ranking member of any other Senate committee or 
     subcommittee may jointly permit the task force to use, on a 
     nonreimburseable basis, the facilities or services of any 
     members of the staff of such other Senate committee or 
     subcommittee whenever the task force or its chairman, 
     following consultation with the vice chairman, considers that 
     such action is necessary or appropriate to enable the task 
     force to make the investigation and study provided for in 
     this title.

     SEC. __04. REPORT AND TERMINATION.

       The task force shall report its findings, together with 
     such recommendations as it deems advisable, to the relevant 
     committees and the Senate prior to July 7, 2000.

      SEC. __05. FUNDING.

       (a) In General.--From the date this title is agreed to 
     through July 7, 2000, the expenses of the task force incurred 
     under this title--
       (1) shall be paid out of the miscellaneous items account of 
     the contingent fund of the Senate;
       (2) shall not exceed $500,000, of which amount not to 
     exceed $150,000 shall be available for the procurement of the 
     services of individual consultants, or organizations thereof, 
     as authorized by section 202(i) of the Legislative 
     Reorganization Act of 1946 (2 U.S.C. 72a(i)); and
       (3) shall include sums in addition to expenses described 
     under paragraph (2), as may be necessary for agency 
     contributions related to compensation of employees of the 
     task force.
       (b) Payment of Expenses.--Payment of expenses of the task 
     force shall be disbursed upon vouchers approved by the 
     chairman, except that vouchers shall not be required for 
     disbursements of salaries (and related agency contributions) 
     paid at an annual rate.

  Mr. BROWNBACK. Mr. President, I appreciate the Senator from 
Pennsylvania accommodating our desires tonight. The reason we offer 
this amendment is to discuss it briefly and then withdraw it as being 
subject to a point of order on this particular bill.
  I rise to explain the amendment.
  What this amendment regards is the establishment of a 1-year, 
actually less than 1-year, Senate task force to study the state of 
American society. There has been a lot of discussion going on about 
this. I want to spend a little bit of time discussing what this is and 
what it isn't because I think both are important.
  We are proposing this task force, Senator Lieberman, Senator 
Moynihan, and myself, the Presiding Officer, a number of others, 
because we believe there is a deep and pressing need to examine in a 
manner that is bipartisan, intellectual, rigorous, dispassionate, and 
publicly accessible, the cultural and social health of our society.
  It is a simple and undeniable fact that our families and children, 
schools, and communities have been subjected to seismic shifts over the 
last 30 years. These changes have had consequences--consequences which 
deeply impact the public, including the formation of public policy, 
which deserve a public forum in which to study and address them.
  First, if we take a quick look at what is happening across America, 
in the last 2 years, we have seen one school shooting after another: 
Conyers, GA; Littleton, CO; Richmond, VA; Paducah, KY; Springfield, OR; 
Edinboro, PA; Pearl, MS; and Jonesboro, AR. Unfortunately, the list 
goes tragically on. We just wonder where next.
  There are other warning signs. The number and percentages of the 
children who live in broken homes continues to increase, regrettably. 
Reports of domestic abuse and child abuse are at shocking levels.
  One of our colleagues and cosponsors of this bill, Senator Moynihan, 
once coined a memorable phrase. He talked about our society in terms of 
``defining deviancy down.'' What he meant--and, Senator Moynihan, 
correct me, if I am incorrect--is that when behavior that was once 
considered deviant or outrageous becomes more ordinary and commonplace, 
societies tend to redefine deviancy.

  This is such a classic and clear example. For example, in 1929, four 
gangsters killed seven unarmed bootleggers. The slaughter was 
considered so horrific that the event was dubbed the ``St. Valentine's 
Day Massacre.'' Remember that one? It was 1929; seven unarmed 
bootleggers were slaughtered. It was so horrifying it got its own name, 
shows, everything, and made news around the world. It so shocked and 
horrified the Nation that it has become a well-known historical event. 
It is even in most encyclopedias--seven people, 1929.
  In sharp contrast, let's look to just 2 weeks ago, when a gunman 
strode into a church in Fort Worth, TX, puffing a cigarette, and 
slaughtered six defenseless people, including several children, before 
turning the gun on himself--just as many people, one less, killed in 
that Fort Worth church as in the St. Valentine's Day Massacre. Yet that 
story, so far from making it into an encyclopedia, didn't even get a 
headline in the Washington Post. Why? Why is it that we no longer 
consider outrageous what is truly outrageous? Perhaps it has become too 
commonplace. It has become common on our streets and airwaves. It is 
both the reality in which many live, and it makes up the entertainment 
into which many escape.
  Over the past 30 years, there are many ways we have made progress as 
a country and as a people. Our economy has grown tremendously. 
Technological advances have been unprecedented. New doors of 
opportunity have been opened to people previously denied access. The 
opportunities available to women and minorities have increased, and 
they need to increase even further. But in the midst of unprecedented 
prosperity, there is a widespread belief that we live in a mean society 
where families are breaking down, children are more prone to crime, 
violence, alienation, drug use and suicide, and our civic fabric is 
fraying. In fact, not only does the United States lead the world in 
material wealth, it also leads the industrialized world in rates of 
murder, violent juvenile crime, abortion, divorce, cocaine consumption, 
pornography production, and consumption of pornography. These facts 
have not been lost on the American people--far from it. Poll after poll 
shows they recognize it.
  I draw the attention of the body to some of the polls that have 
recently come out. Here is one: What poses the greatest threat to the 
United States? You can look through here: recession at 30-plus percent; 
decline of moral values, much higher; military, don't know. That was 
October 30 of last year.
  Here is one from May 3 of this year: Where does the country face the 
most serious problems today? Moral values area, 56 percent; next 
closest, environment at 12 percent. Fifty-six percent of the public 
considering that. That was by a different research group than did the 
last one.
  Here is one done by the Princeton Survey Research Group, July 22 of 
this year: What priority should be given to dealing with the moral 
breakdown of the United States? Fifty-five percent say top priority 
should be given.
  My only point in showing these polls is that this is something the 
American public considers important, indeed, vital for us to be 
considering. We need to address it in this body. This is not to say 
that all societal changes have been negative. Far from it.

[[Page S11724]]

  As I noted earlier, there are many causes for hope, even celebration. 
But there are causes for concern taking place as well. Even where our 
challenges remain stark, I am personally optimistic. I believe for 
every problem in America, there is a solution already in place, usually 
by an individual or family or community with the heart to make it 
happen.
  I hope this task force will encourage the replication of those 
solutions, but first and foremost, my hope is that by working together 
we can begin to better understand where we are as a society and where 
we are headed.
  Senator Moynihan, again, made a point that I think is true: You can't 
change a problem until you can figure out how to measure it. You need 
to be able to measure to know when you are making progress on what is 
happening. That is the stage at which we find ourselves. We know 
something is happening in our society, but we don't know yet how to 
accurately measure it. We are still struggling with asking the right 
questions.
  My hope and intention is that this task force would begin the 
important and necessary work of measuring these issues and asking the 
right questions.
  I want to talk about some of the specifics of the task force, what it 
is and what it isn't.
  There have been a lot of rumors spreading around about this. First, 
this task force will conduct the important business of investigating 
and analyzing and examining the state of our culture the causes and 
consequences of our societal difficulties, and possible solutions. It 
will hold hearings on such topics as civic participation, the state of 
the family structure, the impact of popular culture on young people, 
the causes of youth violence, and innovative and effective initiatives 
that have reduced various social problems that we have.
  It will look at these issues in a holistic and a broad manner and--
let me emphasize this--a bipartisan manner. It will not hold 
legislative jurisdiction. It will not report out or mark up 
legislation. It will not intrude on people's personal lives or seek to 
impose a set of values on anyone. It aims to achieve a better 
description of what is going on in our society, not a prescription of 
morals. It seeks to inform and investigate, rather than to legislate.
  I know there were concerns among some of my colleagues about 
provisions regarding subpoena power. Let me assure all of them, those 
have been taken out. This endeavor will be a task force of concerned 
Members working together to get a better sense of the condition of our 
society. The task force is bipartisan in purpose, process, and 
structure, as bipartisan as possible. It is composed of eight members: 
four Republicans, four Democrats. You can't get much more bipartisan 
than that.
  Together, I hope we can take a good look at what is going on in our 
society, at the state of the cultural environment in which we currently 
reside. While these are not legislative issues, they are important 
public issues with profound consequences, both in terms of public 
policy and in our daily lives.
  This is an important task. I look forward to the counsel and support 
of my colleagues in getting to this important work. We have tried to 
bend over backwards to work in a bipartisan way to get this moving 
forward. We are still working to get this pulled together. I hope my 
colleagues will continue to talk with us about this, about how we can 
do this and how we can work together to address this very important 
problem.


                     Amendment No. 1833, Withdrawn

  Mr. President, as I stated at the outset, as the Senator from 
Pennsylvania noted, I realize this will be subjected to a point of 
order. I wanted to bring it up and discuss it.
  With this discussion, I withdraw my amendment at this time.
  The PRESIDING OFFICER. Without objection, the amendment is withdrawn.
  The amendment (No. 1833) was withdrawn.
  Mr. President, I suggest the absence of a quorum.
  The legislative clerk proceeded to call the roll.
  Mr. SESSIONS. Mr. President, I ask unanimous consent that the order 
for the quorum call be dispensed with.
  The PRESIDING OFFICER (Mr. Brownback). Without objection, it is so 
ordered.

                          ____________________