[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

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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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