[Congressional Record Volume 146, Number 73 (Tuesday, June 13, 2000)]
[Senate]
[Pages S4974-S4978]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
THIS WEEK'S AGENDA
Mr. DURBIN. Mr. President, I am happy to be in the Chamber this
morning to address the issues that are going to be considered before
the Congress this week.
One of the most important issues that I found in my home State of
Illinois, and I think can be found in virtually every State in the
Union, is the prescription drug benefit under Medicare. They are
telling us, the people who do this for a living, that when they ask
families across America what is one of the major issues you are going
to look to when it comes to electing the President of the United States
or electing a Member of Congress, one of the major issues that comes
forward is the prescription drug benefit. It is understandable because
the Medicare program, as good as it is--in fact, it has been there for
40 years as the health insurance program for the elderly and disabled--
does not have a prescription drug benefit. You would not buy a health
insurance plan for your family today that didn't include one because
you never know when you are going to be subjected to an illness that a
doctor will need to treat with an expensive prescription drug. They can
become very expensive. It is not uncommon to spend $50, $100, even
several hundred a month to maintain a certain drug that keeps you
healthy.
When we constructed Medicare, we didn't put a prescription drug
benefit in the plan. That was 40 years ago. Today, seniors are finding
themselves extremely vulnerable. They will go to a doctor and say: I
have a problem. The doctor says: I know just the thing; here is a
prescription. They will find out they can't afford to fill the
prescription. So a lot of seniors on limited, fixed incomes, make a
hard choice and say, I may not be able to take this prescription or
maybe I will fill it and only take half. The net result, of course, is
that the senior doesn't get well, doesn't get strong. In fact, they can
see their health deteriorate simply because they can't afford to fill
their prescriptions.
The irony, of course, is that if a senior can't buy the drugs they
need to stay healthy and they end up in the hospital, guess what. The
taxpayers step in and say Medicare will pay for that. In other words,
if someone gets sick because they don't have prescription drugs, we
will pay for it. If seniors have to go to the hospital, taxpayers pay
for it.
We on the Democratic side believe that we need to do two things. We
need to put a prescription drug benefit in Medicare that gives to
senior citizens and the disabled peace of mind that when they need
these prescription drugs, they will have help in paying for them. That
is something everyone expects from a health insurance plan. It should
be the bottom line when it comes to Medicare, as well.
The Democratic side has been pushing this literally for years. We
believe that is something this Congress should have done a long time
ago. Sadly, we have had no cooperation, none whatever, from the
Republican side of the aisle. They do not believe this is a critical
and important issue. We have tried our very best to bring this issue to
a vote on the floor. We have tried both in the House and the Senate.
They have blocked us every single time.
Who would oppose a prescription drug benefit? On its face, why would
anybody oppose that? It will help seniors. It will mean they will buy
prescription drugs.
There is another issue. If we just passed a prescription drug benefit
and did not address the pricing of drugs, the system would clearly go
bankrupt in a hurry. In other words, if the drug companies can continue
to raise their prices--as they are doing now almost on a monthly
basis--and we say we will pay whatever they charge, no program will
last.
We have to combine with the prescription drug benefit program a
pricing program, as well. Americans know this. I go to senior citizen
gatherings in my State and they understand what is going on in the
world. They know if they happen to live in the northern part of the
United States and can drive across the border into Canada, they can buy
exactly the same drug--made in the United States, by the same company,
subject to the same Federal inspection--for a fraction of the cost.
What costs $60 for a prescription in the United States costs $6 in
Canada because the Canadian Government has said to American drug
companies: If you want to sell in our country, we are not going to let
you run the prices up. There is a ceiling. You have to keep your prices
under control. We will make sure you don't gouge the customers in
Canada.
We don't have a law such as that in the United States. Therefore, the
seniors in this country pay top dollar for prescription drugs. People
in Canada, people in Mexico, people in Europe, get the same drugs from
the same companies at a deep discount. I might add, as well, in this
country the health insurance companies bargain with the same drug
companies, saying, if you want to have your drugs prescribed by our
doctors in our plan, we will not let you keep raising the prices on
them. Of course, that is part of the reality.
Every group in America has a price mechanism, a price competition,
except for the most vulnerable in America--the senior citizens and the
disabled on Medicare. They pay top dollar for prescription drugs. When
they can't pay it and they can't fill the prescription, they can't
maintain their health as they should.
We believe, on the Democratic side, that we need a prescription drug
benefit plan. We need to also address the question of pricing to make
sure these drugs are affordable, so that the drug companies treat
Americans at least as fairly as they treat Canadians. I don't think
that is unreasonable.
Many times, we taxpayers, through the National Institutes of Health,
have put the money on the front side of research to find these drugs.
The drug companies profit from the research, as they should, but they
also have an obligation to the people of the United States to price
these drugs fairly.
We have an obligation to create a prescription drug benefit under
Medicare. But this has been a one-sided discussion to this date. The
Democrats have pushed this plan, and the Republicans have resisted it.
Lo and behold, the people on the Republican side of the aisle have
decided to start asking American families, what do they think is
important? I have in my hand polling data provided to the Republican
conference in the House of Representatives. They went on to find in the
course of their polling that they have been dead wrong on this issue,
that the American people consider this to be one of the most important
issues in America today and in this election. The Republicans, in
resisting the Democratic plan, have missed the most important issue for
seniors and their families.
What are they proposing? They want to change it in a hurry. They
don't want to come on board and work out a bipartisan plan based on
what the Democrats have been pushing for, for
[[Page S4975]]
years. No. Their plan is to come forward with a so-called prescription
drug plan that buys them enough time to get through the election, a
plan that is a sham and a phony, a plan that does not address the real
needs for prescription drug benefits for seniors. They are not offering
prescription drugs. They are offering sugar pills. They are offering
placebos. That will not keep America healthy.
As you read the things they have recommended to the people involved
in this on the Republican side of the aisle, they say one of the things
you have to do is make sure you keep talking about this issue, make
sure you empathize and tell people how much you feel for this issue.
It isn't ``feel good'' politics that Americans need. They need
results. They need a bipartisan plan that really does help seniors. In
the next few days, if you see, as we expect, this presentation by the
Republican leadership in Congress that they have finally discovered the
prescription drug benefit issue and they have finally come up with a
plan, you have an obligation, as I do, to ask them to prove it will
work, prove it will make certain that senior citizens who need help in
paying for prescription drugs get that assistance. Make certain it
isn't a phony that is just buying time until the election.
If you hear the Republican leadership, new-found convert to this
issue, coming up with rhetoric that we haven't heard for years, don't
be surprised. Their polling data has told them they are dead wrong, the
Democrats are right on this issue and the Republicans have missed the
boat.
It is our obligation in Congress to work with those people who have
been involved on this issue for years, to make certain that any
prescription drug benefit plan is real, it addresses the needs of
seniors and disabled across America, it is affordable, and it will work
to maintain the quality of care we expect in this country.
These health care issues will turn out to be the biggest issue in
this Presidential campaign. Yesterday, the Supreme Court decided again
that managed care companies don't have an obligation to their patients
to find out that they get the best quality care as doctors recommend.
Their obligation is to profit and bottom line because of existing
Federal law. On this case, as well, on prescription drug benefits, the
families across America are the ones who are vulnerable.
Mrs. BOXER. Will the Senator yield?
Mr. DURBIN. I am happy to yield to the Senator.
Mrs. BOXER. I thank my friend for again putting this issue of
prescription drugs into context.
I am sure my friend would agree it isn't unusual for political
parties to take polls. However, I think what my friend is trying to
say--and I hope every American can see this document I am holding in my
hand, this poll. This so-called ``research,'' done with the Republicans
over on the House side, is a document that says it all. It is the most
cynical document I have ever seen since Newt Gingrich had the same
thing done when he took over the House, when they told the Republicans
what words to use, not what bills to pass, not what would make a good
piece of legislation to help the millions of Americans who need help,
no, but how to get them reelected and kowtow to their friends in the
insurance business, the HMOs, and so on. If the American people could
just read this document, things would change around here. I am hoping
they will read this document.
I ask unanimous consent to have this document printed in the Record.
There being no objection, the material was ordered to be printed in
the Record, as follows:
[A Presentation to the House Republican Conference, June 8, 2000]
A Prescription Drug Plan for Stronger Medicare
(By Glen Bolger, Public Opinion Strategies)
passing a bill is a political imperative
Prrescription drug coverage is one of the Democrats' ``Four
Corners: offense for winning back the House--along with
health care, education, and Social Security.
We have a good messages on the other issues.
It is imperative that Republicans hang together on this
issue and pass a bill. It is helpful if we can be bi-partisan
in our approach.
On a list of 18 issues that might decide how people plan to
vote for president, ``helping elderly Americans get access to
prescription drugs'' might appear to be a mid-tier issue as
``only'' 73% say it is one of the most important/very
important in deciding how they might vote.
However, the issue has enormous appeal for Democrat
candidates:
Democrats enjoy a huge generic advantage as the party best
perceived as being able to handle this issue.
The prescription drug issue allows the Democrats to not
only mobilize key sub-groups that are part of their political
base, but the issue also is of importance to key sub-groups
who are ``up for grabs'' in the 2000 election.
Of course, chief among these ``up for grab'' sub-groups are
seniors who rank this issue in the top three or four that
they say will determine their vote.
Top issues for the 2000 Presidential election
Percent
Preserving Social Security and Medicare..............................83
Stopping insurance companies from making health care decisions.......82
Improving the quality of public education............................81
The economy and jobs.................................................80
Keeping students safe................................................76
Crime and illegal drugs..............................................76
Controlling federal spending.........................................76
Improving the access to affordable health care.......................76
Restoring respect to the office of president.........................73
Helping elderly Americans get access to affordable prescription drugs73
Pushing for higher academic standards................................73
Keeping taxes lower..................................................66
Reducing the power of big money in Washington........................61
The environment......................................................59
Guns.................................................................54
Dealing with moral values............................................54
Defending America's interests around the world.......................51
Abortion.............................................................38
The issue of ``helping elderly Americans get access to
affordable prescription drugs'' favors the Democrats because
the issue is very important to their core base as well as to
groups that are ``up for grabs'' to both parties (swing
voters).
TOP SUB-GROUPS ON ISSUE
------------------------------------------------------------------------
Core Democratic Base ``Up For Grabs'' Voters
------------------------------------------------------------------------
HS or Less Rural Residents.
Women Less Than College Rural Women.
Conservative Democrats White Women.
Moderate/Liberal Democrats South Residents.
Clinton '96 Voters New England Residents.
Urban Residents Women.
Urban Women Working Women.
Democrats Homemakers.
African Americans Age 55-64.
Environmentalists Age 65+.
Not on the Internet Women 18-34
60+ Retired Women.
------------------------------------------------------------------------
DEMOCRATS HAVE A CLEAR ADVANTAGE ON THESE ISSUES
[. . . tell me if you think as President . . . the Republican candidates
or the Democratic candidates would do a better job of handling this
issue, or if there is no difference between them on this particular
issue]
------------------------------------------------------------------------
In percent
---------------------------------
Issue Difference
Republican-Democrat score
------------------------------------------------------------------------
Improving the quality of public 33-39 -6
education............................
Reducing the power of big money in 25-37 -12
Washington...........................
Stopping insurance companies from 21-41 -20
making health care decisions.........
Preserving Social Security & Medicare. 26-47 -21
The environment....................... 18-48 -30
Helping elderly Americans get access 20-53 -33
to affordable prescription drugs.....
Improving the access to affordable 19-53 -34
health care..........................
------------------------------------------------------------------------
focus group findings
Seniors trust Medicare. They don't believe it is in
financial danger--they perceive that claim to simply be a
scare tactic.
Democrats will want to position Republicans as allied with
the pharmaceutical companies and insurance companies against
senior citizens. That's a positioning you need to
aggressively reject.
Upset seniors don't believe politicians (especially
Republicans) understand how important and concerning this
issue is to them. Message: ``I care'' (but say it better than
that). It is more important to communicate that you have a
plan as it is to communicate what is in the plan.
key points from the focus groups
The main concern seniors have with a prescription drug plan
is the impact on cost. Many seniors know the medicinal
equivalent of HMO horror stories--they know other seniors who
have to choose between paying for food or for prescription
drugs.
``Republicans aren't doing anything to help seniors.''
Seniors like the idea of a voluntary plan, and do NOT want
to lose their own plan. They also want to have choices.
Catastrophic coverage is very important to communicate.
Even seniors who currently have a good plan are worried about
what might happen down the road.
democratic attack messages
We tested multiple messages for the Democrats to attack
Republicans on this issue. Here are the most salient attack
messages:
``Republicans are putting more seniors into HMOs. HMOs
provide terrible care, and this isn't fair to seniors.''
[[Page S4976]]
``Republicans are in the back pocket of HMOs, insurance
companies, and pharmaceutical companies. Republicans are out
to protect these special interests, not the real interests of
senior citizens.''
Don't ignore these charges.
messages to attack democrats
The Democrat plan has some potentially fatal weaknesses:
It is politicians and Washington bureaucrats setting drug
prices.
It is a one-size-fits-all plan that is too restrictive, too
confusing, and puts the politicians and Washington
bureaucrats in control.
It will take most seniors out of the good private drug
coverage they have today.
phrases that work
Too many senior citizens are forced to choose between
putting food on the table and being able to afford the
prescription drugs they need to stay alive. In our great
nation, this is morally wrong.
We must take action to strengthen Medicare by providing
prescription drug coverage for all seniors so nobody gets
left behind.
While ensuring that all Medicare recipients have access to
prescription drug coverage, we must make sure that our senior
citizens also maintain control over their health care
choices.
We should not force seniors into a federal government-run,
one-size-fits-all prescription drug plan that's too
restrictive, too confusing, and allows politicians and
Washington bureaucrats to make medical decisions.
Our plan gives all seniors the right to choose an
affordable prescription drug benefit that best fits their own
health care needs.
Our plan protects low-income seniors by giving them
prescription drug coverage, and offers ALL other seniors a
number of affordable options to best meet their needs and
protect them from financial ruin.
By making it available to everyone, we're making sure that
no senior citizen or disabled American falls through the
cracks.
Because our plan is voluntary, we protect seniors already
satisfied with their current prescription drug benefit by
allowing them to keep what they have, while expanding
coverage to those who need it.
We will not force senior citizens out of the good private
coverage they currently enjoy--that's why our plan gives
individuals the power to decide what's best for them.
A stronger Medicare with prescription drug coverage is a
promise of health security and financial security for older
Americans and we're working to ensure that promise is kept.
America's seniors deserve no less.
Mrs. BOXER. I ask my friend if he has read the page that says ``Focus
group findings.'' Again, focus groups aren't unusual. You bring people
together and ask them to respond. I ask my friend about a couple of
these points.
They say: Upset seniors don't believe politicians, especially
Republicans. They don't believe that, especially Republicans,
understand how important and concerning this issue of prescription
drugs is to them.
This pollster, I am sure, made a lot of money to produce this
document for my friends on the other side says. The pollster says:
Message: I care.
That is the message he wants Republicans to make:
I care (but say it better than that). I care (but say it
better than that).
Then he says:
It is more important to communicate that you have a plan as
it is to communicate what is in the plan.
What I want to say to my friend is this. After reading this, I expect
they are going to come up with some phony deal that looks like a
prescription drug plan. My friend has made a point: If that plan does
nothing to make these prescription drugs affordable, what does it do
for our people other than turn them off?
I say to my friend, he knows people in this country are going to
Canada to get prescription drugs. He discussed that. I know some are
going on the Internet and trying to get drugs from Mexico, prescription
drugs, because they cannot afford them here.
The ultimate question, after making my comments, is this. This
document goes through the fact that the Democrats are doing really well
on these issues. Do you know why? Because the American people know we
have a real plan on this. They don't think we are perfect because
nobody is perfect, but we have a plan on this. The Republicans know
they are going to lose this election unless they get a plan. So they
tell their people to use certain expressions.
Can my friend share with us some of his expressions? It says: How to
talk about this issue. Our friends on the other side are told how to
talk about the issue, what expressions to say in addition to ``I
care.'' Maybe my friend will share some of that with the people?
Mr. DURBIN. I am happy to. I say to the Senator from California, this
is not unusual. I don't want to mislead people. Democrats take polls as
well. We took polls years ago and found out that families really cared
about the issue, and we came up with a plan, and literally for years we
have been trying to bring this issue to a vote in the Senate and House
of Representatives. The Republican leadership has stopped us. They
stopped us because the drug companies want to continue to make the
money from the seniors and others across this country who pay top
dollar for their prescription drugs.
So as we pushed this, year after year, we could never find
cooperation on the Republican side of the aisle. The deathbed
conversion we are witnessing here now reflects the fact that an
election is looming and the Republicans understand they are in a bad
position. They have taken a position that is unpopular, unwise, and
just plain wrong.
Take a look at some of the polling data: Preserving Social Security
and Medicare is the top issue in the Presidential election campaign.
Stopping insurance companies from making health care decisions is the
No. 2 issue in the Presidential campaign, according to Republican
polls.
They have been on the wrong side on both of these. In addition, the
No. 2 issue for the Republicans in terms of the Presidential election
is helping elderly Americans get access to affordable prescription
drugs. Now that they realize they are wrong on the issue and it is
going to be a major issue in every campaign, they are rushing to come
up with a strategy.
The American people don't want a political strategy; They want a law
passed that will help these families. They understand these seniors go
into their pharmacies on a daily basis and make a life-and-death
decision about filling a prescription drug. The Republicans have said
in this polling document that they have to attack the Democrats. That
is part of this. Say you have a plan, even though you don't tell people
what it is, and then turn around and attack the Democrats. Say it is
politicians and Washington bureaucrats who are trying to set drug
prices.
That language is straight out of the pharmaceutical companies' own
platform on this issue. They don't want to have their prices affected.
When the prices are in any way controlled or regulated, you have a
Canadian situation where Canadian citizens pay a fraction of what we
pay in the United States for the same drugs. So create this image,
according to the Republican strategy, in the minds of Americans, that
anytime we talk about pricing, it is just too much of Washington
bureaucrats and politicians.
Then they say attack the Democrats plan as a
a one-size-fits-all plan that is too restrictive, too
confusing, and puts the Washington bureaucrats in control.''
The one-size-fits-all language is because the Democrats believe this
should be a universal plan so people really have a chance to receive
help in paying for prescription drugs. You will find the Republican
plan cuts off people at levels where, frankly, they are vulnerable and
cannot afford to pay for prescription drugs. It also says: Attack the
Democrats and say most seniors will be taken ``out of the good private
drug coverage they have today.''
Let me concede something. About a third of seniors do have good
private drug coverage, a third have mediocre coverage, and a third have
no protection at all. I think we can take that into account. But the
bottom line is, if you happen to be a fortunate senior because, for
example, you worked for a company with a union that gave you good
health care benefits when you retired, that is good for you. I have met
those folks. But so many others, two out of three, do not have that
benefit. We want to make sure everybody in America is protected. Take a
close look, a careful look, at the Republican alternative. You are
going to find they leave literally millions of seniors behind.
The drug companies want it that way. They don't want prices affected.
They don't want a major plan. They believe they can create some kind of
insurance protection for the seniors. I can tell you pointblank,
insurance
[[Page S4977]]
company executives have met with us and said already the Republican
proposal will not work. That is the bottom line.
Mrs. BOXER. Will my friend yield further?
Mr. DURBIN. I will be happy to yield.
Mrs. BOXER. The other interesting number here is that the Republicans
have found out, much to their chagrin, that Democrats have a 34-percent
advantage--in the Republicans' own poll here--on improving the access
to affordable health care and a 33-percent advantage on prescription
drugs. So they take this information but they don't say, You know what,
the Democrats are right on these issues. Let's go over to their side of
the aisle. Let's call on President Clinton. He has been talking about
protecting Medicare and so has Vice President Gore, and prescription
drugs. Let's work together now.
They don't do that. They set out a document here that instead of
saying: We just found out President Clinton is right; We just found out
the Democrats have been right; We have just found out that Al Gore is
right when he says we need a Medicare lockbox. So maybe they cross the
aisle? Maybe they come over here and visit us, we join hands, and go
down the aisle together here and cast some votes for the people for a
change? No. That is not the way they see it.
They get this information and they basically do what my friend
suggested. They are going to use the right words. They are going to
attack us, they are going to scare people, and they are going to go
home and say they have done something.
I hope every American family can see this document today. In a way, I
feel badly about it because it will build cynicism, but I will say
this: The information in this document could be used to do the right
thing. It is quite unfortunate that our friends on the other side of
the aisle, instead of taking this information, recognizing they are
wrong and joining us and President Clinton and Vice President Gore,
they are going to create a sham plan for prescription drugs. They are
going to say they are protecting Medicare while doing nothing. Sadly,
the American people will lose, unless they make some changes around
here.
I thank my friend.
Mr. DURBIN. I say to my friend from California, this phrase says it
all. This is the advice given by the pollsters and consultants for the
Republican leadership when it comes to the prescription drug issue. It
has already been made part of the Congressional Record, but it is there
for the world to see, and I want to quote one line and one line only to
tell you what the bottom line message is:
It is more important to communicate that you have a plan as
it is to communicate what is in the plan.
If you talk about the cynicism people feel about politicians and
campaigns, that hits the nail on the head. In other words, don't
describe it, don't tell people what it is going to do for families
across America, just tell them you care, tell them you have a plan.
That is the thing I think turns people off the most.
If the Republicans have a better idea, for goodness' sake, come
forward with it. Let's debate it. That is what this is supposed to be
about.
We have a plan. We are willing to debate it. We are willing to stand
up for it on the floor. I believe in it. I will campaign for it in
Illinois and any other place. But to come up with an idea, a few words
to try to gloss over this so people forget before the election what
this is about, is really a mistake.
Here is something else I want to note in the Republican consultants'
document to the Congressional Republican leadership:
Prescription drug coverage is one of the Democrats' ``Four
Corners: offense for winning back the House--along with
health care, education and Social Security.
That is a quote directly. Yes, it is true. I would say that pollster
has really hit the nail on the head. This is exactly what we are trying
to do. We are trying to focus this election campaign, not on negative
slam ads, not on personal attacks, but on four basic issues. For
goodness' sake, we are willing to stand up and say this is what our
vision of America will be. We look at this country and we feel blessed.
We live in one of the greatest nations in the history of the world.
We feel doubly blessed that we are living in such good times for most
Americans. This is a period of economic prosperity unparalleled in our
history. One cannot find this long a string of good economic progress
in the history of the United States.
Who can take credit for it? First and foremost, Americans and
families can take credit for it because they work hard every day. They
start the businesses. They teach the kids. Those things have paid off.
That is where the credit belongs, first and foremost.
From a policy viewpoint, credit also has to be given to those people
who make good decisions when it comes to our economy. We made a good
decision in the Senate and in the House as well in 1993 when President
Clinton said: The first thing we will do is reduce the deficit. Once we
bring that deficit under control, we think the economy will move
forward.
We could not get a single Republican in the House or the Senate to
vote with us on that. Only the Democrats voted for it and Vice
President Gore, sitting in the Presiding Officer's chair, cast the tie-
breaking vote to reduce the deficit and move us forward. And it worked.
Critics on the other side of the aisle, a Republican Senator from
Texas, said this was going to create an economic disaster for America.
He has a little egg on his face today because for 7 years it has
created just the opposite: economic prosperity. That was a good
decision.
Tough decisions from the Federal Reserve Board regarding interest
rates, for example, have kept inflation under control.
We are moving forward. We believe on the Democratic side that we
cannot stand back and say we deserve election and reelection because of
all the good things we did in the past. That is not good enough. If any
party deserves election or reelection, it is because they learned the
lessons of history and they have a vision of the future.
The vision tells us to take the surplus we are generating in our
Treasury and pay down the national debt, a debt of almost $6 trillion
that cost us taxpayers $1 billion a day in interest payments. That is
right, the payroll taxes they are taking out of your paycheck and
taking away from businesses and families across America to the tune of
$1 billion a day do not educate a kid, they do not buy anything to
enhance the security of America. That money is used exclusively to pay
interest on old debt.
Think about it. We are paying interest on the debt for things we
bought years ago that we have already built and maybe have used. We on
the Democratic side believe that the fiscally prudent thing to do, the
responsible thing to do is to take our surplus and reduce that $6
trillion debt. I want to say to my kids and my grandson: The best
legacy I can leave you is less of an American debt so that you do not
have to carry my burdens into your generation.
I believe that makes sense, and that is what Vice President Gore has
stood for: To reduce America's national debt and to strengthen Social
Security and Medicare as we do that to make sure those two systems are
there for years to come.
If we just stop at that point, we would not be doing enough. We have
to have a vision for this next century and ask, What decisions can we
make as leaders of Government in Washington today to create
opportunities for tomorrow?
It comes down to the four basic issues already identified by the
Democrats and acknowledged by the Republicans.
First, health care in America. It is disgraceful in America that we
still have tens of millions of people who have no health insurance.
Think about their vulnerability: an accident, an illness, and all the
plans they have made for their life just fall apart. They have medical
bills they cannot possibly pay. People are in a vulnerable position
because we have not addressed health care in America. We believe we
need to address health care when it comes to not only coverage of
health insurance but prescription drug benefits for the elderly and
disabled under Medicare and, most basically to make sure medical
decisions are made by doctors and not by insurance companies.
Yesterday, the Supreme Court of the United States ruled in an
important
[[Page S4978]]
case involving an HMO, a managed care company, in my State of Illinois
at the Carle Clinic. A woman called the Carle Clinic in Bloomingdale,
IL, and reported she was having pains in her stomach. They said: We
would like to examine you. Why don't you come in in 8 days.
Before she could go to the clinic her appendix burst, and she went
through a terrible situation and a terrible recuperation in the
hospital.
She came to learn that this plan, as so many other managed care
plans, actually rewarded doctors financially if they showed more profit
for the company as opposed to providing quality health care. The bottom
line was making money. The bottom line said let the lady wait at home
for 8 days and see if she still complains instead of bringing her into
the office for an examination.
She sued them. She said: I thought I could trust you. I thought that
was the bottom line when it comes to the health insurance company. The
bottom line was profit, and it was made at my expense. I paid for it in
a hospital stay.
The Supreme Court said: You cannot do anything about it. Congress
passed legislation that said managed care companies can do that and you
cannot sue them. Your right against these companies is extremely
limited. That is a Federal decision.
That is a decision that should be changed. That is one Democrats have
pushed for on Capitol Hill for years and the Republican leadership has
blocked it. These insurance companies are making big dollars. They are
big special interest groups. They are big players on the Washington
political scene. They do not want anybody changing these rules. That is
why they have resisted, and that is why we have done literally nothing
in the Senate and the House to deal with these abuses.
Education: Can anyone think of anything in the 21st century more
important than education in America? I cannot. We are going to have a
debate in the near future on trade. It is a hot issue. There are many
who believe globalization and free trade are part of America's future,
part of the future of the world. To resist trade is to resist gravity:
It is going to happen.
The question is, How will we respond to it? Many workers are
concerned that if there is expanded trade, they might lose their jobs.
Companies will take their plants and move them overseas, and folks who
have good jobs today will not have them tomorrow. Shouldn't we as a
nation acknowledge that, whether the jobs are lost to trade or
technology? Shouldn't we be putting in place transition training and
education so workers do not have to fear this inevitable change in the
economy?
We are not hearing any suggestions on this from the Republican side.
They do not believe there should be a Federal role when it comes to
education and training. They talk about it being State and local. It
has been historically, but we have had Federal leadership that has made
a difference on these issues. We believe on the Democratic side we
should continue to do that.
I will tell my colleagues about another related issue. We know from
the best companies in America that the single biggest problem they have
today is not estate taxes; it is not a tax burden under the code. The
single biggest problem they have today is jobs they cannot fill with
skilled workers.
I hear that in Illinois everywhere I go. I was in Itasca yesterday
with the Chamber of Commerce. That is their concern as well. We have to
acknowledge the fact there are good paying jobs unfilled in America
because we do not have skilled workers to fill them.
What do we do about it? Wait for the market to create an answer? I
hope we will do more. In 1957, when the Russians launched Sputnik and
we were afraid we were going to lose the space race, this Congress
responded and said: We will respond as a nation. We will create the
National Defense Education Act. We are going to encourage young people
to get a college education to be scientists, to be engineers, to
compete with the Russians. We did it. It was an investment that paid
off handsomely. We created an engine for growth in the American economy
that not only made certain the private sector had the people they
needed but also sent a man to the Moon and so many other achievements
unparalleled in the history of the world.
Why are we not doing the same thing today? Why are we not
acknowledging we need to make an investment at the Federal level to
help pay for college education so kids have a chance to become
tomorrow's scientists and engineers, leaders of the 21st century so we
do not have to import computer experts from India and Pakistan?
The PRESIDING OFFICER (Mr. L. Chafee). The Senator's time has
expired.
Mr. DURBIN. I yield the floor.
The PRESIDING OFFICER. The Senator from Pennsylvania.
Mr. SANTORUM. Mr. President, I am going to take 15 minutes of the
time set aside for the Senator from Wyoming.
The PRESIDING OFFICER. Without objection, it is so ordered.
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