[Congressional Record Volume 150, Number 49 (Thursday, April 8, 2004)]
[Senate]
[Pages S4002-S4006]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                          ASBESTOS LITIGATION

  Mr. CARPER. Mr. President, before Senator Byrd leaves the floor, I 
wish him a joyous Easter and thank him for reminding us of what Easter 
is all about.
  When Members reflect on the diversity of the religious views of our 
constituents--some are Protestant, some are Catholic; some folks in 
West Virginia or Delaware are Jewish, as some here are. We have folks 
in our States who are Hindu, Muslim, Buddhist. There is a wide 
diversity of religions in this country. It is a sign of our strength, 
not a sign of weakness.
  We are reminded that one of the reasons we are strong is because we 
respect the right of everyone to worship God as he or she sees fit, or 
to not worship at all.
  Ironically, whether we happen to be Jewish, Catholic, Protestant, or 
some other faith, it is interesting how often we agree on a premise, a 
principle laid out in the New Testament.
  I don't think Senator Byrd read it today, but we call it the Golden 
Rule. The idea there is to treat other people the way we want to be 
treated. I am not enough of a religious scholar to know where that 
scripture appears in the New Testament. It may also appear in the Koran 
or the Torah or any other religious text of other religions around the 
world. But my guess is it does say, in so many words, we should treat 
other people the way we want to be treated.
  I want to talk about that principle and how it might apply to what we 
do in the Senate. I apply it to an issue we may address as soon as we 
return April 19.
  Majority Leader Frist has said, when we return immediately following 
the Easter holiday, the first issue of any consequence he would like 
for us to address deals with asbestos litigation. This is something I 
have worked on, along with many of my colleagues, for most of the 3 
years I have been in the Senate.
  My first year in the Senate, about a year or two before the Presiding 
Officer arrived, I remember visiting Senator Byrd. I asked how this 
place works and he gave me some pointers. He was a great mentor then 
and he continues to be a great mentor today.
  Among the pieces of advice he gave me: When people want to talk to 
you, talk to them.
  It turns out one of the calls my first year was from a fellow named 
Frank Macher. He is somebody my wife introduced me to. She worked at 
DuPont at the time and had dealings with Ford Motor Company. Frank 
Macher was a fairly senior official at Ford Motor Company. He retired 
from Ford Motor Company.
  I lost track of him for a few years and he called to say he had 
assumed a new position with a new company. I asked, ``Who is that,'' 
and he told me he had just become the CEO of a company called Federal-
Mogul. I was not familiar with the company. He said I was probably 
familiar with some of their products. They manufacture or sell and 
distribute, among other things, Champion spark plugs and a variety of 
other products used in the automotive industry.
  He said: Sometime when I come to Washington in my new role I want to 
be able to come and see you; it is good to renew a friendship. I said: 
Come on over.
  Lo and behold, a month or so later he came. We had a great meeting. 
It was a good moment. He headed for home. I said: If you are back this 
way, let us know.
  After 6 months or so, he called me again. I said: How are you doing?
  He said: We have a problem.
  I asked: What is that?
  He said that somewhere along the line, before he became CEO of this 
company, Federal-Mogul had acquired a subsidiary, I think it was a 
British subsidiary, for a period of time, not a long period of time but 
maybe a couple of years.

[[Page S4003]]

  He said because of that relationship--they acquired it and sold it 
within a couple of years--his company, Federal-Mogul, had been exposed 
to all kinds of litigation with respect to asbestos because this 
subsidiary that they owned years ago for a short period of time had a 
position or presence in the asbestos business.
  We met and talked. I said: Since you live in Michigan, maybe you 
ought to spend some time with your Senators. I think he visited his two 
Senators. I suggested he visit with the chairman of the Senate 
Judiciary Committee at the time, Senator Leahy. He was good enough to 
meet with Frank Macher.
  What proceeded from there, about a year or so later, is Federal-Mogul 
ended up going into bankruptcy. Ultimately, it was reorganized and 
emerged from bankruptcy.
  I don't know the effect on the employees within that company. I do 
know this: The shareholders in the company lost, as far as I 
understand, the entire value of their shares. The employees of the 
company who had money in a 401(k) plan that included company stock lost 
the value of that company stock. The pensioners from Federal-Mogul who 
were retired, or trying to retire, probably lost some of their pensions 
as the company went in and out of bankruptcy.
  We know what happens all too clearly--in fact, I am reminded of 
legislation we worked on today--to employees or retirees of companies 
that go into bankruptcy and how that can adversely affect the size and 
amount of their pensions.
  In any event, that experience with Frank Macher and with Federal-
Mogul acquainted me with an issue that, frankly, I had not thought 
about for one minute before I came to the Senate.
  Fast forward for several months, subsequent to that initial meeting 
with Frank Macher, a second meeting with Frank Macher from Federal-
Mogul, to a conversation, a visit I had from an attorney from the west 
coast. I can't recall his name off the top of my head, but he was a 
good person, a trial lawyer. His particular specialty was representing 
people who were afflicted with mesothelioma. Apparently, mesothelioma 
is something folks contract from exposure to asbestos. There is no 
known cure. There are several thousand people who will die each year 
from that disease.
  The attorney who came to meet with me talked about his clients. Those 
who were fatally stricken and soon to die, and how in many instances 
they or their families were not receiving the compensation for what 
they were going through and for the loss of life.
  He said the current system we have is broken. It ought to be fixed. 
In too many cases, the way the current system works is that the people 
who may have mesothelioma or a serious asbestos-related disease, lung 
cancer that has grown from exposure to asbestos, these individuals or 
their families are receiving pennies on the dollar for what they should 
be getting for pain and suffering and loss of life.
  Meanwhile, in too many instances people who may have had exposure to 
asbestos but are not impaired, are not sick, are taking away, siphoning 
off, some of the money that ought to be going to people who are 
impaired or seriously ill and may ultimately die. Instead of the money 
actually getting to the victims, I am told maybe half goes to other 
parties in transaction costs.
  That is not a good situation. It is not a healthy situation. Almost 
everybody here familiar with this situation would say if there is 
anything we ought to fix this year, this is near the top of the list. 
We should fix it. We can fix it.
  I have been here about 3 years and for most of those 3 years people 
on both sides of the aisle have been trying to do that. Progress has 
been made. The Judiciary Committee marked up and reported out a bill 
last year, a bill that has been criticized by a number of people, a 
number of parties that are involved in this issue. Nonetheless, it 
represents an effort to try to address a situation we all know needs to 
be addressed.
  The bill was reported out of committee last year. Since November of 
last year, there have been a series of negotiations that have taken 
place involving, among others, organized labor, as a proxy for the 
victims and the workers, insurers, manufacturers; and, from time to 
time, the trial lawyers have been involved in those discussions. Those 
discussions were intended to try to bridge the differences that 
separated them and us from legislating successfully on this issue and 
establishing a procedure and funding to make sure people who are sick 
and dying get the help they need, and folks who are not sick but may 
have had an exposure have their health monitored, and if they do become 
sick, they get the financial help they and their families need, to try 
to reduce the transaction costs so it becomes pretty much a no-fault 
system.
  While some progress has been made, there is more work to be done. I 
spoke yesterday with Majority Leader Frist, whom I respect very much. 
In fact, the conversation I had with him yesterday is similar to one I 
had with him the week before, and I think probably the week before and 
the month before that. I have suggested to him, in strong terms, that 
as we return from the recess that begins tomorrow--and we return in 
about 10 days--that the first bill we take up be legislation about 
which there has emerged a bipartisan consensus.
  Again, it involves legal issues, but the first bill that we take up, 
in my judgment, should not be asbestos litigation reform. It should be 
class action reform. We have debated it to some extent on the floor. We 
had a cloture vote on class action legislation last year. We ended up 
one vote short of the 60 we needed to proceed to the bill and take it 
up.
  In the time since then, three other Democratic Senators have stepped 
forward and been part of a negotiation with our friends on the other 
side--negotiations in which Senator Kohl and I participated. I think 
out of those negotiations has emerged a significant improvement to the 
class action bill that came to the floor last year and is a path 
forward to enacting that legislation in the Senate the week after we 
return from this upcoming recess. We should take it up. We should 
provide a week to debate it. We should let it be like a bottle of wine, 
to breathe on the floor, if you will, to give Members the opportunity 
to offer amendments, hopefully, mostly germane. And I know there are 
some Members who have constructive amendments to offer. There are 
others who would like to offer some nongermane amendments, and I hope 
the other side would allow some votes on those nongermane amendments.
  After a reasonable period of debate, we ought to be able to go to 
final passage and send that bill to the House of Representatives.
  I do not believe we are at that point yet with respect to asbestos 
litigation. I urge Senator Frist not to lead with asbestos litigation 
on April 19. Progress has been made in recent months, particularly 
since November, in a negotiation begun by Senator Specter and overseen 
by Judge Becker. They have been successful in getting organized labor, 
insurers, and manufacturers to agree on the administrative structure: 
Where should this fund be housed? How should people go about applying 
for money if they are sick or impaired? How do they go about, in a 
practical way, getting the help they need?
  It has been a very constructive negotiation. Out of that negotiation 
I think a sense of trust and confidence has grown among the parties who 
have been negotiating under the auspices of Judge Becker and Senator 
Specter.
  Previously, when the legislation was voted on, debated in committee, 
among the very positive things the committee did was to agree on 
medical criteria. It is a tough issue. They reached consensus. We have 
the medical criteria agreed to by the committee. We have agreement on 
the administrative issues, which is important. My hope is they will be 
agreed to by the Senate.
  But there are other issues that still remain to be addressed, and 
they need to be resolved. I am not convinced, by a long shot, that our 
best bet and our smartest course is to try to resolve all of these 
issues, and a number of others yet to be resolved, on the Senate floor.
  Let me mention a few. How much money should each individual victim 
receive? How much money should be contributed to the fund? How much 
from the insurers? How much from the manufacturers? How do we treat the 
several hundred thousand current claims--more than a quarter of 
a million current claims? What kind of

[[Page S4004]]

screening should be provided for workers? How do we treat railroad 
employees who are covered under a unique compensation system of their 
own? What happens if our assumptions are wrong, and the fund runs out 
of money 10 or 15 years from now, and people are still getting sick 
from their exposure to asbestos?

  Those are big issues. Those are important issues. They are central to 
the overall premise of this bill. And despite the best efforts of all 
sides thus far, we do not have consensus on them, at least we do not 
have consensus as yet. That certainly does not mean we ought to give 
up, not by a long shot; quite the contrary.
  Senator Frist has said the bill he has recently introduced is not a 
take-it-or-leave-it offer. He said he is willing to work with Senators 
on both sides to improve the bill and to improve its ultimate chances 
of passage.
  I would say again to Senator Frist, I am anxious to be part of this 
solution. I know others on my side, and certainly on the Republican 
side, are anxious to be a part of that solution. I would call on him 
today to join with Senator Daschle in a bipartisan effort where they 
convene, under their auspices a negotiation that includes, among 
others, organized labor, the insurers, the manufacturers, and perhaps 
the trial bar, and get people in a room who can make some decisions, 
and to keep them there until most of the issues I have just gone 
through--at least those--are, for the most part, worked out to the 
satisfaction of the parties.
  We hear from organized labor that more money needs to go into the 
fund. And $114 billion--now I think a lot of people are suggesting that 
is enough. It may be; it may not. On the other hand, organized labor 
says a number closer to what was reported out of committee--I think 
$153 billion--might be enough. But whether the number is $114 billion 
or $154 billion, there is some point there between $114 billion and 
$154 billion where we ought to be able to agree that those dollars--
whether it is $124 billion, $134 billion, $144 billion--that those 
dollars are likely to be sufficient to meet the legitimate claims that 
are going to be submitted for people who are sick from asbestos 
exposure.
  And there needs to be a provision that says: If somewhere down the 
line the fund does run out of money, there has to be a way for people 
who are still getting sick from their asbestos exposure to have a way 
to be compensated.
  Some have suggested that maybe the way to do it is to let those 
people back into the tort system. I would suggest not this tort system, 
through State and local courts, but through the Federal court. So if 
the money ever runs out--and I hope it doesn't--people would have the 
opportunity to come back into the tort system.
  If we take up asbestos litigation legislation that has been 
introduced by Senator Frist on April 19 and immediately ask for a 
cloture vote, we are going to get an objection from this side for 
moving forward at that time. We accomplish nothing. We could take up 
class action on the same date. We have the votes to go to the bill. We 
have a bipartisan consensus to do something to make sure that when 
national class action litigation is brought of a national scope, of a 
sufficient financial magnitude, that it would be heard in a Federal 
court, particularly when the defendant is from a different State than 
the plaintiffs. We can pass that bill. We ought to. We should send it 
to the House and hopefully they will find favor with it. I believe they 
will.
  But if we take up asbestos litigation at the beginning of the next 
period in which we are working in the Senate, we are going to end up 
making people angry, turning people off, raising further the sense of 
distrust that permeates this body. We will make no progress. My fear is 
we may poison the well for our ability to pass a class action bill that 
should move through here pretty easily.
  Again, I say to Senator Frist, reach out to Senator Daschle, to my 
leader, engage him earnestly, the two of you pulling interested parties 
together. I am not kidding, get them in a room and get them to stay 
there. If some of us can be in the room, fine. Some of our staffs that 
are very knowledgeable on these issues and want to see this legislation 
worked out, get them in the room, too, to keep the negotiating parties 
honest and to keep them moving. But let's put some focus on getting 
that negotiation done so the issues around the amount of money we need 
and where it should come from, what to do with those hundreds of 
thousands of claims that are pending, so that we can resolve those 
issues before we bring the bill to the floor.
  Senator Cornyn has been here a little over a year now. I have been 
here a little bit longer than he. We both have been here long enough to 
see bills come to the floor that are literally worked out on the floor 
because the committee was not able to do it, maybe it was not possible, 
and we ended up writing the bill on the floor. Sometimes that works 
out. Sometimes it doesn't.
  If we try to write the asbestos litigation on the floor on April 19, 
we are not going to work it out. There is value in setting a date 
certain when we are going to take up this bill. I don't have a calendar 
with me, but I think that Monday, May 17, is the last week we will be 
here before the Memorial Day recess. I believe that is the date we 
should set. I urge us then to take up asbestos litigation legislation 
the week of Monday, May 17.
  Maybe if we have had a chance to already do good work on class action 
legislation in April, that will be helpful in dispelling some of the 
distrust and mistrust that characterizes so much of what goes on in 
this body and in this building these days.
  A lot of Democrats and a lot of Republicans--going back to the adage 
we talked about in the New Testament--understand that we ought to be 
trying to treat other people the way we would like to be treated, 
whether they happen to be folks whose health is impaired, maybe their 
lives are threatened because of asbestos exposure, or maybe they are a 
company that is like Federal-Mogul that went bankrupt or an insurance 
company, some of which are, frankly, pretty close to the edge of 
remaining solvent because of their exposure over this issue. Maybe we 
can put ourselves in the shoes of all those different parties and make 
sure that whether you happen to be impaired, injured, or you happen to 
be an insurer or an employer, that we try to treat them with a 
compromise bill where we treat them the way we would want to be treated 
ourselves.

  It is critically important that people who are sick and dying get the 
help they need now and that it be generous. It is important that people 
who may have had an exposure, who become sick from asbestos exposure, 
if they become sick, they get the help they need, that it is fair, 
generous, and prompt. It is also important that people who may have had 
an exposure but are not sick, as they go forward in time, their health 
be monitored, and that, frankly, somebody pay for that monitoring for 
them, and that this fund we would create under this legislation pay for 
medical monitoring costs so if those folks become impaired or develop 
the symptoms that have costs the lives of too many people, they can get 
the help they need and get it promptly.
  By the same token, we have seen a whole lot of companies go under. 
They have gone into bankruptcy. Some will say: Well, they will 
reorganize. Everything is fine.
  It is not. It is not fair to the people whose 401(k)s are in company 
stock, if it is gone. It is not fair to the retirees whose pensions 
have been reduced. It is not fair to the employees who may have lost 
their jobs at those companies. It is not fair to the shareholders who 
have lost almost everything they invested in those companies.
  Finally, as we bemoan the loss of manufacturing jobs--and we have 
seen literally millions more manufacturing jobs lost just in the last 3 
or 4 years--it is important for us to create an environment in this 
country where manufacturing jobs can continue to exist and we don't 
lose even more jobs. I am convinced there are a couple things we could 
do to help reverse this trend, or at least stop it in its tracks. One 
of them is to provide a legal system, a system of justice that makes 
sure when people are hurt, they are compensated and they are 
compensated fairly; that the folks who damage them, who have hurt them, 
pay their fair share.
  It is also important as we do that work that we do it in a way that 
is fair and does not make our country an even less attractive place for 
companies to be in business, manufacturing businesses especially. We 
have to be smart enough to figure this one out.

[[Page S4005]]

  We need to set a deadline for action, action to take the bill up 
here. In the 3 or 4 weeks before we do that, there needs to be 
continued negotiation. My view is that negotiation should be fostered 
and overseen by the majority and minority leaders. We don't need to 
take this up and do this on April 19. We need to take it up and we need 
to change it and improve it. We need to infuse that legislation with 
more consensus that may grow out of the negotiations I am encouraging. 
If that happens, we can pass a bill Delaware and Texas can be proud of. 
It will really put truth to the notion that we treated other people the 
way we want to be treated, whether they happened to be an asbestos 
victim or the company that is required to pay for their treatment.
  I yield the floor.
  The PRESIDING OFFICER. The majority leader is recognized.
  Mr. FRIST. Mr. President, over the next 30 minutes or so, I have a 
couple of statements I want to make on important issues and, shortly 
thereafter, we will be adjourning for our recess.
  I had the opportunity to hear most of the comments from the Senator 
from Delaware, who, as he knows, I respect tremendously on a whole 
range of issues, but in particular his commitment to doggedly working 
these issues of class action and asbestos, issues that are so important 
to the American people. He and I have had many discussions in terms of 
approach and how best to address the issues. It is frustrating for me, 
obviously, in many ways in trying to schedule a lot of legislation that 
is important for us to have to stop or to switch and sequence these 
pieces of legislation. Two of those pieces he mentioned--the asbestos 
legislation and class action--are two that I hope we can address. 
Although it is difficult on the floor of the Senate to fully address 
them, it is harder in committee. Both have been addressed in committee. 
The issues on each have taken a different course.
  Although no final decision is made, part of the reason for 
introducing a revised asbestos bill last night was that people who care 
very much about this issue--the 100 people in this body, and others who 
will be impacted by this significant piece of legislation--will be able 
to read a current document that I think is improved in many ways. 
Others may disagree, and that is why we need time to look at it and 
discuss it. But in the area of administration of the bill itself, there 
has been a lot more discussion since the asbestos bill was marked up in 
committee. Those have been incorporated. There have been other changes 
we need to debate and discuss. We can argue about the most appropriate 
forum. You can take it back through committee, or you can do it on the 
floor of the Senate, where everybody can be involved.
  Since we have given it one good shot through committee, I think it is 
time to take the improved product, put it out there, which is what we 
have done, and let people digest it and discuss it, starting today. 
That was the whole purpose of introducing it. Then we will see over the 
next 8 to 10 days. Hopefully, people will be getting together. I will 
make that commitment to the Senator. He has appealed to common sense 
that we get together on both sides of the aisle with leadership. I will 
do that.
  I am confident that in the end, we are going to be able to work 
through a lot of these issues. He enumerated the issues that were 
addressed in committee, which made it a good bill, and the issues that 
need to be addressed, whether it is the size of the fund or payout of 
the fund, the level 7 type criteria, a whole range of things I think we 
can address.
  We have addressed class action on the floor of the Senate. It was 
debated and we had good debate here and in committee. There it was 
blocked. We had a filibuster here. We can, again, argue why there was a 
filibuster, but it was filibustered. We tried it. Since then, we have 
gone back and worked together and have improved the product. My 
challenge is to bring that improved product, where there are probably 
more than 60 votes, to the floor, but do it in a way that we can stay 
on the bill, have germane amendments, improve the bill, debate it, and 
vote on it.

  My problem, as my distinguished colleague knows, is that nobody can 
make that commitment. He and others have seen, without that sort of 
commitment, what happens. It has happened with the FSC/ETI JOBS bill, 
which we will be talking about shortly. We spent 3 weeks on that, and 
we would start and stop and start and stop, starting with 75 amendments 
on one side, and we may have had 75 on our side, I don't know. But it 
has been overwhelming. Now we are 3 weeks into that bill, and finally 
we are going to come to some agreement on a universe of amendments. On 
class action, we were unsuccessful. So I will shift to asbestos and see 
what we can do there by working together. Then we will come back to 
class action. I heard loud and clear the rationale of why we can't 
consider class action now, so I have decided another course. There is 
no agreement to address it yet. I express my willingness to work on 
these issues.
  Even though it is a very partisan environment and we have campaigns 
and it is an election year, if I look at what has been filibustered--
the JOBS Act, Welfare Reform Act, energy, medical liability, FSC/ETI, 
which were all filibustered--you almost say we are not going to get 
anything done. But we can. We can make progress on the JOBS bill here 
shortly, and I think also on these important tort-type issues where we 
know we can do better and we can make progress as well.
  So I thank my colleague. I don't think there is anybody in the body 
who has worked harder on these issues on a personal basis to try to 
move America forward on the issues, recognizing there has to be give 
and take. Nobody has the perfect answer. My purpose last night was to 
introduce a product we can look at and debate and approve. We have that 
opportunity, over the next 8, 9, or 10 days, to do that.
  We need to get everybody to the table, not excluding anybody, and to 
really make it work. There is no way to pass a bill right now unless we 
get people to the table. Unless we are going to get more than 60 
people--but even 60 people isn't much--you have to have people as 
committed as the Senator from Delaware.
  Mr. President, I want to comment on a public health issue. I know 
people say every time I get up, I am taking a health issue. It is 
important to me personally, but also to the American people, to address 
issues that don't necessarily make it to the front page every day which 
ultimately impact people's lives, some of whom don't have anybody 
speaking for them directly all the time. But also there are so many 
issues in health care that, if you shine a spotlight on them, people 
say, that makes sense; let's do something about that.
  One such issue centers on the fact that this week is National Public 
Health Week. It started in the early part of the week and runs 
throughout the week. It is a week during which health care 
professionals and the public at large, hopefully, take the time to 
reflect on the successes of our public health system and examine ways 
it can be improved.
  As a physician and one who has spent 20 years in the field of health, 
I have always admired our public health system. I think our country has 
underinvested in it in the last 10 or 15 years. But I think as people 
look at issues like bioterrorism, the threat of biological agents, and 
chemical agents, and emerging infectious diseases such as SARS, HIV/
AIDS, people realize that the frontline of defense is our public health 
system. With regard to Public Health Week, the American Public Health 
Association has focused its efforts this year on raising public 
awareness about health disparities, along with a short list of issues. 
I want to focus my remarks on the health disparities.
  Each day over the course of this week, the national association has 
convened a townhall discussion in a different city to highlight an 
aspect of this topic of health disparities. People say: What is Dr. 
Frist talking about? It is the disparities, the differences that center 
on race, on ethnicity, on geography--where somebody lives, whether it 
is in a city, a rural area, or different parts of the country--or 
health care disparities that center on health literacy, how educated 
you are to understand what is being told to you about health care, your 
own health care, the environment and chronic disease, all of which have 
these disparities

[[Page S4006]]

which, if we shine the light, we would probably eliminate a large 
number of them.
  Two days ago on Tuesday, the American Public Health Association held 
a townhall meeting in Memphis, TN, to highlight rural health 
disparities, one of those geographic disparities that affect people in 
ways that may not always be obvious. I want to take a moment and 
acknowledge several people: The Honorable Dr. W. W. Herenton, mayor of 
Memphis, the Honorable A. C. Wharton, mayor of Shelby County, as well 
as all the other many distinguished participants and sponsors of this 
successful event, including another good friend, a former classmate of 
mine, a medical colleague when I practiced medicine, Dr. Kenneth S. 
Robinson, who is now commissioner of the Tennessee Department of 
Health; Georges Benjamin, M.D., executive director of the American 
Public Health Association; Pat Santel, president of the Tennessee 
Public Health Association; Shavetta Conner, M.D., regional medical 
officer, west region, Tennessee Department of Health; Robin J. Womeodu, 
M.D., executive director, Center on Health Disparities, University of 
Tennessee; the Rural Health Association of Tennessee; the Tennessee 
Hospital Alliance, as well as TennCare.
  I especially wish to commend APHA, the American Public Health 
Association, for taking time to hold this particular meeting in 
Tennessee and for their efforts to bring a comprehensive approach to 
the problem of health disparities.
  I strongly believe any health care disparity among our citizens is 
simply unacceptable. No patient should be denied quality health care 
because of their race, where they live, what their ethnicity is, what 
their gender is, or their socioeconomic status.
  Consider some of the facts, and once you hear these facts, you will 
see why I believe it is unacceptable, there is no good reason for it, 
and almost all of these have reasons we can address that can change the 
disparity.
  Even when socioeconomic status is equal, the mortality rates are 
higher among African Americans and American Indians than among other 
groups.
  My own speciality of heart disease--heart disease is, by the way, the 
leading cause of death in the United States. Heart disease mortality 
rates are almost twice as high among African Americans as among Whites. 
Even when we examine heart disease mortality by socioeconomic status, 
the differences between African Americans and Whites, though 
significantly reduced, are not eliminated.
  African-American and Hispanic women both experience a higher 
prevalence of diabetes when we compare those groups to White women.
  New studies indicate 70 percent of American Indians live in urban 
areas, and nearly 1 in 4 of these live below the poverty level, and 
nearly half below 200 percent of the Federal poverty level. These rates 
are substantially higher than the rates for all other races combined.

  I mentioned income and geography. When we look at the disparities, 
both income and geography play a major role. For example, African-
American men with incomes less than $10,000 have a heart disease 
mortality rate that is nearly 3 times that of their counterparts with 
incomes greater than $15,000.
  Geography is also important. Twenty percent of the U.S. population 
lives in rural areas. These rural communities often experience poorer 
overall health status than many urban communities. Notably, residents 
of rural communities have higher rates of chronic illnesses, such as 
diabetes mellitus and cardiovascular disease. They also have higher 
rates of disability.
  The reasons for these rural disparities are many. They include 
factors such as transportation difficulties, lack of physicians, and 
lack of other health services. Often the health care services that are 
available are much more limited than those services available to their 
urban counterparts, to their counterparts in the cities. Also, 
residents who are in rural areas are much more likely to be uninsured 
than those in urban areas.
  Last year in a speech at Morehouse University, I laid out a plan to 
combat these health disparities. Since that time, I reached out broadly 
to a whole range of constituencies, working with stakeholders and 
national leaders to gather input and ideas. Together we are working to 
ensure my proposed legislation includes the very best possible 
strategies to eliminate these health disparities.
  These efforts culminated in the introduction earlier this year of 
major bipartisan legislation. Two months ago, I joined with Senator 
Mary Landrieu, Senator Thad Cochran, Senator Mike DeWine, Senator 
Christopher Bond, Senator James Talent, and Senator Kay Bailey 
Hutchison to introduce Closing the Health Care Gap Act of 2004. This 
legislation builds on past bipartisan efforts to address disparities, 
most importantly the Minority Health and Health Disparities Research 
and Education Act of 2000.
  In this legislation, we target five key areas. First, expanding 
access to quality health care; two, strengthening national efforts and 
coordination; three, helping increase the diversity of those health 
professionals who are active; four, promoting more aggressive health 
professional education that is intended specifically to reduce the 
barriers to health care, several of which I have already mentioned; and 
five, enhancing the research to identify sources of those disparities--
racial disparities, ethnic disparities, and geographic disparities--and 
also to assess the intervention strategies we know today are quite 
promising.
  In addition, in closing, we know reducing and eliminating health care 
disparities is not going to be easy. It is going to be a huge challenge 
before us. Even a lot of the conversations we must have as a society 
are very difficult, but we must try, and I believe we can do so.
  When we engage in this debate, even in the heat of an election year, 
all of us need to keep in mind the stakes could not be higher. We are 
talking about the health and the lives of our fellow Americans. The 
only way we can make progress toward ending health disparities is by 
forging bipartisan solutions.
  Again, I commend the APHA for focusing this entire week on health 
care disparities. I also appreciate the efforts they have made to 
support this bipartisan legislation in this arena of health 
disparities.
  I look forward to working with the APHA and all of my colleagues to 
continue to work to combat the health care disparities that currently 
do plague our American health care system and, as long as those 
disparities exist, hurt innocent people.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. FRIST. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Smith). Without objection, it is so 
ordered.

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