[Congressional Record Volume 146, Number 136 (Thursday, October 26, 2000)]
[Senate]
[Pages S11107-S11111]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
H.R. 2614--CONFERENCE REPORT
Mr. BOND. Let me move to the bill before us. It has been thoroughly
covered with faint praise. Maybe it deserves a hearing in its own right
before this thing gets pasted all over the place. I would like my
colleagues and our constituents to know what is in it because I think
there are some good things in it.
The conference report on H.R. 2614, the Certified Development Program
Improvement Act, has grown over the past week to include not only a 3-
year reauthorization bill for the Small Business Administration, but it
includes extensive tax legislation, provisions to reform and improve
the Medicare program, and, as I mentioned, pension reform. We might
call this bill ``Small Business and Friends.'' A lot of important
luggage is being carried on the train that our little small business
bill is pulling.
As chairman of the Committee on Small Business, I will comment first
on the Small Business Reauthorization Act of 2000. This is, as I said
before, the result of many months of work by the Senate and House
Committees on Small Business. The bill is the conference agreement to
reauthorize most small business programs at the Small Business
Administration, and it reauthorizes the Small Business Innovation
Research Program.
To summarize the provisions briefly, this includes an 8-year
reauthorization of the Small Business Innovation Research Program, the
SBIR Program. This program was initially implemented in 1983 and allows
Federal agencies to award research grants and contracts to small
research firms. This is vitally important to develop the capacity in
the economy as a whole, and the country as a whole, to do high-quality
research needed by the Federal Government.
Some 50,000 SBIR awards have been made since the inception of the
program. It contains measures to ensure that small businesses receive
the appropriate allocation of Federal R&D funds, to require that
agencies retain more comprehensive information on the program's
operations that will improve its management, and to protect the
intellectual property of the small businesses that participate in the
program.
The conference report also establishes what we call the FAST program,
a matching grant initiative to provide incentives to States to assist
in the development of high-tech small businesses.
We have noted, particularly those of us from the heartland, that
companies on the east and west coasts generally receive the vast
majority of SBIR awards, while companies in the South, Midwest, and
Rocky Mountain States receive proportionally very few awards. Out in
the heartland, we, too, have technology. We have research capabilities.
The FAST program will help even out the concentration of the awards by
providing wide latitude to States to provide the type of help their
high-tech businesses need to succeed and create high-paying quality
jobs for their citizens.
The Small Business Reauthorization Act of 2000 also includes a
comprehensive reauthorization of the credit and management assistance
programs that are included in the broad umbrella of small business
programs administered by the SBA. The omnibus bill includes the
flagship 7(a) guaranteed business loan program, the Small Business
Investment Company program, and the Microloan program. Certain
improvements were made to the Microloan program championed by the
ranking member of the Committee on Small Business, the distinguished
Senator from Massachusetts, Mr. John Kerry. The Microloan program has
been expanded. We also included aspects which will be especially
beneficial to women-owned small businesses across the United States.
In addition, this extensive legislation would reauthorize and make
improvements in the management assistance programs, including the SCORE
and Small Business Development Center program. As a result of the
continuing oversight responsibilities of the Committee on Small
Business, the bill includes a significant improvement package for the
HUBZone program. This is a program which I was pleased to present and
have adopted by Congress, signed by the President, that provides set-
aside contracts to bring jobs and economic opportunity to areas where
there has been high unemployment and high poverty. This is a
geographically based program, which actually takes the jobs to the
communities that need them to help people get from welfare to work by
using the power of the Federal Government as a purchaser to create
business opportunities.
First and foremost, the bill, H.R. 5545, addresses the inadvertent
exclusion of Indian tribal enterprises and Alaska Native corporations
from the program. These provisions resulted from extensive negotiations
between
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the Committee on Small Business, the Committee on Indian Affairs, and
the Alaska congressional delegation. The HUBZone section of the bill
also seeks to clarify the effects of the HUBZone price evaluation
preference on commodity procurements in which the range of bid prices
tends to be small, and the HUBZone price evaluation preference would be
overwhelmingly decisive.
In addition, the legislation makes other improvements and
clarifications in a variety of SBA programs to make them more
effective. For example, there has been some confusion among the Federal
agencies about contract preferences for service-disabled veterans. This
bill would make it absolutely clear that service-disabled veterans are
on the same preference level as the small disadvantaged businesses and
women-owned small businesses for Federal contracting opportunities.
The conference report incorporates the new market venture capital
program of 2000. The purpose of this program is, similarly, to promote
economic development, new investment, and job opportunities in low-
income areas. It accomplishes this goal by providing incentives to
encourage small venture capital firms to invest in targeted low-income
communities and economically distressed inner cities and poor rural
counties.
This is a program that has been developed with bipartisan support.
This is certainly something that will assist us in this country in
getting more people off of welfare, making sure that job opportunities
go to the places and the people who most need them.
When the Congress enacted my HUBZone legislation 3 years ago, it
established the Federal contracting incentives to lure small businesses
into distressed cities and rural counties. I believe this new market
venture capital program will add an additional building block in our
strategy to make sure these economically distressed areas are
attractive to small businesses and that they will be able to bring job
opportunities and new vitality to these historically neglected areas of
the Nation.
As everybody now has heard from the other side, the conference report
does deal with taxes. I believe it is a great victory for the American
taxpayers. The tax portion has four sections. First, the legislation
includes the Foreign Sales Corporation Repeal and Extraterritorial
Income Exclusion Act of 2000. I can see that is going to be a real
winner. That title really rolls off your tongue, the FSC Repeal and
Extraterritorial Income Exclusion Act of 2000. That one will be a
winner. But it is must-do legislation, seriously. We have to do it by
November 1, if we are to avoid a potential trade war--at least
sanctions --with the European Union.
Second, the conference report includes a House-Senate compromise on
the Retirement Security and Savings Act of 2000, which has enormous
bipartisan support, having passed the House earlier this year by a vote
of 401-25 and being reported out of the Senate Finance Committee by
unanimous vote. That legislation includes sweeping changes encouraging
retirement savings, expanding pension coverage by increasing
contribution limits on IRA and other types of pension plans, increasing
portability, and providing meaningful relief for women who often take
time off to raise their families. And it contains a number of
provisions to reduce regulatory burdens that are very excessive and
will be especially helpful to small businesses, our constituency in the
Committee on Small Business.
The third part of the tax portion of the conference report is a
minimum wage increase and a package of small business tax provisions. I
raised questions about raising the minimum wage when it first came
here. I think it can be detrimental to small business. I do not believe
it is good economics. We know it is good politics. It is always nice to
promise somebody a raise, particularly when you don't have to come up
with the money that they are being paid. This is great election year
politics. I know everybody wants to do something. It makes you feel
good to give somebody a raise out of someone else's pocket.
The problem is, right now it probably won't hurt small businesses too
much because most small businesses I know of, if they are hiring
reasonably competent workers, have to pay well over the minimum wage.
The real downside is that the very people it is supposed to help are
the ones who may not get the jobs. Right now we see people who have
never had a job before, teenagers, first-time employees, perhaps
persons with disabilities, often minority students coming out of
college, have trouble getting jobs. If the minimum wage is raised, we
may see in the United States, as we do in Europe, high unemployment
among teenagers.
What the minimum wage does is make it very difficult to get on the
first rung of that ladder of economic progress. It is like putting
grease on that first rung of the ladder and saying, boy, this is going
to make it easy to slip onto that first rung. Unfortunately, the grease
on the first rung of the ladder too often slips people off, when
businesses find they just can't make a profit, hiring people at an
inflated minimum wage.
I hope we will continue, as a result of the economic and fiscal
restraint of the Republican-led Congress, if we can keep the economy
going as it has since the Republicans took control of the Congress
beginning in 1995, we hope that wages will continue to go up and
productivity will continue to go up so we don't need the minimum wage.
If the time comes when there are tight economic times, the victims of
the increased minimum wage will be the small businesses, the smallest
businesses, the ones with the lowest profit margin and the most needy
workers, the workers very often not supporting their families but
trying to get on the first rung of the economic ladder so they can
build a bank account and make enough money to start a family.
In addition to the minimum wage, however, there are small business
advantages from this bill. I appreciate the work of Chairman Roth to
include a significant package of small business tax relief items,
including something that has been my top priority since we began in
1995, and that is 100 percent deductibility of health insurance for the
self-employed starting in 2001. I have been working on it for over 5
years to ensure that the self-employed are on a level playing field
with their corporate competitors.
In the past we said, you can have it, but it was 2007 and then 2003.
A lot of self-employed people said: That is nice, but I can't wait
until 2007 or 2003 to get sick. Well, now I hope we will have it in
2001, so they will be able to afford the health insurance for
themselves and their families. Coupled with a new above-the-line
deduction for employees who pay for the majority of their health
insurance costs, we will now reach more than a million of the uninsured
and help them get the coverage they need and deserve.
Second is a repeal of the Clinton-Gore installment limitation, which
has been an unforeseen barrier to small businesses looking to sell all
or part of their business assets, in many cases to fund the small
business owner's retirement.
Third, a clear safe harbor for small businesses to use the cash
method of accounting. This has been a real nightmare for the smallest
businesses, to have to come up with accrual accounting. They are in
business to make widgets or sell hamburgers, not to be accounting
specialists who have to come up with an accrual system. Now small
businesses with gross receipts under $2.5 million can continue to use
cash accounting. It also lets the IRS know that it can stop its
campaign to force small businesses into using the more burdensome
accrual accounting rules.
We will increase expensing of equipment up to $35,000 per year, which
will reduce compliance costs by allowing small firms to deduct
purchases rather than setting up elaborate depreciation schedules to
figure out how to deduct them over many years.
Something we are proud of, particularly in the Ninth Congressional
District in Missouri, which is represented by my colleague on the House
side, who has been a champion of this measure, and my Senate colleague
to the north, Senator Grassley, is the new farmer, fisherman, and ranch
risk management accounts --the FFARRM accounts--which permit farmers,
fishermen, and ranchers to make tax-deductible contributions of up to
20 percent of the income in good years for use during subsequent
economic declines. The bill
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also provides important alternative minimum tax--or AMT--relief for
farmers who use income averaging, and it extends the work opportunity
tax credit through June 30, 2004.
The fourth component of the tax package is the Community Renewal and
New Markets Act of 2000, which is intended to reinvigorate our
distressed communities. This portion of the legislation includes the
House-Administration compromise on empowerment zones/renewal
communities and new markets tax credit, which creates 40 renewal
communities and 9 empowerment zones.
This certainly was not my recommended legislation, but this was part
of the bipartisan compromise we reached with the President and
incorporated it in the bill. These renewal communities would have a
zero capital gains rate, and the legislation creates a new-markets tax
credit for equity investments in qualified low-income communities. The
goal of this program is to bring the innovation and creativity of
America's businesses--and especially small businesses--into these
renewal communities to make real economic change for the future.
The legislation also increases the low-income housing tax credit and
private-activity-bonds volume caps, which are key financing features
for renewal communities. They included provisions to help clean up
brownfields by allowing expensing of brownfield cleanup costs, except
Superfund sites, through 2003. That is good for communities and for the
environment.
These four core components of the tax package provide important tax
relief for Americans throughout our economy.
The legislation also addresses several other priorities, such as the
school construction bond provision which I have already mentioned. This
is another avenue to address construction and modernization needs
without a Federal stranglehold. It is my belief that local school
districts know best how to address their needs. While providing them
this assistance, it keeps the Federal camel's nose out from under the
tent.
The adoption tax credit, which is very important and has been
addressed previously on the floor, is to encourage loving families to
adopt children. It also makes other strides toward improving and
reforming our Tax Code as which we are going to have to rely. The White
House leadership, next year, I believe will complete that work.
Medicare. This legislative package addresses the problems caused by
the Balanced Budget Act of 1997, as implemented with the chronic
incompetence of the Health Care Financing Administration. I have heard
time and time again health care providers talk about what is happening
to them under the BBA. When you ask the questions, you find out it is
how HCFA has implemented the BBA. They have used the BBA to cut far
more than Congress ever mandated.
What they seem to want to do is to cut out choice for patients--cut
out the choice they have of going into a Medicare insurance plan such
as we have or an HMO plan as is available to FEHBP members; it puts out
their choices to use home health care.
HCFA has gone about doing everything in its power to collapse the
present system. I guess--and I can only surmise --that they would like
to see the kind of health care plan that was so infamously run up the
flagpole in 1993 without getting any salutes.
I remember hanging around here in August of 1993 as they talked about
Mrs. Clinton's health care plan and kept waiting for somebody to try to
introduce it and get a vote on it. But as we looked at that June bug
longer and longer, as people got to look at it more and more, the
minimum amount of enthusiasm I saw initially grew even less. But HCFA
has never given up. By killing off parts of our health care system one
at a time, they hope maybe we can have a totally Government-run health
care system.
The Vice President on the campaign trail has said he hopes to be able
to go to a European system within a few years. Well, if you let HCFA in
control long enough to kill the existing health care system, there may
not be anything left.
This Medicare bill, just very briefly, provides benefits to patients
and providers worth $32 billion, benefits for nearly 40 million
Americans relying on Medicare. Glaucoma screening, colonoscopy
screening, mammography, nutrition therapy services for some patients,
additional coverage of immunosuppressive drugs --all have been added to
the Medicare program. Help for just about every type of Medicare
provider to allow them to continue to provide high-quality care to
seniors and the disabled. Hospitals, particularly rural hospitals, home
health care, nursing homes, hospice providers, and Medicare HMOs
that have been driven out of the field by cuts, and targeted help for
particular health care providers that are most in need. As one who
lives in a rural community, the bill targets $1.7 billion for rural
health care providers to help them deal with the unique challenges of
rural health care, which I think is very important.
More than $6 billion to Medicare HMOs will help address the
widespread withdrawals from the Medicare program we have seen in the
last couple of years.
Why have HMOs been leaching Medicare? Not because they are evil
incarnate, as some would have us believe. If that were the case, the
seniors losing their HMO coverage would not be so upset. No, these
providers left because the payment system for HMOs is seriously flawed
and in many areas has provided inadequate reimbursement. This new
funding will address this issue.
Approximately $1.5 billion in assistance to home health care
providers. Home health care patients have, by far, borne the greatest
brunt of HCFA's maladministration of the BBA. They were supposed to
save $16 billion over 5 years, and they are on the path to save $55
billion to $60 billion by eliminating too much of home health care and
making it unavailable. It has been devastating. Tens of thousands of
seniors previously receiving home health care lost it during the crisis
of the last few years. The bill postpones for 1 additional year the
potentially devastating 15 percent cuts which are addressed in this
legislation. They would be the death knell of home health care.
Next year, we need to get rid of that completely. We need to get a
brand new Medicare system, such as the bipartisan deal that was worked
out in the Breaux-Frist commission before the White House pulled the
plug on it.
Finally, this bill helps community health centers, the clinics that
exist in more than 3,000 urban and rural medically underserved areas
nationwide, ensuring that they continue to receive adequate
reimbursement from the State Medicaid programs so they can pursue their
mission of providing care to those Americans who would otherwise not
get any.
There is a long list of more than 40 organizations, led by the
American Hospital Association, supporting this legislation.
I ask unanimous consent to have a letter from the AHA to Chairman
Bill Thomas on the House side listing the letters of support for the
provisions printed in the Record at the end of my remarks.
The PRESIDING OFFICER. Without objection, it is so ordered.
(See Exhibit 1.)
Mr. BOND. Mr. President, overall I believe this is an excellent
package that is badly needed by seniors, the disabled, hospitals,
nursing homes, and other providers.
Finally, we have already had a lot of discussion about the Pain
Relief Promotion Act. Obviously it is controversial. The bill simply
amends the Controlled Substances Act to prohibit the use of federally
regulated drugs to help his or her life.
Let me be clear about that. Simply put, this would prevent any effort
to assist in a suicide by using controlled substances such as powerful
pain killers. The bill goes further in its efforts to provide
appropriate relief to people suffering great pain. It provides a
variety of provisions and educational programs to encourage appropriate
pain relief. Indeed, under this legislation for the first time ever the
Controlled Substances Act would explicitly recognize that aggressive
pain relief is an appropriate and fully warranted use of controlled
substances.
I believe a vast majority of Americans share a simple belief--that I
hold very strongly--that doctors we rely on to nurture and extend our
lives should not be party to efforts actively to promote someone's
death. The bill simply recognizes that consensus.
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It looks like we are going to have lots of discussion and have an
opportunity to hear many different views on this legislation. But
before we paint it as the most ugly duckling coming down the path, I
thought my colleagues and those who may be watching or listening still
at this late hour would like to know that there are some beautiful
limbs and beautiful facets of this that are very important bipartisan
measures.
I hope we can pass this because there are many priorities that the
President has asked for, that leaders on the Democratic side have asked
for, and I believe our side wishes as well that are beneficial to a
great number of American people who are waiting for our response.
I thank the Chair. I apologize to my colleague from Nevada whom I
misled into thinking that it was going to be a short set of remarks.
Exhibit 1
AHA, Advancing Health in America,
Washington, DC, October 26, 2000.
Hon. Bill Thomas,
Chairman, Subcommittee on Health, House Ways and Means
Committee, Washington DC.
Dear Representative Thomas: On behalf of the 5,000 members
of the American Hospital Association (AHA), I am writing to
express our views regarding the ``Beneficiary Improvement and
Protection Act of 2000'' (BIPA). We believe this legislation
will take another step forward in addressing the unintended
consequences of the Balanced Budget Act of 1997 (BBA).
Consequently, as we approach the remaining hours of the
congressional session, we are urging Members to vote in favor
of this legislation, and have recommended that the President
not veto the legislation.
As we understand the provisions of the legislation, it
includes a number of provisions that provide much needed
relief to hospitals and health systems throughout the
country. Such provisions include: a full market basket
inflationary update in FY2001, and elimination of half of the
reduction in FY2002; temporary elimination of the reductions
in Medicaid DSH state allocations in FY 2001 and 2002, and
allow the program to grow with inflation in those years;
increase the adjustment for Indirect Medical Education to
6.5% in 2001 and 6.375% in FY 2002, and establish an 85%
national floor for direct Graduate Medical Education
payments; equalize payments to rural hospitals under Medicare
DSH; increased flexibility for critical access, sole
community, and Medicare dependent hospitals; increased bad
debt payments from 55% to 70% for all beneficiaries; and a
full market basket update for outpatient hospital services.
The bill will also provide relief to home health agencies
and skilled nursing facilities. As our members operate
approximately one-third of the home health agencies and one
fourth of the skilled nursing facilities, relief in this area
is also vitally necessary, and is an important feature in the
bill. In addition, the bill includes important beneficiary
protections, particularly the execrated reduction in
beneficiary coinsurance for hospital outpatient services.
At the same time, we are disappointed that certain
provisions we have advocated, such a full market basket
increase in FY2002 for both inpatient and outpatient hospital
services, complete elimination of the impact of the BBA's
reductions in Medicaid DSH, and maintaining the IME
adjustment of 6.5% beyond FY 2001, were not included. We are
also concerned that additional reductions in the hospital
inpatient market basket in 2003 were included in the bill. We
look forward to working with you in the next congress to
achieve these additional changes.
Again, we appreciate your efforts to achieve additional BBA
relief this year.
Sincerely,
Rick Pollack,
Executive Vice President.
medicare, medicaid & schip improvements act of 2000--letters of support
Federation of American Hospitals,
National Association of Community Health Centers,
American Medical Rehabilitation Providers Association,
HealthSouth,
National Association of Long Term Hospitals,
Acute Long Term Hospital Association,
National Association of Children's Hospitals,
Kennedy Krieger Institute,
National Association of Rural Health Clinics,
National Association of Urban Critical Access Hospitals,
American Medical Group Associates,
Mississippi Hospital Association,
Tennessee Hospital Association,
The University of Texas System,
National Association of Psychiatric Health Systems,
Healthcare Leadership Council,
National Association for Home Care,
American Association for Homecare,
American Federation of HomeCare Providers,
Alliance for Quality Nursing Home Care,
American Association of Homes and Services for the Aging,
Visiting Nurses Associations of America,
National Hospice and Palliative Care Organization,
National PACE Association,
Association of Ohio Philanthropic Homes, Housing and
Services for the Aging,
John Hopkins Home Care Group,
Patient Access to Transplantation Coalition,
LifeCare Management Services,
American Cancer Society,
Alliance to Save Cancer Care Access,
Intercultural Cancer Center,
The Susan G. Komen Breast Cancer Foundation,
National Kidney Foundation,
The Glaucoma Foundation,
Juvenile Diabetes Foundation,
National Multiple Sclerosis Society,
American College of Gastroenterology,
American Academy of Ophthalmology,
American Optometric Association,
American Dietetic Association,
American Association of Blood Banks/America's Blood
Centers/American Red Cross,
Association of Surgical Technologists,
AdvaMed,
GE Medical Systems,
Landrieu Public Relations,
National Orthotics Manufacturers Association,
American Orthotic and Prosthetics Association,
UBS Warburg.
The PRESIDING OFFICER (Mr. Sessions). The Senator from Nevada.
Mr. REID. Mr. President, the Senator from Missouri did not mislead
me. He never has. The fact is, he didn't contemplate our leader coming
forward and saying a number of things that the Senator felt deserved a
response. I enjoyed listening to the Senator from Missouri, even though
I may not have agreed.
Mr. President, first of all, just a couple of comments on what my
friend from Missouri just said.
With the pension provision in the bill--now some $64 billion--it is
true there was some action taken in the Finance Committee. But not a
single second was spent on this floor dealing with the $64 billion
provision which is jammed into this bill.
On the budget amendment, $80 billion--nothing in finance. In fact,
the chairman of the Finance Committee said he would allow a vote in the
Finance Committee if all the Members promised not to bring up
prescription drugs in any way, or Patients' Bill of Rights. The
minority would not agree to that. It seems totally reasonable in the
Finance Committee that this is something that should have been brought
up. As a result of the chairman's action, the matter was not brought
before the Finance Committee. And again this $80 billion matter
received no floor consideration.
New markets initiative: $25 billion--nothing in the Finance
Committee; no action taken on the floor.
Keep in mind that I have gone over just a few things; in fact, three.
We are already up to about $200 billion, and not a single minute spent
on the Senate floor with $200 billion of the taxpayers' money. That
doesn't take into consideration foreign sales. That is $4.5 billion.
The Finance Committee spent a little time on that; nothing on the
floor. Why? Because the outlandish proposition was made that if this
came to the floor, someone was going to offer an amendment. Pardon me.
But isn't that what the Senate is all about? People have a right to
offer amendments to pieces of legislation. But because there was this
terrible threat that on a piece of legislation a Senator will offer an
amendment, we have no floor action on it; again, $4.5 billion.
I also say there is going to be plenty of debate tomorrow on a number
of these issues. But on this bill itself, there has been no conference
and no Democratic involvement at all in bringing this bill to the point
where it is. The Democrats were not even allowed to see the document
until it came here.
These are members of the Finance Committee. One of the most
bipartisan and, I would say, nonpartisan people I have ever worked with
is the senior Senator from Louisiana, John Breaux, a senior Member of
the Finance Committee. He was not allowed to look at any of the papers.
He was not happy about that.
Today the bill was dumped in our lap.
I would also say about the assisted suicide that there will be lots
of debate on it tomorrow. The Senator from Oregon, Senator Wyden, feels
very strongly about this, as he should. Why? It doesn't matter how you
feel on this
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issue. The fact is that the voters in the State of Oregon said we feel
this way on assisted suicide. As a result of the people of Oregon
passing a law in the State of Oregon, we now have this action.
It seems to me those who keep talking about States rights should
leave a State alone. People of the State of Oregon voted a certain way.
If you disagree with what the people of the State of Oregon did in
voting in favor of assisted suicide, then let's at least have the
ability on the Senate floor to debate the issue which we have been
prevented from doing.
My friend from Missouri, for whom I have the greatest respect, talked
about health care.
They always throw in the 1993 Clinton health care plan. Let's bring
this down to reality so people really understand what this is all
about.
When the health care debate started, 80 percent of the people of
America favored reforming the health care system. But then comes
Halloween and the masquerade by the health insurance industry. They
spent over $100 million trying to abuse and frighten the American
people. They succeeded beyond anyone's wildest dreams. They were
probably even surprised on how they succeeded in frightening the people
of America with their Harry and Louise ads and with their clever
manipulations.
As a result of that, we got no health care reform because after they
did their television and radio advertising, 80 percent of the people in
America didn't want health care reform. They were frightened. They were
confused.
That doesn't take away from the fact that we now have 45 million
people with no health insurance. It doesn't take away from the fact
that we have many people who have insurance that gives them minimum and
inadequate rights. That is why we tried to pass the Patients' Bill of
Rights--to give patients certain rights.
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