[Congressional Record Volume 149, Number 174 (Tuesday, November 25, 2003)]
[Senate]
[Pages S15918-S15919]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                         OMNIBUS APPROPRIATIONS

  Mr. SPECTER. Mr. President, with respect to the omnibus 
appropriations bill, the Senator from Missouri is correct that we ought 
to complete it. He has pointed out the importance of having the 
increases for veterans. I would add to that the importance of increases 
in the appropriations bill for Labor, Health and Human Services, and 
Education, where I chair the subcommittee.
  I would like to comment briefly on two points in the appropriations 
bill for my subcommittee. One of them involves the issue of overtime 
pay. The Senate passed, by a decisive majority, 54 to 45, a prohibition 
on any expenditures to implement the regulation on overtime which would 
cut out overtime for many Americans who really need that compensation, 
especially in light of the fragility of the economy at the present 
time.
  In the House of Representatives, the regulations stood by three 
votes. Then on a later vote in the House of Representatives, by 18 
votes, the House directed the conferees to strike the regulation, not 
to fund it until September 30, 2004.
  When the omnibus was in the final stages of preparation last week, it 
was apparent to me that any course of action would leave the regulation 
in effect. If Senator Harkin and I had insisted on keeping in the 
Senate amendment striking funding for the regulation, then our 
appropriations bill was scheduled to be taken out of the omnibus and 
our three Departments, Health, Education, and Labor, would be funded on 
a continuing resolution and the regulation would remain in effect. If 
we agreed to remove the amendment striking the funding, then of course 
the regulation would go into effect. So either way, the regulation was 
going to go into effect. By having our bill included in the omnibus, we 
had $4 billion more for vital programs in NIH, for Head Start, for 
education, Leave No Child Behind, and workers' safety. So in effect we 
did not have a Hobson's choice, we had no choice at all. Either way we 
went, the regulation would remain in effect. If we agreed to take it 
out so we would be included in the omnibus, then the prohibition 
against funding would fall. If we were taken out and made a part of the 
continuing resolution, then the regulation would stay in effect.
  It is my hope, when this matter goes forward, the vote in the Senate 
will remain and the provision remains in the Senate bill to strike the 
funding for the regulation. So that battle is not over. We intend to 
continue to fight it right down to the wire, until the omnibus 
appropriations bill is adopted.
  One other point, and I will be brief. I know my other colleagues are 
waiting to speak. One other point, and that involves the House language 
to prohibit funding for patents for human tissue. That provision in the 
appropriations bill for the Departments of Commerce, Justice, and State 
is going to cause enormous uncertainty. It is very expensive, and a 
very long process, to have a patent. There will be many people, who 
will be interested in proceeding with patents, who will not understand 
the ramifications of the language on human tissue.
  I am against human cloning. I made that point emphatically clear in 
our conference, where I offered an amendment, a motion to strike the 
House language, which passed on the Senate side 18 to 8, but the House 
refused to agree. So the language remained in the bill. But I believe 
the scientific community in America is going to march on the Congress 
to stop the meddling with scientific research with vague prohibitions 
which can only lead to grave difficulties and which impede medical 
science.
  One concluding thought. I thank those on the other side of the aisle 
who, as I understand it, have removed the holds on all of the pending 
nominees. Just a word in support of Pennsylvania Attorney General 
Michael Fisher, who is up for confirmation for the Third Circuit. I 
have known Attorney General Fisher for the better part of three 
decades. He has an extraordinary record in the Pennsylvania Legislature 
and as the State attorney general and as candidate for Governor.
  I ask unanimous consent that a full statement of his resume be 
printed in the Record at the conclusion of these remarks.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                      Attorney General Mike Fisher

       Mike Fisher, the Attorney General of Pennsylvania since 
     1997, was nominated on May 1, 2003, by President George W. 
     Bush to serve on the Untied States Court of Appeals for the 
     Third Circuit, which covers Delaware, New Jersey, 
     Pennsylvania and the Virgin Islands. The nomination is 
     subject to a majority confirmation by the United States 
     Senate.
       Currently serving his second four-year term, Attorney 
     General Fisher is only the third elected Attorney General in 
     State history. His top priorities have included protecting 
     Pennsylvanians from crime, reducing the use of illegal drugs, 
     stopping the tobacco industry from marketing to children, and 
     expanding consumer protection services.
       Attorney General Fisher personally argued major cases in 
     State and Federal appellate courts. In March 1998, he 
     sucessfully argued before the United States Supreme Court a 
     precedent-setting case ensuring that paroled criminals meet 
     the conditions of their release.
       Attorney General Fisher has worked to improve the quality 
     of justice in Pennsylvania. He is an active member of the 
     Pennsylvania Bar Association (PBA), serving in its House of 
     Delegates and on various committees. Working with the PBA, he 
     has co-sponsored an innovative violence prevention program in 
     Pennsylvania elementary schools called Project PEACE, which 
     helps young people learn to resolve conflicts without 
     violence. Fisher also encourages PBA participation by the 
     attorneys in his office.
       Before his election as Attorney General, Mike Fisher served 
     for 22 years in the Pennsylvania General Assembly, serving 
     six years in the State House and 16 years as a member of the 
     State Senate. He was a member of the House and Senate 
     Judiciary Committees, the Chair of the Senate Environmental 
     Resources and Energy Committee and the Majority Whip of the 
     Senate. During his legislative career, he was a leader in 
     criminal and civil justice reform and an architect of many 
     major environmental laws.
       Attorney General Fisher began his legal career in his 
     hometown of Pittsburgh following his graduation from 
     Georgetown University in 1966 and Georgetown University Law 
     Center in 1969. As an Assistant District Attorney for 
     Allegheny County, he handled nearly 1,000 cases, including 25 
     homicides. He

[[Page S15919]]

     continued to practice law during his career in the General 
     Assembly and was a shareholder or partner in various firms, 
     including Houston Harbaugh, where he practiced from 1984 to 
     1997. Fisher's law practice included civil ligation, 
     commercial law, estate planning and real estate.
       Mike Fisher was Pennsylvania's Republican candidate for 
     Governor in 2002. During a hard-fought campaign, he raised 
     key issues and helped shape current public debate on matters 
     such as Pennsylvania's growing medical malpractice insurance 
     crisis, the need to improve public education and the 
     necessity of property tax reform.
       Attorney General Fisher and his wife, Carol, an education 
     consultant, have two children, Michelle, 27 an attorney in 
     Pittsburgh, and Brett, 24, an information technology sales 
     consultant in the Washington, D.C. area.
  Mr. SPECTER. Mr. President, since Medicare was established in 1965, 
people are living longer and living better. Today Medicare covers more 
than 40 million Americans, including 35 million over the age of 65 and 
nearly 6 million younger adults with permanent disabilities.
  Congress now has the opportunity to modernize this important Federal 
entity to create a 21st century Medicare Program that offers 
comprehensive coverage for pharmaceutical drugs and improves the 
Medicare delivery system.
  The Medicare Prescription Drug and Modernization Act would make 
available a voluntary Medicare prescription drug plan for all seniors. 
If enacted, Medicare beneficiaries would have access to a discount card 
for prescription drug purchases starting in 2004. Projected savings 
from cards for consumers would range between 10 to 25 percent. A $600 
subsidy would be applied to the card, offering additional assistance 
for low-income beneficiaries defined as 160 percent or below the 
Federal poverty level. Effective January 1, 2006, a new optional 
Medicare prescription drug benefit would be established under Medicare 
Part D.
  This bill has the potential to make a dramatic difference for 
millions of Americans living with lower incomes and chronic health care 
needs. Low-income Medicare beneficiaries, who make up 44 percent of all 
Medicare beneficiaries, would be provided with prescription drug 
coverage with minimal out-of-pocket costs. In Pennsylvania, this 
benefit would be further enhanced by including the Prescription 
Assistance Contract for the Elderly (PACE) program which will work in 
coordination with Medicare to provide increased cost savings for low-
income beneficiaries.
  For medical services, Medicare beneficiaries will have the freedom to 
remain in traditional fee-for-service Medicare, or enroll in a Health 
Maintenance Organization (HMO) or a Preferred Provider Organization 
(PPO), also called Medicare Advantage. These programs offer 
beneficiaries a wide choice of health care providers, while also 
coordinating health care effectively, especially for those with 
multiple chronic conditions. Medicare Advantage health plans would be 
required to offer at least the standard drug benefit, available through 
traditional fee-for-service Medicare.
  We already know that there are many criticisms directed to this bill 
at various levels. Many would like to see the prescription drug program 
cover all of the costs without deductibles and without co-pays. There 
has been allocated in our budget plan $400 billion for prescription 
drug coverage. That is, obviously, a very substantial sum of money. 
There are a variety of formulas which could be worked out to utilize 
this funding. The current plan, depending upon levels of income has 
several levels of coverage from a deductible to almost full coverage 
under a ``catastrophic'' illness. One area of concern is the so-called 
``donut hole'' which requires a recipient to pay the entire cost of rug 
coverage.
  As I have reviewed these projections and analyses, it is hard to say 
where the line ought to be drawn. It is a value judgement as to what 
deductibles and what the co-pays ought to be and for whom. Though I am 
seriously troubled by the so-called donut hole, it is calculated to 
encourage people to take the medical care they really need, and be 
affordable for those with lower levels of income. Then, when the costs 
move into the ``catastrophic'' illness range, the plan would pay for 
nearly all of the medical costs.
  I am pleased that this bill contains a number of improvements for the 
providers of health care to Medicare beneficiaries. Physicians who are 
scheduled to receive cuts in 2004 and 2005 will receive a 1.5 percent 
increase over that time. Moreover, rural health care providers will 
receive much needed increases in Medicare reimbursement through raises 
to disproportionate share hospitals and standardized amounts, and a 
decrease in the labor share in the Medicare reimbursement formula. 
Hospitals across Pennsylvania will benefit from upgrades to the 
hospital market basket update and increases in the Indirect Medical 
Education. Furthermore, the bill will provide $900 million for 
hospitals in metropolitan statistical areas with high labor costs due 
to their close proximity to urban areas that provide a 
disproportionately high wage. These hospitals may apply for wage index 
reclassification for three years starting in 2004.
  I would note that I do have concerns with this legislation with 
regard to oncological Medicare reimbursement and the premium support 
demonstration project for Medicare Part B coverage. Proposed reductions 
in the average wholesale price for oncological pharmaceuticals may have 
a grave effect on oncologists' ability to provide cancer care to 
Medicare Beneficiaries. Every Medicare beneficiary suffering from 
cancer should have access to oncologists that they desperately need. I 
will pay close attention to the effects that this provision has on the 
quality and availability of cancer care for beneficiaries and 
oncologists' ability to provide that care. Further, the premium support 
demonstration project for Medicare Part B premiums poses a concern. 
Some metropolitan areas may face up to a five percent higher premium 
for fee-for-service care than neighboring areas. While these provisions 
remain troublesome, we cannot let the perfect become the enemy of the 
good with this piece of legislation.
  The Medicare Prescription Drug legislation has been worked on for 
many years. I believe this bill will provide a significant improvement 
to the vital health care seniors so urgently need. I congratulate the 
members of the conference committee including Majority Leader Frist, 
Senator Grassley, Chairman of the Finance Committee, and the Ranking 
Member, Senator Baucus, for the outstanding work which they have done 
on an extraordinarily complex bill.
  The PRESIDING OFFICER (Mr. Chafee). The Senator from Nevada.

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