[Congressional Record Volume 154, Number 10 (Wednesday, January 23, 2008)]
[Senate]
[Pages S158-S179]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
INDIAN HEALTH CARE IMPROVEMENT ACT AMENDMENTS OF 2007
The PRESIDING OFFICER. Under the previous order, the Senate will
resume consideration of S. 1200, which the clerk will report.
The assistant legislative clerk read as follows:
A bill (S. 1200) to amend the Indian Health Care
Improvement Act to revise and extend that Act.
Pending:
Bingaman/Thune amendment No. 3894 (to amendment No. 3899),
to amend title XVIII of the Social Security Act to provide
for a limitation on the charges for contract health services
provided to Indians by Medicare providers.
Vitter amendment No. 3896 (to amendment No. 3899), to
modify a section relating to limitation on use of funds
appropriated to the Service.
Brownback amendment No. 3893 (to amendment No. 3899), to
acknowledge a long history of official depredations and ill-
conceived policies by the Federal Government regarding Indian
tribes and offer an apology to all Native Peoples on behalf
of the United States.
Dorgan amendment No. 3899, in the nature of a substitute.
Sanders amendment No. 3900 (to amendment No. 3899), to
provide for payments under subsections (a) through (e) of
section 2604 of the Low-Income Home Energy Assistance Act of
1981.
The PRESIDING OFFICER. The Senator from Maryland is recognized.
Ms. MIKULSKI. Mr. President, I ask unanimous consent that I be
allowed to speak as in morning business for 7 minutes.
The PRESIDING OFFICER. Without objection, it is so ordered.
Labeling Cloned Food
Ms. MIKULSKI. Mr. President, I know the Indian health bill is very
important. Senator Dorgan will be coming to the floor to lead the
advocacy of its passage, which I support.
Mr. President, I come to the floor because I want to share some very
disturbing news with you and all of my colleagues. Last week, the FDA
gave the green light for cloned foods to enter our food supply.
The FDA announced food from cloned animals, or their progeny, is safe
for human consumption. Despite pleas from thousands of Americans, and
this Senator, to wait until there was more science, the FDA went ahead
anyway.
Mr. President, I want to be clear. I am not opposed to cloning that
follows strict scientific and ethical protocols. This Senator has
always been on the side of science for the advancement of mankind. This
Senator has always been on the side of the consumer and the consumers'
right to know, right to be heard, and their right to be represented.
So today I come to the floor for a vigorous call to action that my
legislation to label cloned food be passed as quickly as possible. This
is a consumer alert today and a call for action.
My bill requires the Government to label any food that comes from a
cloned animal or its progeny. Mr. President, my bill requires that the
FDA and the Department of Agriculture put a label on this cloned food.
The FDA handles milk products. We say FDA should work on this issue.
The Department of Agriculture regulates meat products. That, too,
should be labeled.
My labeling bill would insist that cloned food be labeled at the
wholesale level, the retail level, the restaurant level, the school
lunch level, and the Meals on Wheels level.
My bill allows the American public to make an informed decision.
People have a right to know what they are eating. This is necessary
because the FDA and the Department of Agriculture have refused to put a
label on cloned food. My legislation allows for consumer choice and
also, at the same time, it would allow for monitoring of food as it
comes into the food supply for postsurveillance to see if there are any
negative consequences.
Americans find cloned food disturbing, and some even repulsive. Close
to 80 percent of Americans have said they would not drink cloned milk.
There is a ``yuck'' factor to this technology. Right now, under FDA and
USDA provisions, there would be no way to tell if food comes from a
cloned animal or its progeny. I want the public to be informed, so that
is why my labeling bill is for their benefit.
The FDA has been most troubling to me. They made their decision
despite two congressional directives--one in the omnibus bill and one
in the farm bill. The omnibus bill, which the President signed on
December 26, strongly encouraged FDA to hold off on a cloning decision
before additional studies were done. On December 14, the Senate
overwhelmingly passed the farm bill that would require the National
Academy to peer-review FDA's decision.
Now, this was limited to 1 year. So I wasn't talking about a 20-year
longitudinal study. I do want more science.
Second, I am concerned if we discover a problem with cloned food
after it is in our food supply, and it is not labeled, we will not have
any way of monitoring this. It is labeling that allows us to monitor.
The FDA has been very weak in postmarketing surveillance of drugs.
Why would they be stronger on cloned food? Who will worry about the
ethics? And where is the urgency? We are not facing a global shortage
of beef and a global shortage of milk.
I know FDA's decision on the risk assessment is over 900 pages long.
Mr. President, I have been skeptical of long reports. I have found that
the longer the report, usually the more shallow the information.
My concerns are grave. I am for more science, and I have asked for it
responsibly through the legislative process. I am going to continue to
advocate for more studies on this issue. In the meantime, I want to
protect the consumer and also allow scientists to monitor this new
technology.
If America doesn't keep track of this from the beginning with
labeling, our entire food supply could be contaminated. I am not
opposed to cloning. I
[[Page S159]]
am on the side of science, but let's label and monitor it.
The National Academy of Sciences suggested that we monitor this new
technology because it is very new. They urged the Federal Government to
use diligent postmarket surveillance mechanisms. That requires
labeling.
Mr. President, last week, the EU decided that cloned foods were safe,
but they also put up a big yellow flashing light. They referred it to
their science and ethics and new technologies committee. They said
there is no ethical justification to use cloned food. The EU called for
more scientific study on cloned food, and they also said it should be
labeled.
Denmark and Norway have already banned cloned food from their food
supply. I am worried that they will start banning our exports if they
are not labeled. My State depends on the export of food, whether it is
seafood, chicken, or other products. We want to be able to export our
food.
Mr. President, we are going down a track that I want to be sure is
not irrevocable or irretrievable. The way to ensure safety in our food
supply and consumer choice and the ability for science to continue is
monitoring and labeling.
I stand here on behalf of the consumer to say, please, let's pass
this labeling bill. It is needed, it is responsible, and it will be
effective. I think it will save us a lot of ``yuck'' in the future.
I yield the floor.
The PRESIDING OFFICER. The Senator from Colorado is recognized.
Mr. ALLARD. Mr. President, I ask unanimous consent that I be allowed
to speak as in morning business.
The PRESIDING OFFICER. Without objection, it is so ordered.
U.S.S. ``Pueblo''--40th Anniversary
Mr. ALLARD. Mr. President, I rise now, 40 years since the North
Korean government unlawfully captured the lightly armed U.S.S. Pueblo
while it was on a routine surveillance mission in international waters.
The U.S.S Pueblo was the first ship of the U.S. Navy to be hijacked on
the high seas by a foreign military force in more than 150 years, and
is currently the only commissioned U.S. naval vessel that is in the
possession of a foreign nation. Forty years ago today, 83 crew members
were kidnapped and 1 sailor was killed in the assault. Following the
capture, our men were held in deplorable, inhumane conditions for more
than 11 months before being released. While we were grateful to see the
return of our brave sailors, 40 years later we are still waiting for
the return of the U.S.S. Pueblo.
The U.S.S. Pueblo remains a commissioned naval ship and property of
the U.S. Navy. Currently, the North Korean government flaunts the
Pueblo as a war trophy and a tourist attraction in Pyongyang, North
Korea's capital. We must not continue to remain silent about North
Korea's continued violation of international law by possessing our
ship, the U.S. Navy's ship. Each day tourists visit and tour the U.S.S.
Pueblo, similar to the way visitors see retired naval ships in New York
and San Diego. Americans in particular are encouraged to be
photographed by the U.S.S. Pueblo. As recently as April 2007, it was
reported that President Kim Jong Il stated that the Pueblo should be
used for ``anti-American education.'' North Korea's capture of the
U.S.S. Pueblo is in blatant violation of international law and the
further exploitation of the Pueblo is tasteless and disingenuous. I
believe 40 years of relative silence on this issue is far too long, and
it is important that the Senate take action and denounce the current
situation.
The U.S.S. Pueblo bears the name of the town of Pueblo, CO, a city
with a proud military tradition and is the only city to be home of four
living Medal of Honor recipients simultaneously. In fact, in 1993
Congress deemed Pueblo the ``Home of Heroes'' for this unique
distinction. Many in our State and all over the country want to see the
vessel returned to its proper home. To this end, I am reintroducing a
resolution seeking the return of the U.S.S. Pueblo to the U.S. Navy.
This bill is cosponsored by my good friend and proud veteran, Senator
Daniel Inouye, and I encourage all of our colleagues on both sides of
the aisle to support this legislation and see to it that the U.S.S.
Pueblo is returned to the U.S. Navy.
Mr. President I ask unanimous consent to have printed in the Record
an editorial that appeared in the Pueblo Chieftain today regarding the
anniversary.
As that editorial says, ``Mr. President, bring back the U.S.S.
Pueblo.''
There being no objection, the material was ordered to be printed in
the Record, as follows:
[From the Pueblo Chieftain, Jan. 23, 2008]
Infamy
Today marks the 40th anniversary of what for Puebloans is a
day that shall live in infamy. On Jan. 23, 1968, naval and
air forces of North Korea attacked and took hostage the USS
Pueblo and its crew.
The Pueblo was a Navy intelligence ship operating in
international waters. Despite that, the Stalinist regime in
Pyongyang decided on a bold course of action and sent patrol
boats and MiG fighters to harass the lightly armed U.S.
vessel.
This was during the height of the Vietnam War, and the
North Koreans correctly figured that American military brass
weren't focused on the American spy ship's mission. They were
right.
Armed only with one .50-caliber machine gun, the Pueblo
crew tried to fend off the advancing Communist forces, to no
avail. One crewman was killed while comrades tried to destroy
as much equipment and paperwork as possible.
But the die was cast. The North Koreans boarded the Pueblo
and took the rest of the crew hostage.
For the next 11 months, the crew was subjected to cruel and
inhumane treatment at the hands of their captors. But the
American spirit was not to be tamed.
During propaganda photo sessions, the Yanks dutifully
smiled for the Koreans' cameras--and flashed ``the bird,''
that one-finger salute that Americans know too well but was
above the heads of the Communists.
But that did not last. When the Reds figured out what that
sign of defiance meant, the men of the Pueblo were subjected
to more severe beatings.
The man who took the worst of the pummeling was Cmdr. Lloyd
Bucher, the Pueblo's skipper. After each torture session,
he'd crawl back to his cell--and surreptitiously give his
comrades the high sign.
He, and his men, were not to be beaten.
It was exactly 11 months after the seizure when the North
Koreans freed their American captives. They were allowed to
walk one by one across the Demilitarized Zone separating
North and South Korea.
While the Pueblo crew was free, their ship was and still is
not. It is being held as a trophy of war in a river near
Pyongyang--a tourist attraction and propaganda piece for the
regime.
North Koreans have been forced at times to eat grass, so
poorly is their economy run by central planners. But they
have ``bread and circuses'' in the form of the American
intelligence ship which bears this city's name.
Many attempts have been made to persuade the North Koreans
to give the ship back to its rightful owners. When he was
governor of California, Ronald Reagan urged Washington to
bomb North Korea in order to force the ship's release.
Over the years since, numerous diplomatic moves have been
tried. Recently, at the behest of Colorado's U.S. Sen. Wayne
Allard, a Korean battle flag on display at the U.S. Naval
Academy was returned to the Hermit Kingdom as a sign of this
nation's goodwill.
That and all other overtures have thus far been fruitless.
But this incident of four decades ago remains an ugly scar on
the history of this nation, one which cannot be allowed to
continue to fester.
We realize that with the War on Terrorism in Iraq,
Afghanistan and elsewhere across the globe, there are other
pressing international security issues. But if this nation
were to show the world its resolve by getting the USS Pueblo
back, by whatever means, we would show those who think they
can bring us to our knees that we are not to be cowed.
Mr. President, bring back the USS Pueblo.
The PRESIDING OFFICER. The Senator from North Dakota is recognized.
The Economy
Mr. DORGAN. Mr. President, when I am completed talking about the
economy, we will return to the Indian affairs business and debate the
bill on the floor. If there are those who wish to offer amendments, I
certainly hope we can bring them to the floor and debate them and vote
on them.
As I mentioned, I would like to talk for a moment about the economy.
There is the 24/7 news hour all across this country talking about what
is happening: What on Earth is going on in this country's economy? What
is happening in the stock market, which is moving up and down like a
yo-yo--not so much up anymore but down substantially in recent weeks
and months.
So what is happening? There are many pieces of evidence to suggest
this economy is in very big trouble, including a substantial reduction
in the stock market, an increase in unemployment, and a dramatic drop
in housing starts. As a result of all of that,
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there has been frenzied activity, both at the White House and in the
Congress, to talk about something called a stimulus package. We need to
do a fiscal stimulus package.
In fact, the President announced a stimulus package of $145 billion
to $150 billion. That is a stimulus package of about 1 percent of our
gross domestic product in this country.
Yesterday, the Federal Reserve Board took action in monetary policy
to cut a key interest rate by 75 basis points. That was a significant
and aggressive move by the Federal Reserve Board. This Congress and
this President will want to make some aggressive moves with a stimulus
package that are complementary to what has been done in monetary
policy.
I make this point that is very important: If that is what we do, and
all that we do, we fundamentally misunderstand what is wrong. I think
most of the American people understand what is wrong. Certainly, most
of the people around the world who look at this country understand we
have gone off the track. If we don't fix our trade policy and fiscal
policy, and if we don't fix things that need regulating that have
largely been outside of the view of regulators, we are going to
continue to be in very big trouble. Let me go through just a couple of
these items.
We have the largest trade deficit in human history. Every single day,
7 days a week, we import $2 billion more than we export. That means
every single day we add another $2 billion to the indebtedness of this
country. That is over $700 billion a year. We are hemorrhaging in red
ink. We have to fix it. Warren Buffett, a remarkably successful
investor in this country, said it quite clearly: This is unsustainable,
this cannot continue.
The fact is, the President and the Congress act as if nothing is
wrong. We have the most unbelievably inept trade policy in the history
of humankind--$2 billion a day we import more than we export. That
means we are putting dollars that we pay for those goods in the hands
of foreigners, and they are coming back to buy part of America. We are
literally selling part of this country. But the fact is, you cannot
hemorrhage in red ink like that for any great length of time without
having significant consequences. It is what undermines your currency.
It undermines confidence in your economy.
You add to that $700 billion-plus a year trade deficit a fiscal
policy that is reckless and ill-considered. It is as if we think people
cannot see. It is like a drunk who thinks they are invisible. The fact
is, we have an unbelievable fiscal policy deficit. They say: Well, it
is $200 billion, $300 billion. Nonsense. Take a look at what we have to
borrow for fiscal policy every year. The reason they show the lower
deficit is because they are misusing the Social Security revenues. Take
a look at the real deficit. It is likely to be over half a trillion
dollars this year. You add that to the trade deficit and then ask
yourself, if you were looking from the outside into this country, do
you think this is off track, the fundamentals are out of line? Do you
think they have to be fixed? The answer is yes. We have very serious
abiding problems. You add to that an unbelievably inept fiscal policy
hemorrhaging in red ink and is way off track.
By the way, it is not just the normal budgetary Presidential requests
and congressional actions on spending and taxing. The President, in the
last year, sent to the Congress, in addition to outside-the-budget
system, he said: I want you to appropriate money for me, $196 billion--
that, by the way, is $16 billion a month, $4 billion a week--and I
don't want any of it paid for; I want it added to the debt because I
want it for Iraq, Afghanistan, and other activities with respect to the
war. That takes us to over two-thirds of a trillion dollars this
President has asked for, none of it paid for. We will send our soldiers
to war, but we will not do anything that requires any effort on our
part to begin to pay for it. We will send soldiers to war and say: Come
back and you pay for it later.
In addition to a fiscal policy that just does not work, we are now
engaged in a war in which we borrow the money. Even as we borrow the
money for the war, we have a President who says: I want more permanent
tax cuts, mostly for the wealthy. It is not a secret. Everyone sees
what is going on--everyone, apparently, except those in the White House
and those in the Congress.
We have to fix the fundamentals, and if we do not, there isn't any
amount of fiscal policy stimulus or any amount of activity by the
Federal Reserve Board that is going to set this straight. It just is
not.
You add to that inept trade policy and the hemorrhaging of red ink on
fiscal policy that is reckless and out of control these issues:
regulators who really do not care. They come to the body of regulatory
responsibility bragging that they don't like government. What happens?
We have what is called a subprime lending crisis. What does that mean?
What it means is no one was watching and no one cared very much, and
what we had was an orgy of greed with respect to an industry that is
essential to this country--that is, providing loans so people can buy
homes.
We had a bunch of highfliers decide: What we really want to do is to
sell you a loan, and we want to put you in a new home. To do that, we
will give you rates that you will not even believe. We will give you a
home loan at a 2-percent interest rate--2 percent. We will quote the
payment. That looks good, a 2-percent interest rate. What they don't
tell you is the interest rate is going to reset in 3 years, it is going
to reset way up, and then you will not be able to make the payments, or
they do not tell you there also is an escrow you have to pay every
month on top of that.
Here is what was going on. This was an advertisement on television:
Do you have bad credit? Do you have trouble getting a loan?
You've been missing payments on your home loan? Filed for
bankruptcy? Doesn't matter. Come to us. We've got financing
available for you.
We have all heard these ads and probably scratched our heads and
wondered: How on Earth can this happen? The fact is, it can.
I will give an example. The biggest mortgage lender is Countrywide,
which now is being purchased by Bank of America, apparently. The CEO of
Countrywide, Mr. Mozilo, made off now with hundreds of millions of
dollars. They had brokers cold-calling people saying: We want to put
you in a subprime loan. Then they sold these subprime loans. They
packaged these subprime loans with other good loans. They were enticing
people into these loans at teaser interest rates that were going to
reset in ways people could not afford to pay. Then they decided, just
as in the old days when the discussion was about meat-packing plants
and they put sausage and sawdust together--when you make sausage, you
need a filler. So they put sawdust in sausage. These companies that
were hawking these loans decided to put good loans with bad loans,
subprime with other loans, and then mix them all up like a big-old
sausage, and they would slice them up, securitize them, and sell them.
Who wanted to buy them? The rating agencies were sitting there dead
from the neck up: This looks OK. We don't understand it, but it looks
good to us. Hedge funds were saying: I like these new pieces of
financial sausage because they are sliced up in a way that has a big
yield. Why a big yield? Because they had prepayment penalties for the
loans, loans that would reset to much higher interest rates that people
couldn't make. This new piece of financial sausage shows a very high
yield. So the hedge funds, liking high yields and liking big money, are
buying all these securitized loans, and then all of a sudden, it goes
belly up. And we wonder why. It is because people were advertising on
television: You have bad credit? Have you filed for bankruptcy? Come to
us; we want to give you a loan. Then they package this up in an
irresponsible way.
One might ask the question: How could that all have happened? Weren't
there some regulators around? No, no. The regulators were first
ignoring them and then actually giving them a boost. Alan Greenspan now
stands around scratching his head thinking: What on Earth happened? It
happened on your watch, my friend. The Federal Reserve Board did
nothing. In fact, part of this housing bubble that occurred was part of
the air that comes from these unbelievable subprime loans that boosted
that bubble. Again, Warren Buffett said: Every bubble will burst. And
this one did. It shouldn't
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have surprised us. But regulators sat by and said: That doesn't matter.
Did anybody care about those brokers placing a $1 million jumbo
subprime loan, making a $30,000 commission on that loan? Did anybody
say: Wait a second, what you are doing is misleading the folks who are
going to borrow the money; you can't do that. Did anybody say to the
rating agencies: You can't be rating as top-grade securities this
sausage with sawdust, these financial instruments that have stuck
together bad loans with good loans; you can't do that. Did anybody say
to the hedge funds: You are buying a pig in a poke here; you are buying
something you think is high yield, but you know better than that. What
happened was all of this went out over the transom, and nobody even
knows where it is or how much it is. Now they can't untangle it to find
out where all these subprime loans exist. Nobody knows.
The next time somebody talks about regulation, understand, sometimes
regulation is very important. The danger to this economy, as a result
of the subprime scandal, is very significant. It is having consequences
all across this country. You add this subprime scandal and its
consequences to a fiscal policy that is reckless, to a trade policy
that is inept, and then add this final factor: We have a circumstance
where a gambler goes into a casino in Las Vegas and, in most cases, the
sum total of what they will lose is the money they have carried into
the casino--that is the risk of loss.
Here is the other fact about what is happening in our economy that
nobody wants to talk about. We have hedge funds--yes, they are called
hedge funds, mostly unregulated--to the tune of about $1.2 trillion.
Some would say that is not so much, $1.2 trillion. There is $9 trillion
of mutual funds. There is something like $40 trillion of the total
aggregate value of stocks and bonds. So $1.2 trillion in hedge funds,
that is not so much, except one-half of all the trading on the New York
Stock Exchange is done by those hedge funds. And those hedge funds have
created, among other things, derivatives. There was something like a
notional value of $26 trillion in credit default swaps at the end of
2006.
It sounds very much like a foreign language when I say it, but the
product everyone is worried about at the moment is something called
credit default swaps, trillions of dollars of credit default
derivatives--fancy financial instruments, much fancier than sausage
with sawdust but in many ways the same thing. The interesting thing
about these hedge funds is the dramatic amounts of borrowing, so they
are not going to lose just what they go into the casino with in their
pocket money. They are so heavily leveraged and so deep in credit
default swaps that this could have significant consequences for our
economy.
I and others have spoken on this floor for several years about the
need for regulation of hedge funds. I have spoken on this floor many
times about the issue of derivatives and the total aggregate notional
value of derivatives and its potential consequence to the economy in a
downturn.
A friend told me there is a saying on Wall Street that you will never
know who is swimming naked until the tide goes out, and then it might
not be very attractive. When the tide goes out with respect to this
economy's difficulties and we evaluate who in the hedge funds, in the
investment banks, who in all of these enterprises is left who cannot
pay the bills because they were so unbelievably leveraged in financial
interests most Americans have never heard of, credit default swaps,
what are the consequences to our country's economy?
If this does not sober up our Government on trade policy and fiscal
policy and regulatory requirements with respect to hedge funds and
derivatives, then nothing will. If this does not alert all of us that
we are no longer operating behind a screen somehow--the world sees what
is happening when there is a subprime loan scandal, the world
understands it, and its consequences are felt all across this country
and all across the globe.
I understand we are going to do something called a stimulus package.
We have a roughly $13 trillion-plus economy. We are going to do a
stimulus package probably of $140 billion, $150 billion--1 percent of
our economy. I understand the Federal Reserve has taken substantial
action, 75 basis points yesterday. That is a big deal for the Fed, and
I understand why. It is to try to calm the nerves and say this country
stands behind its economy, and we should. I believe in this country's
economy. This engine of opportunity and engine of growth is unusual in
the world. On this planet, we circle the Sun, and there are about 6.4
billion neighbors, half who live on less than $2 a day and half who
have never made a telephone call, and we have the opportunity to live
in this country. This is a wonderful place. We have built something
unusual on this planet, but we have run into difficulty. No one seems
to want to admit it, and we have to fix the fundamentals. Yes, we can
do stimulative packages, but if we don't fix the fundamentals, we will
not solve the problems for the future, we will not expand opportunity
for the future.
There is so much to say and so much to be concerned about, but there
is so much hope for the future if--if--we understand that a stimulus
package is not our only responsibility. We have to fix trade and fiscal
policy, and regulatory responsibility. We need to begin regulating
hedge funds and be concerned about the notional value of derivatives.
If we do not start doing that, we are not going to fix this issue, and
we are not going to have a better future.
I feel very strongly, if we do what is right, that we can provide
substantial opportunity for this country, but the right things will
include much more than a stimulus package.
Mr. President, I would like, in concluding my portion of morning
business, I would like to talk about the underlying bill on the floor
of the Senate, that is the Indian Health Care Improvement Act.
I spoke yesterday at some length, but I wish to again talk a little
bit about why we are here and what all this means because I think it is
so important. Some might say: Well, why is there an Indian Health Care
Improvement Act? Why not a Norwegian or a Lutheran Health Care
Improvement Act?
The Indian Health Care Improvement Act is designed that way, with
that name, for a very specific reason. This country, for a long period
of time, told American Indians: Look, we are going to take your land,
we are going to force you to a reservation someplace, and we will write
a treaty for you. Our treaty is going to tell you we are going to take
care of your health care. We are going to meet our obligation. We have
a trust responsibility for you.
So we will take your land, we will move you off to reservations, but,
trust us, we are going to provide for your health care because that is
our trust responsibility. Chief Joseph from the Nez Perce Tribe said:
Good words do not last unless they amount to something.
Words do not pay for dead people. Good words cannot give me
back my children. Good words will not give my people good
health and stop them from dying.
He was concerned long ago about the inability of this country to keep
its word on these trust responsibilities. We are here today because,
finally, back in the early 1970s, President Nixon, President Ford, and
every President succeeding them understood we have a trust
responsibility for Indian health care. That is a fact.
In 1970, President Nixon noted we had 30 licensed Native American
physicians in all our country. Thirty. And we created back then a self-
determination policy. In 1976, President Ford signed into law the
Indian Health Care Improvement Act. That is what we discuss today on
the floor of the Senate.
I spoke yesterday, and I wish to again briefly about the challenge. I
have held a lot of listening sessions on Indian reservations, and,
frankly, the challenges we face are daunting.
Indian reservations see unbelievable health challenges. On a good
many reservations, you will find one-half of the adult population who
are suffering from diabetes. On the northern Great Plains, the rate of
death from suicide among teenagers on Indian reservations is not double
or triple, not 5 times the national average, but 10 times the national
average of teen suicide.
I have held hearings about that. I have sat down with Indian
teenagers on an Indian reservation, no other adults present, to say:
What is going on in
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your lives? What is happening? What is causing those clusters of
suicides? There are so many problems of diabetes and suicide and so
many other issues on reservations, dealing with health care. Part of it
is because this system is so dramatically underfunded.
I wish to mention Ardel Hale Baker. Ardel Hale Baker is a woman on an
Indian reservation who allowed me to use her photograph. Ardel Hale
Baker was having a heart attack, diagnosed as a heart attack at a
clinic. She didn't want them to call an ambulance. The nearest hospital
was an hour and a half, hour and three-quarters away. She was lucky she
got to the clinic when it was opened because the clinic, I believe, is
open from 9 o'clock until 5 o'clock or 4 o'clock, with an hour closed
for lunch hour. It is not open on weekends, but that is the health care
on that reservation.
But she went there when the clinic was open. She was diagnosed as
having a heart attack. She did not want them to call an ambulance
because she knew that if the ambulance was not paid for by the Indian
Health Service, she did not have any money and it would ruin her
credit, because they would come after her.
So they said: No matter what you want, you are getting an ambulance.
They put her in an ambulance, drove her about an hour and three-
quarters to the nearest hospital. As they unloaded this woman from the
ambulance gurney to a hospital gurney to pull her into the emergency
room, they discovered a piece of paper attached to her thigh with a
piece of tape.
I want to show you the paper that was attached to the thigh of Ardel
Hale Baker as she was being wheeled into a hospital with a diagnosis of
a heart attack. This is from the U.S. Department of Health and Human
Services. It is a letter attached to this woman's leg with masking
tape. It says on the letter that: You should understand that you have
received outpatient medical services from your doctor at so and so. And
this letter is to inform you that your priority one care cannot be paid
for at this time, due to funding issues.
What they were saying is, as they wheeled this Indian woman into the
emergency room, they were saying to the hospital: Understand this. That
whatever care you give her is not going to be paid for, because we are
out of contract health care funds.
On that reservation, everyone knows the refrain: Do not get sick
after June because they are out of contract health care funds. What
does this do? Well, if they treat this woman, then they have a bill
that they go after this woman on. She does not have the ability to pay
it. So it ruins her credit rating quickly, just like that. I cannot
tell you the number of adults I have run into on these reservations who
have had their credit ratings ruined because contract health care would
not pay for health care.
They did not have the money. They were treated anyway, but then it
ruined their credit rating. This is an example of what is happening
over and over. It is happening today, on Wednesday.
Yesterday, I spoke about a beautiful young woman named Ta'shon Rain
Littlelight. I was on the Crow Reservation in Montana. And Ta'shon Rain
Littlelight's grandmother stood up at a meeting on health care. And
this little 5-year-old girl, with the bright eyes and the beautiful
traditional dress, loved to dance at age 5. And she apparently was a
good dancer.
Ta'shon Rain Littlelight is dead. She lived the last 3 months of her
life in unmedicated pain. This little girl was taken again and again
and again and again to the Indian health clinic. And she was treated
for depression. Depression.
At one of the visits, her grandparents said: Well, she has a bulbous
condition on her toes and her fingers which suggests maybe she is not
getting oxygen or something else is wrong, can you check? Treated her
for depression.
One day she was airlifted to Billings, MT, to the hospital. In
arriving at the hospital in Billings, MT, she was very quickly then
airlifted to the Children's Hospital in Denver, CO, and diagnosed with
terminal cancer.
Now Ta'shon Rain Littlelight was a 5-year-old child. She would not
have known the challenges of this issue of Indian health care. When
diagnosed with a terminal illness, she told her mother what she wanted
to do was to go see Cinderella's castle. And the Make-A-Wish Foundation
folks made that happen.
A few weeks later, she was in Orlando, FL. The night before she was
to see Cinderella's castle, in the hotel room, in her mother's arms,
she died.
And Ta'shon Rain Littlelight told her mother that night before she
died: Mommy, I will try to get better. Mommy, I am sorry I am sick.
This little girl lived in unmedicated pain with an undiagnosed
illness for many months. Would that have happened in our families?
Would it?
A woman goes to a doctor on an Indian reservation, with so much pain
in her leg because her knee is bone-on-bone, unbelievable pain. And she
is told: Wrap it in cabbage leaves for 4 days and it will be fine.
The doctor who subsequently treated her off the reservation said it
was unbelievable. This is the woman who had a knee condition with such
unbelievable pain that any of us or our families would immediately have
wanted to have a new knee, a replacement. But she was told to wrap it
in cabbage leaves for 4 days and it will be okay.
Now, if I sound angry about what is going on, I am. Because this
country has a responsibility to do better. We have a responsibility for
health care for two special groups of people. One, Federal prisoners
whom we send, incarcerated, to Federal prisons because they have
committed crimes. When they are in a Federal prison, it is our
responsibility for their health care, and we provide it.
We also have a responsibility because we promised and made a solemn
trust oath to provide health care for American Indians. We even signed
that into treaty after treaty. Now, all these years later, I find we
are spending twice as much per person to provide health care for
incarcerated Federal prisoners as we are to provide health care for
American Indians.
That is why Ta'shon Rain Littlelight loses her life or at least does
not have the kind of care and diagnosis we would expect for ourselves
or our families or other Americans. That is why we have to fix it.
So having said all that I--I am sorry to go through it again--but I
feel so strongly that this Congress has to take responsibility. Having
said all that, there is much we can do. We have put together a piece of
legislation that is 10 years too late. Ten years this Congress has
delayed in reauthorizing this bill.
Finally, we are on the floor of the Senate to reauthorize this bill.
This legislation is not perfect. It is a step forward, a step in the
right direction. One of my colleagues will come and say: I demand
reform. Well, he cannot demand it more than I demand it. But if you
cannot get the first step done, how are you going to talk about reform
10 years after this should have been done?
I am looking for amendments that can be brought to the floor that can
strengthen this. I am for those amendments. As soon as this passes, our
committee is going to immediately begin a much broader reform of Indian
health care.
But first and foremost, we have to move forward. We expand cancer
diagnosis and treatments, we expand the opportunities for dialysis, we
expand the opportunity for diabetes programs, we expand the
opportunities to recruit doctors and nurses on Indian reservations. We
do a lot of things in this bill that advance the interests of Indian
health care.
It is not all I would like to do, but it is a significant step
forward, that will improve the lives of people who today are not
getting what was expected and what was promised by this country. This
country has a responsibility to meet this, and I am determined,
somehow, someway, we are going to meet it.
It appears, toward the end of this afternoon, the majority leader has
indicated we have to go to the Foreign Intelligence Surveillance Act,
because we have a February 1 deadline on that. We likely will not get
this bill done by the end of this afternoon. We will then turn to FISA
and work on FISA, I believe, perhaps today, tomorrow, perhaps Friday
and Saturday, according to the majority leader.
But when the Foreign Intelligence Surveillance Act is completed, the
majority leader told our caucus a bit ago, then we will pull this back
on the floor and finish this piece of legislation.
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So I ask my colleagues to come to the floor with amendments. Let us
debate amendments, talk through amendments, improve this bill, if we
can. But most importantly, let us get to the end, get it passed and
have a conference with the House and, finally, after 10 long years,
send this to the President for signature.
I yield the floor and suggest the absence of a quorum.
The PRESIDING OFFICER. The clerk will call the roll.
The bill clerk proceeded to call the roll.
Mr. DORGAN. Mr. President, I ask unanimous consent that the order for
the quorum call be rescinded.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. DORGAN. Mr. President, we are attempting, with the two
cloakrooms, to notify offices of Senators that we would like very much
to find a way to get a list of the amendments that are intended to be
offered.
So if there are Senators who have amendments to this bill they intend
to offer, we hope they would notify their cloakrooms so we can put a
list together. We would like to make some progress. I do know the
Republicans have an issues conference this afternoon, or perhaps all
day. But I know they are now at an issues conference, I believe at a
location on Capitol Hill. So I expect this bill will be carried over.
But if we can have some amendments offered this afternoon, still we
can debate these amendments, I would like to ask Senate offices if they
have amendments, notify the cloakrooms so we can put them on a list and
have some notion of what we need to do in order to get this bill
completed.
My understanding is the Senator from Vermont wishes to speak in
morning business.
The PRESIDING OFFICER (Mr. Sanders). The Senator from Vermont.
Mr. LEAHY. Mr. President, I ask unanimous consent to continue for
what will be a relatively short while as in morning business.
The PRESIDING OFFICER. Without objection, it is so ordered.
Foreign Intelligence Surveillance
Mr. LEAHY. Mr. President, the Senator from North Dakota is absolutely
right. Having managed a number of bills, I know that sometimes it is
hard to get people with amendments to come forth. I hope they do. Once
this bill is finished, we will go to the Foreign Intelligence
Surveillance Act or, as we know it here, FISA. It is intended to
protect both our national security and also the privacy and civil
liberties of all Americans. We are considering amendments to that
important act that will provide new flexibility to our intelligence
community. We all support surveillance authority. With terrorists
plotting against us and talking about it, we want to be able to use all
the various electronic and other means to find out what they are
saying. Unlike some in the administration who say we are dealing with
an antiquated law, we have updated this act many times, probably 30 or
more times since its historic passage after intelligence abuses of
earlier decades.
I came here 34 years ago. I well remember that this Nation was still
reeling from the excesses of the COINTELPRO when people were being
spied on by their Government simply because they disagreed with what
the Government was doing; in this case, the war in Vietnam. We enacted
FISA so we could do the legitimate thing of actually spying on people
who wanted to do harm to the United States at the time of the Cold War,
when we had adversaries all over the world. We also wanted to make sure
that Americans who were minding their own business, not doing anything
illegal, wouldn't be spied upon.
We rushed the so-called Protect America Act through the Senate just
before the August recess and with it were a number of excesses. They
came about because the administration broke agreements it had reached
with congressional leaders. The bill was hurriedly passed under intense
partisan pressure from the administration. In fact, the pressure was so
strong, they made it very clear why they were willing to break
agreements with those Republicans and Democrats who had been working
together to try to craft a bill that would protect America's interests
but also protect the privacy of individual Americans.
So we passed a bill that provides sweeping new powers to the
Government to engage in surveillance, without a warrant, of
international calls to and from the United States involving Americans,
and it provided no meaningful protection for the privacy and civil
liberties of the Americans who were on those calls. It could be an
American calling a member of their family studying overseas. It could
be a business person who, as they travel around to various companies
they represent, ends up having their telephone calls intercepted.
But before that flawed bill passed--the one that came about because
of the broken agreements by the administration--Senator Rockefeller and
I and several others in the House and Senate worked hard, in good faith
with the administration, to craft legislation that solved an identified
problem but, as I said, protected America's privacy and liberties.
Just before the August recess the administration decided instead to
ram through its version of the Protect America Act with excessive
grants of Government authority and without any accountability or checks
and balances. They did this after 6 years of breaking the law through
secret warrantless wiretapping programs. It was one of the most
egregious things I have seen in my 34 years in the Senate. First they
violate the law, and then instead of being held accountable, they ram
through a law designed to allow them to continue those actions. Some of
us saw it for what it was and voted against it. Both Senators from
Vermont voted against it. We are from a State that borders a foreign
country. We are concerned about our security, but we are also concerned
about our liberties and our privacy.
We did manage to include 6-month sunset in the Protect America Act so
we would have a chance to revisit this matter and do it right. The
Senate Judiciary Committee and the Intelligence Committee, as well as
our House counterparts, have spent the past month considering changes.
In the Senate Judiciary Committee we held open hearings. We had more
briefings than I can even count and meetings with the administration,
with people in the intelligence service, with people at the CIA, NSA,
and others. We considered legislative language in a number of open
business meetings where Senators from across the political spectrum
could be heard. Then we reported a good bill to the Senate before
Thanksgiving.
The bill we are now considering will permit the Government, while
targeting overseas, to review more Americans' communications with less
court supervision than ever before. I support surveillance of those who
might do us harm, but we also have to protect Americans' liberties.
Attorney General Mukasey said at his nomination hearing that
``protecting civil liberties, and people's confidence that those
liberties are protected, is a part of protecting national security.''
Let me repeat what the new Attorney General said:
Protecting civil liberties, and people's confidence that
those liberties are protected, is a part of protecting
national security.
I agree with him. That is what the Judiciary Committee bill does. I
commend the House of Representatives for passing a bill, the RESTORE
Act, that takes a balanced approach to these issues and allows the
intelligence community great flexibility to conduct surveillance of
overseas targets but also provides oversight and protection for
Americans' civil liberties. The Senate Select Committee on Intelligence
has also worked hard. I know Chairman Rockefeller was as disappointed
as I at the administration's partisan maneuvering just before the
August recess. After being here through six administrations, it has
always been my experience, with Republican or Democratic
administrations at certain points, when you are negotiating a key piece
of legislation with the administration, you have to rely on them to
keep their word and be honest with you, as they have to rely on you to
keep your word and be honest with them. Through six administrations, 34
years, I can never remember a time where an administration was less
truthful or flatly broke their word in the way this one did.
I commended the efforts of Senator Rockefeller and those working with
him. I do so again now. I believe both he and I want surveillance but
we want
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surveillance with oversight and accountability within the law. I also
want to praise our joint members. In the Judiciary Committee we have,
by practice, a certain number of members who serve on both Judiciary
and Intelligence for obvious reasons. The ranking member of Judiciary
and I, of course, have access to a great deal of intelligence whenever
we have requested it, but that is on an ongoing basis.
Senators Feinstein, Feingold, and Whitehouse contributed so much to
the work of the Judiciary Committee. They worked with me to author many
of the additional protections we adopted and reported. They had worked
on the bill in the Intelligence Committee and then worked with us.
These Senators and others on the Judiciary Committee worked hard to
craft amendments that will preserve the basic structure and authority
proposed in the bill reported by the Select Committee on Intelligence,
but then they added those crucial protections for Americans, the part
the Judiciary Committee, because of our oversight of courts, worries
about.
I believe we need to do more than the bill initially reported by the
Senate Select Committee on Intelligence does to protect the rights of
Americans. I know the chairman of that committee joins with me to
support many of the Judiciary Committee's improvements.
Let me cite briefly what they are. The Judiciary bill, for example,
makes clear that the Government cannot claim authority to operate
outside the law outside of FISA--by alluding to other legislative
measures never intended to provide that authority.
I will give you an example of what happened. The House and the Senate
passed an authorization for the use of military force. We did this
right after September 11. It was authorization to go in and capture
Osama bin Laden--the man who engineered 9/11, is still loose, and
taunts us periodically. But what happened? The administration was so
hellbent on getting into Iraq that when they had Osama bin Laden
cornered, they withdrew their forces and let him get away so they could
invade Iraq--a country that had absolutely nothing to do with 9/11. Now
they say that authorization allowed them to wiretap Americans without a
warrant. I have heard some strange, convoluted, cockamamie arguments
before in my life. This one takes the cake.
I introduced a resolution on this in the last Congress when we first
heard this canard. We authorized going after Osama bin Laden, but the
Senate did not authorize--explicitly or implicitly--the warrantless
wiretapping of Americans. By their logic, they could also say we
authorized the warrantless search of the distinguished Presiding
Officer's home or my home. This body did no such thing, but the
administration still is clinging to their phony legal argument.
The Judiciary bill would prevent that dangerous contention with
strong language that reaffirms that the Foreign Intelligence
Surveillance Act is the exclusive means for conducting electronic
surveillance for foreign intelligence purposes.
The Judiciary Committee's amendment would also provide a more
meaningful role for the FISA court to oversee this new surveillance
authority. The FISA court is a critical independent check on Government
excess in the sensitive area of electronic surveillance. The
administration claims that of course the Foreign Intelligence
Surveillance court can look at what they are doing, they just don't
want the court to be able to do anything about it. No. The Judiciary
Committee says the court should be able to look at what they are doing
and should be able to stop them if they are breaking the law. In this
Nation we fought a revolution over 200 years ago to have that right.
With the authority of a majority of the Judiciary Committee members,
I am going to offer a revised version of the Committee's amendment that
makes some changes to address technical issues and also to address some
of the claims the administration has made about our substitute.
For example, in response to concerns raised by the administration in
its Statement of Administration Policy, we have revised the exclusivity
provision to ensure that we are not overextending the scope of FISA. We
have also revised the provision concerning stay of decisions of the
FISA Court pending appeal, the provision clarifying that the bill does
not permit bulk collection of communications into or out of the United
States, and a few other provisions.
I believe these revisions make the Judiciary Committee's product even
stronger, and I urge my colleagues to support it.
Now, in the bill we have a title I, a title II. Title II in the
Intelligence bill talks about retroactive immunity. We do not address
that in the Judiciary Committee's bill, but I do strongly oppose the
bill reported by the Senate Select Committee on Intelligence in that
area. Their bill would grant blanket retroactive immunity to
telecommunications carriers for their warrantless surveillance
activities from 2001 through earlier this year. This surveillance was
contrary to FISA and violated the privacy rights of Americans.
The administration violated FISA for more than 5 years. They got
caught. If they had not gotten caught, they probably would still be
doing it. But when the public found out about the President's illegal
surveillance of Americans, the administration and the telephone
companies were sued by citizens who believe their privacy and their
rights were violated.
Now the administration is trying to get this Congress to terminate
those lawsuits. It is not that they are worried about the telephone
companies. They are not as concerned about the telephone companies as
they are about insulating themselves from accountability.
This is an administration that does not want us to ask them anything,
and they do not want to tell us anything. Interesting policy. If you do
ask them, they are not going to tell you. If they do tell you, it
appears oftentimes they do not tell you the truth.
Now, the rule of law is fundamental to our system. It has helped us
maintain the greatest democracy we have ever seen in our lifetimes. But
in conducting warrantless surveillance, the administration showed
flagrant disrespect for the rule of law. It is like the King of France,
who once said: ``L'Etat, c'est moi.'' ``The state is me.'' They are
saying: What we want to do is what we will do. And if we want to do it,
the law is irrelevant.
I cannot accept that.
The administration relied on legal opinions that were prepared in
secret and shown only to a tiny group of like-minded officials who made
sure they got the advice they wanted--advice that, when it saw the
light of day, people said: How could anybody possibly write a legal
memorandum like that?
Jack Goldsmith, who came in briefly to head the Justice Department's
Office of Legal Counsel, described the program as a ``legal mess.'' He
is a conservative Republican. He looked at this and said: It is a legal
mess. Now, the administration does not want a court to get a chance to
look at this legal mess. Retroactive immunity would assure that they
get their wish and that nobody could ask how and why they broke the
law.
Frankly, I do not believe anybody is above the law. I do not believe
a President is, I do not believe a Senator is, I do not believe anybody
is.
I do not believe that Congress can or should seek to take rights and
legal claims from those already harmed. I support the efforts of
Senators Specter and Whitehouse to use the legal concept of
substitution to place the Government in the shoes of the private
defendants who acted at its behest and to let it assume full
responsibility for the illegal conduct.
Although my preference, of course, is to allow the lawsuits to go
forward as they are, I believe the substitution alternative is
effective. It is far preferable to retroactive immunity, and it allows
this country to find out what happened.
Keep in mind why we have FISA. Congress passed that law only after we
discovered the abuses of J. Edgar Hoover's FBI. Through the COINTEL
Program, Hoover spied on Americans who objected and spoke out against
the war in Vietnam--which pretty well involved 100 percent of the
Vermont delegation in Congress.
It is like the Department of Defense today that is going around
videotaping Quakers protesting the war. Quakers
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always protest the war. But this administration seems to think, if you
disagree with them, somehow you are an enemy of the country and they
can justify spying on you. That is why we put these laws in place. Is
memory so short around here? Is memory so short or are we so frightened
by 9/11 that we are willing to throw away everything this country
fought for and everything that has made this country survive as long as
it has?
We were told this building was targeted by terrorists. I proudly come
into this building every day to go to work. It is the highlight of my
life, other than my wife and my family. But I come in here because I
believe 100 Members of the Senate can be the conscience of the Nation.
We can protect Americans' rights, we can protect those things that our
forefathers fought a revolution for, that we fought a civil war to
protect, that we fought two World Wars to protect. Now we are going to
throw it away because of a group of terrorists? This is ``Alice in
Wonderland.''
So as we debate these issues, let's keep in mind the reason we have
FISA in the first place. As I said, back in the 1970s we learned the
painful lesson that powerful surveillance tools, without adequate
oversight or the checks and balances of judicial review, lead to abuses
of the rights of the American people.
So I hope this debate will provide us with an opportunity to show the
American people what we stand for. We can show them that we will do all
we can to secure their future, but at the same time protect their
cherished rights and freedoms. Those are the rights and freedoms that
protected past generations and allowed us to have a future. If we do
not protect them, what will our children and grandchildren have?
It is incumbent upon us to stand up for this country. When you stand
up for this country, it does not mean jingoism, it does not mean
sloganeering. It means protecting what is best for this country. If we
do that, the terrorists will not win. The United States of America
wins. The people who rely on us around the world will win. Our example
will be one they will want to follow.
Mr. President, I suggest the absence of a quorum.
The PRESIDING OFFICER. The clerk will call the roll.
The bill clerk proceeded to call the roll.
Mrs. FEINSTEIN. Mr. President, I ask unanimous consent that the order
for the quorum call be rescinded.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mrs. FEINSTEIN. Mr. President, I ask unanimous consent to speak as in
morning business.
The PRESIDING OFFICER. Without objection, it is so ordered.
The FISA Bill
Mrs. FEINSTEIN. Mr. President, I know that both chairmen, Senator
Leahy of Judiciary and Senator Rockefeller of Intelligence, are coming
to the floor to speak on the FISA bill. I wish to take this
opportunity, as a member of both those committees, to speak about two
amendments I will offer when the time is appropriate. This is in
morning business and, therefore, I cannot offer them at this time.
The first amendment will deal with a new question, and that question
is: court review of telecom immunity. Let me explain what that means.
First, this amendment is submitted on behalf of Senators Bill Nelson,
Cardin, and myself. Senator Nelson is on the Intelligence Committee.
Senator Cardin is on the Judiciary Committee. I have also worked with
Senator Whitehouse on this, though I believe he is going in a slightly
different direction.
As Members know, the bill before us provides full retroactive
immunity for electronic service providers--that is the legal language--
that are alleged to have provided assistance as part of the Terrorist
Surveillance Program. The amendment I am offering creates a judicial
review by putting forth the issue of whether immunity should be granted
before the FISA Court. There would be no immunity for any individual,
private or public official--that is in the underlying bill--or any
other company other than electronic service providers.
So the immunity provision in the Intelligence bill only relates to
those providers of electronic surveillance--no one else and no other
company. I hear talk this would apply to Blackwater. It does not. This
is strictly for electronic surveillance.
The FISA Court has the most experience with FISA practice and
surveillance law. It has an unblemished record for protecting national
security secrets. It has 11 judges. They sit 24/7. It has an appellate
branch, and it is knowledgeable and skilled in intelligence matters.
Under the amendment, there would be a narrowly tailored three-part
review. First, the FISA Court would determine whether a
telecommunications company provided the assistance alleged in the cases
against them. If not, those cases are dismissed.
Second, if assistance was provided, the court would determine whether
the letter sent by the Government to the telecommunications company met
the requirements of 18 USC 2511. That is part of the FISA law. If they
did, the companies would be shielded from lawsuits.
Let me tell you quickly what that law says. That law, in
2511(2)(a)(ii)(A) and (ii)(B), allows for a certification in writing by
a person specified in section 2518(7) of this title--which means the
Attorney General, Deputy Attorney General, Associate Attorney General,
or by the principal prosecuting attorney of any State or subdivision
thereof acting pursuant to a statute of that State who reasonably
determines that a series of conditions are met: that an emergency
situation exists, immediate danger of death or physical injury to any
person, conspiratorial activity threatening the national security
interest or conspiratorial activities characteristic of organized
crime.
All those provisions, in one way or another, did exist. So a
certification in writing under section 2511 must be by one of the
people I enumerated, or by the Attorney General of the United States,
and say that no warrant or court order is required by law, that all
statutory requirements have been met, and that the specified assistance
is required. Then there are some provisions setting forth the period of
time during which the provision of the information, facilities,
technical assistance is authorized, et cetera. That is the law.
So the question is: Were the certifications provided adequate under
this law that I have read? If they were, the companies would be
shielded from lawsuits.
The third part is the hardest. In any case where the defendant
company did provide assistance but did not have a certification that
complied with the sections I have read in 2511, the FISA Court would
assess whether the company acted in good faith, as is the standard
under common law. The FISA Court would determine whether the company
had an objectively reasonable belief that compliance with the
Government's written request or directives for assistance were lawful.
In the underlying bill, all the cases against the phone companies
will be dismissed as long as the Attorney General can tell the court
that the Federal Government assured the companies that the assistance
it was seeking was legally permitted. That is the way it works in the
underlying bill. Under this formulation, there is no court review of
whether the assistance was, in fact, legal and adequate under the law
or whether the companies had an objectively reasonable belief they were
legal. This is a major shortcoming of any legislative or executive
grant of immunity.
I thought this when I voted for the immunity provision in
Intelligence. I had hoped it would be revised in the Judiciary
Committee. I hadn't come upon this solution until I discussed it at
length with Senator Whitehouse and also with several professors of law
and also with a Member of the House of Representatives. Then I thought,
I wonder if this is a way to handle the immunity question that is fair
and objective and handled by a court that is trained and deals with
these matters on a continuing basis. I believe it is.
There are many Senators who believe the immunity provision should be
taken out wholesale and that the current court case should continue.
That is why I have introduced this amendment with Senators Nelson and
Cardin, which puts before the Senate a court review option. This
amendment would allow phone companies to receive the immunity they are
seeking, but only if the independent review by
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the FISA Court determines whether the assistance that was provided is
lawful on its face or the companies had a good-faith, objectively
reasonable belief that it was in fact lawful.
The arguments run hot and heavy on both sides of the immunity
question. They may well prevent the successful passage of a bill by
both Houses. Here is some history, though.
Shortly after September 11, 2001, the Government reached out to
telecommunications companies to request their assistance in what has
become known as the terrorist surveillance program. Within 5 weeks of
9/11, letters were sent from senior Government officials to these
companies that put a governmental directive by the executive branch,
and these letters were sent every 30 to 45 days to the telecoms, from
October of 2001 to January of 2007, when the program was, in fact, put
under FISA Court orders.
Only a very small number of people in these companies had the
security clearances to be allowed to read and evaluate these letters or
directives. And then even they could only discuss the legal
ramifications internally. They could not go out and get other opinions
and vet it. That is a fact.
We also know that at the time the requests and directives were made,
there was an ongoing acute national threat. The administration was
warning that more attacks might be imminent, and we now know there was
a plot to launch a second wave of attacks against the west coast. In
such an environment, I believe, and I think most of us believe, the
private sector should help the Government when it is legal to do so. In
fact, we should want the private sector to do all it can to help
protect our Nation.
In addition, there has been a longstanding principle in common law
that if the Government asks a private party for help and makes such
assurances the help is legal, the person or company should be allowed
to provide assistance without fear of being held liable.
One would think this should especially be true in the case of
protecting our Nation's security.
However, this is not a situation that had not been contemplated or
prepared for. Congress passed FISA and included language in that
statute to address such situations regarding how and when the Federal
Government may seek assistance from private companies when conducting
electronic surveillance, where there is no court warrant. Those are the
sections I have read to you. In fact, the law is very clear on this and
under what circumstances a telecommunications company may provide such
information and services to the Government, again, as I have indicated.
Assistance can always be provided when there is a court warrant. In
this case, unfortunately, the administration did not even attempt to
get a FISA Court warrant. It essentially dismissed FISA out of hand as
a remedy. That is most unfortunate. The question comes, should the
telecoms be blamed for that? I think that is something we need to
grapple with.
The administration could have gone to the FISA Court. It chose under
its article II power or its misinterpretation of the AUMF that it would
not do that. Is that the responsibility of the telecoms?
As I have said, under United States Code, title 18, section 2511, the
sections I have read, assistance may be provided without warrant if the
Government provides a certification in writing that ``no warrant or
court order is required by law, that all statutory requirements have
been met, and that the specified assistance is required.'' That is the
law.
With that said, I have read the letters that were sent to the telecom
companies every 30 to 45 days for several years requesting assistance
and providing legal assurances. No one can say now with legal certainty
that the certification requirements of section 2511 were or were not
met. I believe this is a question that should be addressed by a Federal
court, and I further believe that the Foreign Intelligence Surveillance
Court is the court to do it.
The administration has had its own view that article II of the
Constitution provided the President with the authority to conduct
international electronic surveillance outside the law, as long as it
complied with the Fourth Amendment. To what extent the phone companies
relied on this legal theory I do not know, nor does anyone else at this
time, I believe.
But the companies have a reasonable argument. They relied on written
assurances in which the Attorney General, the top law enforcement
officer of the country, said their assistance was lawful. They were not
able to do due diligence because of security limitations. We have no
way of knowing the full content of their deliberations regarding
article II authority of the President, despite testimony they have
given to us on the Intelligence and Judiciary Committees.
In addition, these companies face serious, potentially
extraordinarily costly, litigation and are unable at the present time
to defend themselves in court or in public because of the Government's
use of the state secrets defense. This places the companies in a
fundamentally unfair place. Individuals and groups have made
allegations to which the companies cannot answer, nor can they respond
to what they believe are misstatements of fact and untruths.
I asked the companies, when somebody opposed to their position came
to testify before a committee of the other body: Why don't you testify
and respond? They said: Because our hands are tied; we cannot.
So today we are in a situation that creates a difficult and
consequential problem for Congress to address. The way Senator Nelson
of Florida and Senator Cardin and I see this is that the question of
whether telecommunications companies should receive immunity hinges on
whether the letters the Government sent to these companies meet the
requirements of 18 U.S.C. 2511. If not, did the companies have a good-
faith reason to believe there was a lawful reason to comply? In other
words, we should not grant immunity if companies were willingly and
knowingly violating the law.
I believe the best solution is to allow an independent court, skilled
in intelligence matters, to review the applicable law and determine
whether the requirements of the law or the common law principle were,
in fact, met. If they were, the companies would receive immunity. If
not, they would not.
I wish to briefly speak on the second amendment which I will broach
at the appropriate time, and that is the question of exclusivity. This
amendment is cosponsored by both chairmen, Senators Rockefeller and
Leahy, Senators Nelson, Whitehouse, Wyden, Hagel, Menendez, and Snowe.
I will describe it briefly.
We add language to reinforce the existing FISA exclusivity language
in Title 18 by making that language part of the FISA bill which is
codified in Title 50. The second provision answers the so-called AUMF,
the authorization to use military force, resolution loophole. The
administration has argued that the authorization of military force
against al-Qaida and the Taliban implicitly authorized warrantless
electronic surveillance. My amendment states that only an express
statutory authorization for electronic surveillance in future
legislation shall constitute an additional authority outside of FISA.
This makes clear that only specific future law that provides an
exception to FISA can supersede FISA.
Third, the amendment makes a similar change to the penalty section of
FISA. Currently, FISA says it is a criminal penalty to conduct
electronic surveillance except as authorized by statute. This amendment
replaces the general language with a prohibition on any electronic
surveillance except as authorized by FISA by the corresponding parts of
title 18 that govern domestic criminal wiretapping or any future
express statutory authorization for surveillance.
And finally, the amendment requires more clarity in a certification
that the Government provides to a telecom company when it requests
assistance for surveillance and there is no court order.
Remember, on the question of immunity, we have existing law. The law
I read earlier is vague and it is subject to interpretation. The
question is whether we do the interpretation or whether a proper
authority does the interpretation which, of course, is a court of law,
namely, in this case, the FISA Court.
Currently, certifications must say under 18 U.S.C. 2511 that all
statutory
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requirements for assistance must be met. The telecom official receiving
that certification is not given any specifics on what those statutory
requirements are, so the company cannot conduct its own legal review.
This amendment would require that if the assistance is based on
statutory authorization, the certification must specify what provision
in law provides that authority and that the conditions of that
provision have been met.
I believe our amendment will strengthen the exclusivity of FISA, and
I believe it is absolutely critical. Without this, we leave the door
open for future violations of FISA.
When FISA was first enacted in 1978, there was a big debate between
the Congress and the executive branch over whether the President was
bound by law. We have had a repeat of that debate over the past 2 years
since learning of the existence of the terrorist surveillance program.
But the end result of the debate in the 1970s was clear. FISA was
established as the exclusive means by which the Government may conduct
electronic surveillance for foreign intelligence purposes, period. FISA
was meant to be exclusive, and section 2511(f) of title 18 of the
United States Code states that it is, in fact, the exclusive authority
for domestic criminal wiretapping and that ``the Foreign Intelligence
Surveillance Act of 1978 shall be the exclusive means by which
electronic surveillance, as defined in section 101 of such act, and the
interception of domestic wire, oral, and electronic communications may
be conducted for foreign intelligence purposes.''
The legislative history is clear--ignored, but clear. In stating that
``FISA would prohibit the President, notwithstanding any inherent
powers, from violating the terms of that legislation,'' the 1978 report
language was a clear statement of the intent of the Congress at that
time, just as this amendment is now.
Congress also wrote in 1978 that in terms of authority for conducting
surveillance, ``FISA does not simply leave Presidential powers where it
finds them. To the contrary. The bill substitutes a clear legislative
authorization pursuant to statutory, not constitutional, standards.''
President Carter signed the 1978 bill. His signing statement said
this:
This bill requires for the first time a prior judicial
warrant for all
In italics--
all electronic surveillance for foreign intelligence or
counterintelligence purposes in the United States in which
communications of U.S. persons might be intercepted.
So it is crystal clear on its face that FISA was the only legal
authority under which the President could proceed when he authorized
the ``Terrorist Surveillance Program'' after September 11. He chose not
to. And this is where the issue becomes joined, I believe, one day
before the highest Court of the land: whether the President's Article
II power essentially still supersedes these clear statements of
legislative intent and clear drafting of law over many decades.
To make matters worse, the administration claimed and still does
claim that the resolution to authorize the use of force against al-
Qaida and the Taliban provided authority to institute the Terrorist
Surveillance Program. It does not.
I do not know one Member of Congress who believes they voted for the
TSP when they voted to authorize the use of force. It was never
contemplated, and I was present at many of those discussions, in
private and in public. It was never considered.
In fact, FISA allows for 15 days of warrantless surveillance
following a declaration of war. So Congress in 1978 had spoken on the
issue of wartime authorities, and it did not leave open the possibility
of open-ended warrantless surveillance.
Then the Department of Justice came to the Congress in September of
2001 with the PATRIOT Act. The legislation included numerous changes
needed to FISA to wage this new war, but the administration did not
request changes that would allow the TSP, the Terrorist Surveillance
Program, to function lawfully. Nor did the administration express the
limitations on FISA surveillance that the TSP was created to overcome.
In effect, we have a claim from this administration, which has never
been recanted, that the President has the authority to conduct
surveillance outside of FISA. We are spending enormous time and effort
to rewrite FISA, but there is no guarantee that the President will not
again authorize some new surveillance program outside the law. That is
why those of us who put this amendment together have taken so much time
to write strong exclusivity language right into this law.
When I have asked the Director of National Intelligence about this,
he has said that with the new FISA authorities in this bill, the
intelligence community wouldn't need to go outside of FISA. I would
like to find comfort in this response, but I don't, and that is why I
am offering this exclusivity amendment.
The President does not have the right to collect the content of
Americans' communications without obeying the governing law, and that
law is FISA.
I recognize the administration disagrees with me on this point. The
White House believes the President's Article II authority allows him to
conduct intelligence surveillance regardless of what Congress
legislates. I disagree.
However, we are not going to resolve that question. As I said,
ultimately it is for the Supreme Court to decide. But here now we must
make the strongest case that the only authority for electronic
surveillance is FISA, and we must again be as clear as possible exactly
when FISA authorizes such surveillance.
That is our function under article I of the Constitution.
Let me say, however, despite the fundamental differences of views
over separation of powers, this amendment has been carefully negotiated
with officials at the Department of Justice, the Office of the Director
of National Intelligence, and the National Security Agency. The
executive branch has not raised operational problems or concerns with
this language.
This exclusivity amendment will not affect ongoing or planned
surveillance operations. Of course, I should also say clearly that the
executive branch does not support the language. They do not want FISA
to be the exclusive authority. But, legislatively, that has been the
intention of this Congress since 1978.
I have tried to perform my due diligence on this whole terrorist
surveillance program and the FISA issue since the news of the
warrantless surveillance broke in December of 2005. I have become
convinced that without strong exclusivity language such as provided in
this amendment, another Congress in the future will be faced with
exactly the same thing we are now.
I will repeat what I said in December: I cannot support a bill that
does not clearly reestablish the primacy of FISA. We took the first
step with very modest language in the Intelligence Committee. The
Judiciary Committee passed very strong language, but unfortunately it
has not been added to the bill before us. Both committee chairmen have
cosponsored this amendment, as well as the others I have listed. The
Department of Justice and the intelligence community have thoroughly
reviewed the amendment. There is no operational impact. I hope we end
the question once and for all whether the President can go around the
law.
At the appropriate time, I will move this amendment, and I hope it
will be accepted by this body, as well as the court review of the
immunity amendment.
Mrs. FEINSTEIN. Madam President, I yield the floor, and I suggest the
absence of a quorum.
The PRESIDING OFFICER (Mrs. McCASKILL). The clerk will call the roll.
The assistant legislative clerk proceeded to call the roll.
Mr. DORGAN. I ask unanimous consent that the order for the quorum
call be rescinded.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. DORGAN. Madam President, this afternoon the Republicans have held
an issues conference; in fact, I believe for most of the day. As a
result, they have not been here today to engage in discussion on the
Indian Health Care Improvement Act. I just finished speaking with
Senator Murkowski, vice chairman of the committee. We talked about the
bill. She has played a significant role as vice chairman in bringing
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this Indian health care improvement bill to the floor. We both would
like those who have amendments to provide notice to us of their
amendments.
Our cloakrooms have asked for a list of amendments so that we may
process them. It appears, based on what the majority leader indicated,
that we will at some point today, perhaps in the next hour or two, turn
to the Foreign Intelligence Surveillance Act. The reason for that is,
there is a deadline of February 1 by which that Act has to be renewed.
It expires and we have to take action to renew it. It will be
controversial and cause quite a debate. So what the majority leader has
indicated is that he will turn to the Foreign Intelligence Surveillance
Act, and we will be on that tonight, tomorrow, perhaps Friday and
Saturday--who knows?--and that following completion of that, he will
bring the Indian health care improvement bill back to the floor.
My appreciation to the majority leader, he is trying to balance some
difficult things. He, for the first time in 10 years, decided we should
do what we should have done in the last 10 years, and that is
reauthorize Indian health care.
We have a scandal in Indian health care with full scale rationing.
Only 40 percent of health care needs are being met. We have people
dying today on reservations because health care that we take for
granted for our families, many of us, is not being made available on
Indian reservations. I thank Senator Reid for allowing us to come to
the floor and putting this in the schedule. When it is pulled from the
floor to go to FISA, it will be brought back next week or when FISA is
completed. I appreciate that.
I notice my colleague from South Dakota, Mr. Johnson, is here.
Senator Johnson and I share the Standing Rock Sioux Indian reservation
that straddles our boundary of North and South Dakota. It is a large
reservation. Both of us have been there many times. South Dakota has a
number of other Indian reservations. Senator Johnson, as a member of
the committee, has done superb work with us to put this legislation
together. I appreciate his help and his attention to what is an urgent
priority for American Indians, to get the health care this country long
ago promised. We wrote it in treaties. We have a trust responsibility.
That responsibility is affirmed by the Supreme Court of the United
States. Yet we have had broken promises and broken treaties. At long
last we must affirm our responsibility to say to Native Americans: It
is our responsibility. We assumed that responsibility to provide decent
and good health care, health care we can be proud of for Native
Americans. That is what this discussion is about.
Because I have seen my colleague from South Dakota come into the
Chamber, I did want to say a special thanks to him. I know my
colleague, Senator Murkowski, and other Republicans and Democrats on
the committee worked hard. We all worked together--it was bipartisan--
in getting this bill to the floor. Senator Johnson, over a long period
of time, has worked to make this day happen. Let me thank him for his
great work.
The PRESIDING OFFICER. The Senator from South Dakota.
Mr. JOHNSON. Madam President, I am here to speak in favor of the
Indian Health Care Improvement Act. To the nine treaty tribes in my
State, and hundreds of others around the country, this bill is truly a
matter of life and death. It is a sad fact that the six counties in
America with the lowest life expectancy are tribal counties in South
Dakota.
Poor health care affects not only life expectancy but also the
quality of life for American Indians; it is also preventable. My office
gets hundreds of calls from constituents needing help with even the
most basic needs that ought to be met by the Indian Health Service.
For example, Butch Artichoker from the Rosebud Sioux Tribe told my
office he did not want to have a cancer test because he would not be
able to get contract health treatment from IHS if the test was
positive. His situation is not unique.
Another man from Pine Ridge contacted my office after receiving the
results of a cancer test that showed his PSA levels were ten times
above normal. He could not get a referral for a treatment MRI because,
according to IHS, his cancer was not a priority one--threat to life or
limb.
I am a cancer survivor myself thanks to early screening and
detection, which are paramount for effective treatment. This is also
true for mental health problems and many other treatable disorders.
Passing this bill will not fix every health problem facing Indian
Country, but it is a major step that we need to take.
I returned from my own health challenges with a better appreciation
of what individuals and families go through when they face the hardship
of catastrophic health issues.
Providing better health care through IHS will serve not just American
Indians but protect the overall public health network for my State and
the rest of the country.
IHS is a vital part of the patchwork of providers that serve our
State and when one of these providers improves, the entire system
benefits. This is not just a tribal issue or an Indian bill, but a
moral issue for individuals and families as well as the integrity of my
State and our country.
I thank Senator Dorgan for his leadership and persistence. I ask that
my colleagues quickly pass this bill, as these improvements to Indian
health care are long overdue.
I yield the floor.
Mr. DORGAN. I suggest the absence of a quorum.
The PRESIDING OFFICER. The clerk will call the roll.
The assistant legislative clerk proceeded to call the roll.
Mr. SALAZAR. I ask unanimous consent that the order for the quorum
call be rescinded.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. SALAZAR. Madam President, I rise in strong support of S. 1200,
the Indian Health Care Improvement Act of 2007, which will reauthorize,
improve, and expand necessary health care services and programs for the
Native American population. I thank Chairman Dorgan and Ranking Member
Murkowski of the committee for their leadership on this legislation. I
also thank my colleagues on the Finance Committee, Senator Baucus and
Ranking Member Grassley, for their leadership and contribution. The
work we have done in the last year and the debate we will have this
week is a debate that is long overdue.
It has been 16 years since Congress conducted a comprehensive review
of the Indian Health Care Improvement Act, 16 years since we addressed
the persistent health disparities in Native American communities across
the Nation.
This bill is vital to millions of Native Americans across the
country, including the 52,000 Native Americans who reside in my State
of Colorado.
Colorado is home to two sovereign American Indian nations: the Ute
Mountain Ute Tribe and the Southern Ute Tribe. They are located in the
southwestern part of Colorado. But as we must remember--and my
colleagues have alluded to this in this week's debate--the majority of
Native Americans across this country, including in Colorado, do not
live on the reservations. In Colorado, members of 35 different tribal
nations live in the urban, suburban, and rural communities of my State,
from Durango to Denver.
It is hard for us in this Chamber and in America to overstate the
contributions of Native Americans to our economy, our society, our
culture, and our history.
In my State, the Utes are the oldest known continuous residents of
Colorado. The earliest Ute tribes traveled along the eastern slope of
the Rocky Mountains before settling in Colorado, Utah, and New Mexico.
In western Colorado, they hunted, gathered, and worked the lands, often
moving with the seasons to better climates to better their
possibilities of livelihood. The Spanish arrived in the Southwest--in
Colorado and New Mexico--in the late 1500s--in the 1630s and 1640s--and
in the beginning, they became the trading partners for the Utes,
exchanging tools for meats and fur.
What followed that chapter is a set of very sad chapters in Colorado
and the United States. It was a set of sad chapters characterized by
violence, retaliation, and tragedy, much of it at the hands of the
Federal Government.
Over the next few decades, under pressure from the Federal
Government,
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the Utes would enter into agreements to establish reservations, but
this included giving up very large sections of their land. While a
small part of that land was ultimately returned to the Utes in the two
reservations that were set up in Colorado and the one that was set up
in Utah, the modern-day reservations are the result of various
Government actions, encroachment by settlers, and mining interests that
ultimately limited the two tribes in Colorado to a small percentage of
the reservations that were originally contemplated for the Ute Indians
before the existing reservations were established.
The issues confronting Native American communities today are
inextricably tied to this history. The Federal Government's
responsibility to Native American communities is likewise tied to this
very difficult and painful history.
But this week, under the leadership of Chairman Dorgan, we hope to
write another chapter into this history. We hope to take another step
toward making good on the Federal Government's promise to improve
health care for Native Americans.
The health care statistics for Native American communities do not
lie, and they are troubling. They should be troubling to all of us here
in America. The infant mortality rate is 150 percent greater for Native
Americans than that of Caucasian infants. Native Americans are 2.6
times more likely to be diagnosed with diabetes. Life expectancy for
Native Americans is 6 years less than the rest of the U.S. population.
Suicide rates--suicide rates--for Native Americans are 250 percent
higher than the national average.
The health care disparities we see throughout the country are also
evident in my State of Colorado. In 2006--that was not too long ago--
5.5 percent of Native Americans died from diabetes, more than twice the
rate of the general population. In the same year, 3.9 percent of Native
Americans died from chronic liver disease, compared with 1.6 percent
for the general population.
For many Native Americans, access to health care is the biggest
challenge they face as human beings. I have heard countless stories of
individuals, Native Americans in my State, who are sick or are in pain
and have to drive hundreds of miles to receive any kind of treatment.
When they get there, after having driven sometimes 9 hours, they will
find that the clinic cannot provide them the treatment they seek. Those
services, they learn, are in hospitals located hundreds of miles away.
Access problems affect not only Native Americans on reservations that
span hundreds of miles but Native Americans living in urban areas as
well.
For the 25,000 Native Americans living in Denver, CO, today, there is
only 1 health care facility that is available to meet their health care
needs. That is the Denver Indian Health and Family Services facility.
This facility is funded by the Indian Health Service program through
funding allocated through title V of the Indian Health Care Improvement
Act, which provides funding for urban health centers for Native
Americans.
The Denver Indian Health and Family Services began providing health
care onsite to Native Americans living in the Denver metro area in
1978. The majority of its patients are single parents, making an
average of $621 per month--$621 per month. That is a total of
approximately $7,400 a year. That is not a lot of money for any family.
When a patient needs specialized treatment, however, they often have to
travel 6, 7, 8, 9 hours to places such as Rapid City, SD, or
Albuquerque, NM. This is a long trip for anyone, particularly if they
are sick or injured.
The U.S. Government has a longstanding and solemn responsibility to
the Native American population of our country. That responsibility is
set forth and recognized in treaties, statutes, U.S. Supreme Court
cases, agreements, and in our U.S. Constitution. It is a trust
responsibility that flows from Native Americans' relinquishment of over
500 million acres of land to the United States of America. Native
Americans see the reauthorization of this health care bill as part of
the U.S. Government living up to its end of the bargain with tribal
governments. And they are right.
The disparities in health care between Native Americans and the
general population is a real problem, and it is one Congress has a
responsibility to address. I am proud of the bill we are considering
today because it takes major steps toward reducing the health care
disparities that persist in Native American communities.
Although appropriations for IHS have traditionally fallen far short
of the actual health care needed in Indian Country, the focus on
preventive care in current reauthorization legislation will make more
efficient use of the Indian Health Service's limited resources.
Difficulties in recruiting and retaining qualified health
professionals have long been recognized as a significant factor
impairing Native Americans' access to health care services. The
programs authorized in this bill will help recruit Native Americans
into the health care profession. Additionally, this bill provides for
health education in schools, mammography and other screenings for
cancer, and helps cover the cost of patient travel to receive health
care services. Additionally, this legislation removes barriers and
increases participation and access to Medicare and Medicaid Program
benefits.
Title V of this legislation would also fund programs in urban centers
to ensure that health services are accessible and available to Native
Americans living in cities across the country, such as Denver, CO. Key
programs include immunization, behavioral health, alcohol and substance
abuse programs, and diabetes prevention, treatment, and control.
In addition to reauthorizing and expanding existing programs, this
legislation will ensure that Native Americans are able to take full
advantage of new technologies and new Federal programs that have
emerged since the last reauthorization, including Medicare Part D and
the State Children's Health Insurance Program. Indian health programs
should work hand-in-glove with these new programs and new resources.
Native Americans in the United States of America deserve access to a
21st-century health care system.
I again thank my colleagues, Senator Dorgan, the chairman of the
committee, and Senator Murkowski, for their bipartisan leadership on
this very important legislation and for their tireless leadership for
Native American communities across the country.
I hope my colleagues will support this bill. We need to get this bill
to the President's desk as soon as possible.
In conclusion, as we look at the United States of America, we see an
America that is an America that has a covenant about being an America
in progress. We see it in a number of different ways--in the ways which
we have treated women and other racial or ethnic minorities. But there
is a sad and painful story to this America in progress that is
particularly poignant when you look at how we, as the United States of
America, have treated the Native American communities of our Nation. So
this is an issue in my mind that is a fundamental issue of civil
rights. It is a fundamental issue we must resolve in order to be able
to uphold this covenant of America that makes us an America in
progress.
Madam President, I yield the floor.
The PRESIDING OFFICER. The Senator from North Dakota.
Mr. DORGAN. Madam President, I thank the Senator from Colorado, who
is a strong voice for fairness and justice and for health care on
Indian reservations. I appreciate very much his work and his relentless
determination to help us get this done. I know he comes from a State
that has a good number of Indian tribes and that he has toured those
areas and is very concerned about this issue.
Madam President, I want to, in just a couple minutes, show once again
a photograph of a man I showed yesterday during this discussion. His
name is Lyle Frechette. Lyle Frechette, shown in this photograph, was a
member of the Menominee Tribe of Indians in Wisconsin. He came of age
during a time when there was what was called the ``termination and
relocation era of Indians.''
This picture of Lyle Frechette is a picture of a high school graduate
who was newly entering the Marine Corps to proudly serve his country. I
showed that photograph yesterday to describe
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that there is no group of Americans that has served their country in
the military in larger numbers per capita than Native Americans--than
American Indians and Native Alaskans. There is just no group that has
enlisted in higher numbers to support their country in our military.
This is a photograph of one of them. His experience, following his
service in the Marines, was the experience of so many Indians.
During the termination and relocation period, many of them were given
one-way bus tickets and told: You need to mainstream; you need to go to
a city someplace. They found they had limited opportunities in the
cities. They lost their health care capability. It was a time that we
are now not proud of in terms of public policy because it was the wrong
thing to have done, particularly when we had promised a trust
responsibility, providing health care for Native Americans.
Spending Practices At Veterans Charities
Madam President, I wanted to show that photograph again because I
wanted to say something else that is not on the topic of this bill but
something I read last Friday which has bothered me ever since I read
it. It deals with those such as Lyle Frechette and others who joined
the military and became soldiers for our country.
The Washington Post, last Friday, contained a story about a hearing
that was held the day before in the U.S. House of Representatives. It
was a hearing about spending practices at veterans charities.
There is an organization that has evaluated various charities that
have been established to provide assistance for veterans. That
organization, the American Institute of Philanthropy--which is the
leading watchdog group--said there are about 19 military-oriented
charities that manage their resources very poorly.
But let me describe what made my blood boil Friday morning when I
read it. I was not aware of it. But Help Hospitalized Veterans--a tax-
exempt organization--Help Hospitalized Veterans--an organization that
is presumably going to collect funds from around the country to help
hospitalized veterans-- it spent, according to the report, hundreds of
thousands of dollars in donations that were to help wounded soldiers on
personal expenses instead for those who were running the organization.
Instead of helping wounded soldiers as the title says--Help
Hospitalized Veterans--those who were running the charity were bathing
themselves in cash: a $135,000 loan to the fellow who runs the
organization for a divorce settlement with his former wife; a $17,000
country club membership; a $1 million loan to Mr. Viguerie, the direct
mail guru, for a startup initiative at his firm.
The second charity, the Coalition to Support America's Heroes--also a
charity designed presumably to help America's veterans--was
fundraising, getting tax-exempt donations or tax-deductible donations,
and they used a four-star general, retired Four-Star GEN Tommy Franks,
to sign letters of solicitation asking for funds, and paid him $100,000
for that. Now, I think Tommy Franks ought to explain to the Congress
and ought to explain to veterans why a retired four-star general is
being paid $100,000 to sign letters to solicit money to help veterans.
I think GEN Tommy Franks has a lot of questions to answer, including a
number of questions dating back about 4 years, from me and others. But
I was very surprised that a charity is paying $100,000 to a retired
four-star general for allowing his name to be used to solicit funds
from individuals across the country to help veterans.
The Help Hospitalized Veterans raised more than $168 million from
2004 to 2006. They raised $168 million from 2004 to 2006, and they
spent one-quarter of it on veterans. Let me say that again. They raised
$168 million of tax-deductible contributions to an organization called
the Coalition--excuse me, this is Help Hospitalized Veterans--raised
$168 million, and one-quarter of it went to help veterans; the rest
went elsewhere. That is unbelievable, just unbelievable. In this
Congress--I hope the committee in the House that held these hearings
will continue, and I am now evaluating whether we can begin a series of
similar hearings. I think that is equivalent to theft, and I hope very
much that we will continue to apply heat to those who would use
veterans' names in this manner. An organization that solicits $168
million and uses only one-fourth of it in support of veterans when
their title is Coalition to Support America's Heroes--or I guess Help
Hospitalized Veterans, one of the two--one-fourth of the money is used
to go to veterans, the rest of it is going for country club memberships
and loans for divorce settlements. That is unbelievable to me. I hope
very much that both the House and the Senate will continue to
aggressively investigate these organizations, and I hope perhaps if we
have some hearings, we might ask retired GEN Tommy Franks to come and
explain to us why it is appropriate for him to accept $100,000 that
comes from tax-deductible donations in order to sign a letter
soliciting money that is presumed to be in support of veterans when, in
fact, three-quarters of the money went elsewhere.
My colleague from Alaska has come to the floor, and I want to again
say it has been a pleasure to work with her. She is vice chairman of
the Indian Affairs Committee and has done a remarkable job. She,
perhaps more than anyone in the 48 States and the mainland, has very
unique issues in the State of Alaska, because the Native Alaskan
villages are remote and the health care issues that relate to them are
different, difficult, and unusual, and she has represented that
situation aggressively and relentlessly as we have tried to put
legislation together to address it. I thank her for the work she has
done, and I look forward to working with her. We will not apparently
finish this bill today, but we will get the bill back on the floor
following the Foreign Intelligence Surveillance Act, and when we do--
the two of us have talked--we very much are intent on finishing this in
1 day and getting to conference, getting the bill to the President, and
getting it signed.
Mr. President, I yield the floor.
The PRESIDING OFFICER (Mr. Pryor). The Senator from Alaska is
recognized.
Ms. MURKOWSKI. Mr. President, I thank the chairman of the committee
for his great cooperation on this very important issue. I know we had
all hoped--certainly my constituents had hoped, and I think my
colleagues as well, as so many around the country who have been waiting
years--literally waiting a decade--for reauthorization of this Indian
Health Care Improvement Act. We are pleased that we are on the floor.
We would like to see this moved through the process as quickly as
possible. We understand the issues we have in front of us and what we
have to do in order to get this through, but I appreciate the great
leadership of the chairman of the Indian Affairs Committee and of so
many who have worked to advance this legislation.
I thank Chairman Dorgan for reminding all of us of the great
contributions we have had from so many of our American Indians, Alaska
Natives, when it comes to serving our country. I think if you look at
the demographics and look at it on a per-capita basis, we see higher
numbers, certainly in Alaska, of our Alaska Natives serving in the
military than any other populations in the State, serving admirably
over the years, whether they be the Eskimo Scouts or whether they be
the group serving from the National Guard which recently returned from
Kuwait.
I had an opportunity a couple of months ago to meet those Alaskans
who were returning. I met up with them in Camp Shelby and had an
opportunity to talk to the men who were returning from Kuwait after
well over a year. They had been in the desert. Most of these soldiers
came from villages from around the State. There were some 80 villages--
communities--that were represented amongst this particular unit. Many
of them, when they returned back home to Alaska after coming from the
desert and going home to the snow, would be returning to very small
towns and very small villages that are not connected by any form of a
road system. During the winter months, you have connection because the
rivers are now frozen and you can take a snow machine to get from one
small village to another and hopefully out to a larger hub community.
But the reality is so many of these fine men who have served our
country are going back to areas where health care options are very
limited.
Yesterday I had an opportunity to show my colleagues a couple of
pictures. There is one of the health clinic
[[Page S171]]
in Atka. We also had a picture of the health clinic in Arctic Village.
As you look at the pictures, you can see the health clinics are small
and they are clearly broken down. They are older facilities. They are
very limited in terms of what they can provide. But this is what we
have out in these villages. These soldiers who are returning need to go
to the VA for services. They don't have a VA out in Chevak. They don't
have a VA facility out there in Atka. They have the Atka Village Health
Clinic. This is a two-story clinic, so it is by all standards perhaps
better than some of the others in some of our villages. But what we
have seen in a State like Alaska where access to care is so very
limited, is the IHS facility essentially ends up being the entity that
will provide for that level of care for that serviceman, for that
veteran, because to get from Atka to Anchorage, to the Anchorage Native
Medical Center, is costly. Sometimes the VA picks up the travel,
sometimes not. It depends on your income eligibility. If there isn't
any--if the Government is not there to pick up your costs, not only do
you have the cost of air travel, which can be upwards of $1,000 for
your roundtrip fare, but you have your expenses while you are in the
city--in town.
So we look at what is provided to so many in our small clinics around
the State. Now, is it right that the clinic should have to pick up or
basically carry the water or carry the bag for the VA? Not necessarily,
no. But is this where we can provide for a level of care that is in the
village for the individual, with their family, and ultimately reducing
so many of the travel costs that are there? Absolutely. So I say this
to my colleagues, so people can understand that oftentimes what we are
dealing with in terms of access when you are in a State where it is so
rural, where you don't have roads, or the cost to travel is
prohibitive, we have to be more creative in how we provide for the
level of care. In Alaska, we think we are being more creative with
that. But with the reauthorization of the Indian Health Care
Improvement Act, it allows and facilitates greater sharing, greater
cooperation, ultimately greater collaboration, that leads to greater
cost savings.
I want to take a couple moments this evening--it has been mentioned
by our colleague from Colorado, and certainly the chairman mentioned
the provision we have in the substitute amendment regarding violence
against Indian and Alaska Native women. I mentioned in my comments
yesterday that we have seen some successes in Indian health, even with
the very stark health statistics that have been repeated by so many on
this floor. There is one area, though, where I do not believe we have
made any progress, and one I am very pleased we are addressing in this
bill, and that matter is the terrible violence that faces native women
and children.
Back in September of 2007, the Committee on Indian Affairs held an
oversight hearing on the prevalence of violence against Indian women.
We had several witnesses, very compelling witnesses, at that hearing,
one of whom was from Alaska, a woman by the name of Tammy Young, and
she represented the Alaska Native Women's Coalition Against Domestic
Violence and Sexual Assault. She testified about the intensity of such
prevalence and the need for remedies to properly address the problem.
In my State, we have one major city. Anchorage holds about almost
half the population of this State. The Alaska Native people make up 8
percent of the total population of Anchorage. But the percentage of
Alaska Native victims in Anchorage alone was 24 percent. You can see
the disparity in these numbers. Alaska has one of the highest per-
capita rates of physical and sexual abuse in the Nation.
In Alaska, an Alaska Native woman has a likelihood of rape that is
four times higher than a nonnative woman in the State. Our statistics
are horrendous. They are deeply troubling. But we know it is not only
in Alaska that there is this danger of violence that faces our Native
women. Statistics show that Native women around the country are two to
three times more likely to be raped than women from other populations
in the United States. As I say, in Alaska it is four times higher. But
even if this fact were not as disturbing as it is, it gets even worse
because so many of these women who have had this violence upon them
also face the prospect that the rapist may not be brought to justice.
This is for a variety of reasons. At the hearing we had a witness
indicate that the health services within the Native communities simply
lacked the proper infrastructure, the proper resources, to even conduct
the forensic exams and therefore assist in the prosecution of the
perpetrators. It is as simple as not having rape kits available in the
IHS facilities in that village or that community on that reservation,
simply not having the forensic equipment, not having it there. Why
don't you have it there? It is a funding issue apparently. But you have
a situation where you have a woman who has been violated. She comes
seeking help, and she can't even have a proper exam so they can collect
the evidence so she may then go on and try to prosecute the
perpetrator.
In addition, it is the training. We simply do not have enough who are
trained in the proper collection of the evidence. Back in 2005, we in
Congress passed aggressive programs and services for the
reauthorization of the Violence Against Women Act, or VAWA. The
witnesses who were there at the hearing back in September advocated
that we build on the foundation of VAWA. That is what this legislation
does. It provides for just that. It includes programs to address
domestic and sexual violence that are critical to shoring up this
health infrastructure, that are necessary to support a successful
prosecution, whether it is providing for rape kits at the Indian
clinics and hospitals or the training for the health professionals to
become the sexual assault examiners. Pretty basic stuff. But if you
don't have it there, if you cannot collect the evidence, if you don't
have the trained medical professionals to help facilitate that, these
victims will be victimized again by simply knowing that the system has
let them down.
In addition, the legislation will also require the Secretary of HHS
to establish protocols and procedures for health services to victims of
violence, as well as to coordinate with the Attorney General in
identifying areas for improvement within the health system to support
these prosecutions. I believe this aspect of the legislation is
extremely important for so many. Again, our statistics in this area are
devastating, unacceptable. There is more we can do about it, and this
is one small step.
Mr. President, I want to talk about one aspect of the Indian health
care reauthorization. I don't believe many of my colleagues have spoken
to the underlying policy of self-determination and self-governance, but
that is such an integral part of this reauthorization. The Federal
policy of self-determination was conceived by President Nixon in the
early 1970s, and it has been nurtured or improved upon by almost every
administration since then. The legislation, S. 1200, embraces these
policies in a very profound manner.
Indian self-determination represents one of our Nation's first
enlightened Federal Indian policies. It has been by far the most
successful policy in improving the lives of American Indians and Alaska
Native people. This policy has been embodied in Federal legislation for
over 30 years in the Indian Self-Determination and Education Assistance
Act.
S. 1200 facilitates the important interplay between the Indian health
care delivery system within the Department of Health and Human Services
and the policy of Indian self-determination and self-governance.
Beginning in the 1990s, there were a growing number of Indian tribes
and Alaska Natives who have taken over the IHS programs. They have made
them more efficient and responsive and, I would say, more relevant to
the local needs.
In Alaska, I think we can point to what has happened in the area of
self-governance as a good example, a positive example of how the Native
people have embraced this policy of self-determination and self-
governance.
In April 2003, the Committee on Indian Affairs held a hearing on an
earlier version of this bill. We had a gentleman there from Seldovia
Village, President Don Kashevaroff. He testified about how Alaska
Natives began compacting IHS programs in 1997 and how, within 6 years,
they had compacted virtually all of the IHS programs within the State
of Alaska.
[[Page S172]]
Now, within my State, the Indian health care system is almost
entirely a Native-driven system. Senator Stevens, my colleague, spoke
to this in his comments on the Senate floor yesterday. When you take
into account that in Alaska there are about 230 separate Native
villages, you manage the numbers there, and despite this large number
of separate sovereign governments spread out across a State with
enormous distances from each other, spread out from the State's
metropolitan area, they were able to create a highly efficient and
integrated health care delivery system.
I showed you the pictures earlier of the clinics in Arctic Village.
Behind me in the photo is the Alaska Native Medical Center, located in
Anchorage. Quite different. Yet what we have there in Anchorage at the
ANMC is a model for others to view. In Alaska, we have 180 small
community health centers, about 180 of what you saw with the Arctic
Village clinic, and they provide primary care. We have 25 subregional
midlevel care centers. There are four multiphysician health centers,
six regional hospitals, and one tertiary care facility. The Alaska
Native Medical Center in this picture is that one tertiary care
facility. So in the entire State, the Alaska Native Medical Center is
the one that provides that tertiary care.
This system was made possible through the Indian Self-Determination
Act. This health care system is tailored to meet the very unique needs
of the Native people. I don't believe it would have been possible
within the administrative structure of the Indian Health Service
itself.
Now, I don't want to spend all my time just talking about the
situation in Alaska because the success story that you see there is by
no means limited to my State. Self-governance is being embraced in
several other areas of the country as well: in the Pacific Northwest,
the Southwest, in Oklahoma, and in other parts of the country. I think
it is important to note that many tribes and tribal organizations have
supplemented their IHS programs with their own resources where
possible. The Indian Health Service has documented the fact that
Federal Indian health programs are only meeting approximately 60
percent of the need. You have heard that time and time again as we have
discussed this. Only about 60 percent of that need is met.
The hearings on Indian health held by the committee and information
from a 2005 GAO report demonstrated that this underfunding has led to
rationing health care within the Indian community. Of course, the
unfortunate result of this underfunding is exactly as you have heard
many of my colleagues say. It results in many American Indians either
foregoing any kind of treatment or delaying receiving medical care,
which in turn, then, leads to disease progression. But ultimately it
leads to higher costs, greater costs to the system.
I want to point out that several tribes have stepped up with their
own resources to enter joint ventures with the Federal Government or to
even supplement the Federal dollars in an effort to bridge that 60
percent gap we keep talking about between the Federal funding and the
level of need. I want to show a few of the examples.
In the Cherokee Nation in Northeast Oklahoma, we have a self-
governance tribe with one of the largest service populations in the
country. The Cherokees have just constructed a new clinic in Muskogee,
OK, using their own tribal dollars. This facility serves Indian people
in northeastern Oklahoma, including members of the Osage, Muskogee
Creek, Choctaw, and numerous other tribes.
We also have the Muckleshoot Tribe in Auburn, WA, which built this
facility in 2005 at a cost of nearly $20 million using its own tribal
dollars. The Muckleshoot facility is located near the I-5 corridor in
Washington and also provides very tailored care for its patients. As
you can see from the picture, they try to cater to some of the younger
patients as well.
Another Oklahoma tribe in southeastern Oklahoma is the Choctaw
Nation, which used their own tribal dollars to construct a 54,000-
square-foot facility at a cost of $13.5 million. In this facility the
average monthly patient encounter over the past 12 months has been over
3,800 patients.
Out in Oregon, located in Chiloquin, we have the Klamath Tribe Health
Center built in 2004, paid for through a unique partnership between the
Klamath Indian Tribe and the IHS, as a health center that primarily
serves the Klamath Tribe. It serves a tribal population of 2,890
individuals and cost $3.6 million to construct.
The last one I want to share with you comes out of Bylas, AZ, and the
San Carlos Apache Tribe has constructed this two-building complex on
its reservation, which is about 130 miles east of Phoenix. As the main
source of primary care for Indians there, this clinic provides dental,
behavioral health, optometry, laboratory, pharmacy, health education,
and preventive care, among other services.
I use these examples to demonstrate some of the many cases where
tribal ingenuity and resourcefulness have changed the Indian health
care system for the better. I think this is illustrative of what can
happen when the tribes are given the flexibility to plan, to develop,
and to determine the future for their own people. We promote that
ingenuity in this bill through the amendment to the Indian Self-
Determination Act, which will make it possible to bring private sector
money into Indian communities to supplement--again, I repeat
``supplement,'' not supplant--the Federal resources that are
appropriated by Congress.
S. 1200 establishes the Native American Health and Wellness
Foundation, the primary purpose of which will be to support the mission
of the Indian Health Service by supplementing the Federal resources
with private funds and, hopefully, bringing the level of funding for
Indian health care closer to that level of need.
Mr. President, I will conclude my remarks this afternoon by repeating
that within the Indian health system, you have great disparity. You
have seen some of the pictures of beautiful facilities and some
pictures of facilities that are in desperate need of help. We have
heard stories that just break your heart of people who were denied
services, of people whose illness was only compounded because of
failures within the system.
But we have also heard some statistics that give us cause for hope
that we are making headway within the system in terms of some of the
chronic diseases and how we might approach them. Through the Indian
health care reauthorization, we focus on those areas that will allow us
to do better, whether it is in the area of behavioral health,
additional screenings, those programs that focus on prevention, those
programs that focus on wellness, so that we can, A, lower our cost of
health care but, B, to really allow American Indians and Alaska Natives
to have a quality of health care that is at least on par with what you
would get if you went to a non-IHS facility.
We have not advanced legislation that would update the Indian Health
Care Act since 1992. As I have said, all one needs to do is think back
to what we were doing in 1992 in terms of health care. Think how far we
have come with the technology. Think how far we have come with the
techniques that are utilized. Let's not leave the Indian health care
system 10, 20 years ago. Let's allow them to come into a level of
service that we care to enjoy.
I mentioned one way we in Alaska are able to deal with the issue of
access. In a large State with a small population who are not connected
by roads, we have to rely on telehealth. Telemedicine has allowed us to
provide for a level of care, whether it is checking out an infant's ear
to make sure how bad that ear infection is or whether it is literally
videoconferencing with a suicidal teenager and counseling to make sure
he is not going to do something precipitous, that he knows he has
somebody who is there for him. Our technology allows us to do that, but
our legislation needs to be put in place to allow us to take full
advantage of the changes in these intervening years.
Again, I stand with my colleague, the chairman of the Indian Affairs
Committee, and urge our colleagues, if they have amendments, if there
are still issues outstanding, let's work through those, let's get the
amendments, but let's work through any remaining issues. We owe it to
all our constituents around the country to provide for a better level
of care.
With this legislation, it is one small step forward.
[[Page S173]]
I yield the floor.
The PRESIDING OFFICER. The Senator from Washington.
Mrs. MURRAY. Mr. President, I come to the floor this afternoon to
join with the Senator from Alaska and the Senator from North Dakota to
urge our colleagues to support this legislation that is going to make a
critical difference to thousands of American Indians in Washington
State and across our country.
I join in the words of my colleague, the Senator from Alaska. She
mentioned several of the tribes in Washington State. This has an
important impact on them. I agree with her and thank her for the
tremendous work on this issue, helping us bring it to the floor and
hopefully to passage so we can make a difference.
I am proud to be an original cosponsor of this Indian Health Care
Improvement Act. It does reauthorize and update the health care
services our Government provides to American Indians and Alaska
Natives. This bill will allow our Indian health clinics and our
hospitals to modernize their services and enable them to provide better
preventive care. These services are vitally important in Indian
Country, where our tribal members suffer from high rates of diabetes
and other chronic illnesses. Our Government has a legal responsibility
to provide health care for American Indians, but we have a moral
responsibility to ensure we provide the best care possible.
The Indian Health Care Improvement Act has not been reauthorized
since 1992, and in the years since it expired in 2001, what Congress
has done is simply appropriate money for health care programs without
examining this act to see how we can improve it. This bill we are now
considering takes important steps toward ensuring we are providing the
best and the most cost-effective care. It is long time past to pass it.
The health disparity between American Indians and the general
population is great. The numbers show why this bill deserves our
attention now. The infant mortality rate among Indians is 150 percent
greater than for Caucasians. Indians, in fact, are 2.6 times more
likely to be diagnosed with diabetes. Indians suffer from greater rates
of post-traumatic stress disorder, and the suicide rate among Indians
is more than twice the national average. In fact, life expectancy for
American Indians is nearly 6 years less than the rest of the U.S.
population.
An example from my home State of Washington helps to illustrate the
impact these numbers have on Indian communities.
Three years ago, in a 6-month period, the Skokomish Tribe, which has
a reservation near Hood Canal, lost 9 of its 1,000 members. Among them
were two children, two young adults, and five elders. One of those
elders was Bruce Miller. He was a Vietnam veteran and a nationally
known artist and spiritual leader. Bruce helped restore ceremonies that
were once banned by the U.S. Government. His work to prevent drug abuse
and rebuild tribal customs will be sorely missed. Bruce was only 60
years old when he passed away.
Many of the Skokomish Tribe members died of conditions that are all
too common on our Indian reservations--drug overdose, heart disease,
cancer, diabetes. These conditions we know are preventable, and many in
Indian Country have been working very hard to reverse the numbers I
mentioned. But their work has been hindered because Indian health
services are badly in need of updating.
The most important thing the Indian Health Care Improvement Act does
is help to modernize those services. In the last 16 years, as the
Senator from Alaska said, we have revolutionized the way we approach
chronic illnesses such as diabetes. Doctors' offices and health clinics
around the country now emphasize the importance of eating right,
staying healthy. We have changed where we provide services. Instead of
treating elderly and chronically ill patients in the hospital, more and
more people get care at home or in a community clinic. And now, of
course, it is standard practice to coordinate mental health and
substance abuse and domestic violence prevention services. But while we
have done all that, health care for Indians has gone badly out of date.
We are still providing services today as if it was 1992.
The bill we are considering today will help bring health care for
Indians into the 21st century and enable their clinics to do more than
treat symptoms and instead focus on prevention and mental health.
It is particularly important to ensure Indian health clinics can
provide up-to-date care because for many of our tribal members, those
clinics are the only source of health care available. For tribal
members in rural Washington State and across the West, visiting a
doctor off the reservation often means driving for hours to get to the
nearest big city. In some of our remote areas, some tribal members
never see a doctor off the reservation. They are born in Indian
hospitals, they see that doctor for their entire life, and they die in
the same hospital.
This bill also funds urban Indian health clinics. In recent years,
President Bush and some of my colleagues have questioned the need to
provide health services to Indians who live in and around major cities.
In fact, disappointingly, the President's budget routinely eliminates
funding for the 34 urban Indian health centers that exist in this
country, and every year Congress restores the funding because those
centers serve thousands of Indians, many of whom are uninsured and
would not get care elsewhere. The doctors and the nurses who staff
those urban clinics specialize in the conditions many Indians face.
Even more importantly, they are sensitive to the cultural needs of
their patients. That makes the difference all too often when a patient
is deciding whether to seek care or to do preventive treatment and it
increases the chance that an Indian will continue to get the treatment
they need, as I said, for preventive or even mental health care.
I am disappointed Republican objections have limited how far the
important improvements for urban Indians in this bill can go, but this
bill, as now written, does ensure those important health centers stay
open. My State has two of them. I have to tell you, I have heard
firsthand from a number of our tribal members how important and
critical they are.
Both our urban and our rural Indian health clinics also give tribes
more decisionmaking power over health programs so they can determine
how best to serve their people. In Washington State, we have the
Nisqually Health Clinic that is located near Olympia. It offers a
community health representative program that trains the tribal members
about how to provide basic preventive care and education to help their
elders and members who suffer from diabetes or substance abuse.
We need to give programs such as those a boost so they can grow and
they can succeed so other tribes can try similar programs.
Reauthorizing the Indian Health Care Improvement Act will help us to do
that.
Finally, this bill also makes important improvements to the medical
benefits provided to tribal veterans. Tribal veterans, as many of my
colleagues know, have served throughout this Nation's history with
great honor and valor. In fact, American Indians have served in higher
numbers than any other ethnic minority in this Nation. But despite that
extraordinary commitment to this Nation, veterans services for American
Indians oftentimes falls short of what is available for non-Indians.
Fortunately, this bill we are considering changes current law to
allow the Secretary to enter into or expand arrangements to share
medical facilities and services with the Department of Veterans
Affairs. That provision requires consultation with the affected Indian
tribes before entering into those agreements, and it requires
reimbursement to the IHS, tribes or tribal organizations.
I wish to repeat something I said earlier because it is important.
Providing health care to Indians is part of our Government's trust
responsibility. It dates back to the 18th and 19th centuries. Congress
enacted the Indian Health Care Improvement Act in 1976 to better carry
out that duty. In President Ford's signing statement, he said:
Indian people still lag behind the American people as a
whole in achieving and maintaining good health. I am signing
this bill because of my own conviction that our first
Americans should not be last in opportunity.
Thirty-two years later, we still have a long way to go toward
achieving that
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goal, but we can take some important steps by reauthorizing this bill
now.
Housing and Emergency Preparedness
While I have the floor this afternoon, I wish to change gears and
talk about two other issues I heard a lot about at home--housing and
emergency preparedness--because I am hearing now disturbing rumors that
the President's upcoming budget proposal is going to recommend cuts in
those two areas.
First, I wish to emphasize how important it is we continue to provide
Federal support for police, fire, and emergency responders in all our
communities. This past month, I held several roundtables with our first
responders in Washington State to hear what they need to protect their
communities, and at every stop, they told me they have already been
squeezed by budget cuts and that they have spent the last several years
trying to do more with a lot less. They said they are very worried
about what it will do if their budgets are cut again.
Emergency responders in our small and rural communities are
especially concerned because they depend on Federal grants to keep
their communities safe. Let me give one example of the impact these
grants have had in my State that I think illustrates why Federal
support is so important.
A month ago, storms causing major flooding and wind damage slammed
into western Washington. Thousands of our homes on the coast and in the
inland counties were flooded and damaged severely. Grays Harbor County,
which sits along the Pacific coast, was one of the hardest hit. But
Grays Harbor emergency officials told me they were ready because they
had recently done exercises to practice emergency response training.
When those horrendous storms hit, first responders in Grays Harbor
County relied on vital equipment, basic radio and other safety gear.
Without that training, without that equipment, more people in Grays
Harbor would have been hurt in that storm. Grays Harbor had both of
those thanks to Federal homeland security grants.
From the flooding in Washington State to Hurricane Katrina, to
California wildfires, we have had too many opportunities now to witness
the need for effective predisaster planning and response support. Real
security in our communities does not come cheap.
Now, I have already written to President Bush to warn him against
cutting money for port security, transit security, and emergency
management grants. I am prepared to fight for these grants. Supporting
and protecting Americans here at home has to be a priority for all of
us.
Housing
When I was home, I also heard from citizens and lenders, housing
counselors, people involved in the housing issues in Washington State
who are very concerned about the potential cuts to housing grants they
are hearing about.
Washington State is fortunate that the economy is still relatively
strong compared to the rest of the Nation. But we are seeing signs of
trouble. In fact, I heard from a housing official who worked in Kitsap
County, one of our more rural counties. She has seen a dramatic
increase in the number of people who are now seeking housing
counseling. She told me that last fiscal year, their two full-time
housing counselors helped homeowners with 50 defaults. They saw that
many people in this first quarter alone. In fact, in the 2 days she was
with me and others talking about housing, she said she went back home
and there were seven more calls on her answering machine about
foreclosures.
The Federal Government has to do everything possible to address this
wave of foreclosures. One way we can do that is investing in housing
counseling. It is vital for troubled mortgage holders to get help early
so they can avoid foreclosure and keep their homes.
At a time when we are trying to work to help repair the economy and
ensure people can pay their bills, we cannot afford any cuts in our
budget for that safety net for our homeowners.
We also have to ensure that low-income Americans who are not
homeowners also get help. That means we have to continue to support
programs such as Section 8, homeless assistance, and CDBG, which will
help keep our communities strong through this and help make sure our
low-income residents have a home and can avoid homelessness.
Next month, when we get the President's budget sent to us, you can
count on me, I will be scrutinizing every word of it, and I will be
back on this floor, if necessary, to fight funding cuts to those
programs that are so important to keeping our communities strong.
I yield the floor.
The PRESIDING OFFICER. The Senator from Pennsylvania.
Honoring Pennsylvania's Troops
Mr. CASEY. Mr. President, I rise today to talk about an issue which
is on the minds of millions of Americans, but you would not know about
it from listening to the news.
Most of the news has been focused, appropriately so I think, on the
economy and the challenges we face. We are all going to be focusing on
that issue and we are going to be talking a lot about it and taking
action on it.
But at the same time, the war in Iraq remains an urgent issue for our
country but especially for the families who are living through this,
the small percentage of American families who have someone serving in
Iraq, a loved one, a relative, and also, of course, the troops
themselves who are serving.
So Iraq, the war in Iraq, remains an urgent issue, an issue that
deserves our attention and our continued focus. Today I do not want to
talk about the policy. We are going to have months and months to talk
about it. I have strong feelings about it, but today I rise for a very
simple but I think important reason and that is to salute the troops
from the State of Pennsylvania who have recently died in the war.
In July, I came to the floor to talk about the then 169 Pennsylvania
natives, in some cases residents, who had died in Iraq. Today,
unfortunately, I have to add nine more since July. We all know a lot of
the lyrics of the great singer and songwriter, Bruce Springsteen. I
quoted them last summer when I talked about the lyrics from his song
``Missing,'' where he talked about, in the context of 9/11, those who
had perished and the effect on a family.
His lyrics say, in part, he talks about waiting for that person to
come home, the person who would have lost their life at the tragedy of
9/11. He says: Your house is waiting. Then he repeats it. He says: Your
house is waiting for you to walk in, but you are missing.
He says: You are missing when I turn out the lights, you are missing
when I close my eyes, you are missing when I see the sunrise.
And he goes on from there. I think that song and those lyrics have an
awful lot of meaning for those who have lost a loved one in Iraq. Even
if they did not, the time spent away in Iraq for a loved one is
difficult enough but especially for a family with a member of their
family who died in Iraq. They are missing, and for a lot of those
families, will be missing for the rest of that family's life.
It is important to remember and remind ourselves these troops
volunteered for service. They were not drafted. They knew their task
would be difficult. They knew they would be in danger but they made
that commitment.
In the end, they made the ultimate sacrifice. To those families
across Pennsylvania, in communities such as Altoona and Falls Creek and
State College and Wexford and on and on and on, the war in Iraq is not
some obscure abstract policy being debated in Washington. For them, the
war is something very real.
As I said before, these fighting men and women in Iraq were born into
families, not divisions and brigades. These families and these
communities have lost sons and daughters, husbands and wives, brothers
and sisters, classmates, friends, all those relationships and all those
families and communities.
We know this war has gone on longer than World War II. We know the
numbers, more than 3,900 dead. In Pennsylvania, it is at 178.
Nationally, the wounded number is about 28,000. In many cases, those
who have been wounded are grievously, irreparably, permanently wounded.
We will not forget their sacrifice. But let me read the names of the
recently lost from Pennsylvania, the nine members we have to add to our
list. I will read their names and their hometowns.
First, Michael A. Hook from Altoona, Pennsylvania; Zachary Clouser,
from
[[Page S175]]
Dover; Michael J. Tully, Falls Creek; David A. Wieger, from North
Huntingdon; Adam J. Chitjian, from the city of Philadelphia; also from
the city of Philadelphia, Camy Florexil; from Pittsburgh, Ryan D.
Maseth; David A. Cooper, Jr., from State College, PA; Eric M. Foster,
Wexford, PA.
So after reading these nine names, we have now read, between July and
this date, all those from the State of Pennsylvania who have died in
Iraq since the beginning of the war.
I know we are short on time today, and we could read biographical
sketches of all those 178 soldiers. But let me read a couple of notes
about a few of them before I conclude.
By way of example, one of the names is Adam J. Chitjian from
Philadelphia. There is a section called Somerton in the city of
Philadelphia. He was on his second tour of duty in Iraq, 39 years old.
He joined the Army and his brother was quoted as saying: He wanted to
act rather than just talk. That is why he joined the Army.
He leaves behind a father and sister. When he visited Texas, after
being in Pennsylvania and serving our country all those years, when
Adam was in Texas, he met Shirley, who would later become his wife. So
for that family, we are thinking of Adam and his family. He died on
October 24, 2007.
Then we go backward in time to 2003 in November, Nicholas A. Tomko
from Pittsburgh, and a couple highlights about his life. He was 24
years old, from just outside Pittsburgh. The town is called New
Kensington. His father's name is Jack Tomko. He is quoted, in part, as
saying about his son that: He was a great kid, brave as hell. And he
goes on from there talking about his son.
Now this is a young man who left behind a fiance. And he was working
as an armored car driver near Pittsburgh. He joined the Reserves 3
years ago hoping to get a head start in a career in law enforcement.
I wish we could say Nicholas A. Tomko would have that opportunity to
serve in law enforcement, but this war took him from us.
His fiance said, and I am quoting in part here: I am going to make
sure people know about his service--that he went over there to fight
for his country and that he went over to serve. So we remember him.
Two more before I conclude. SSG Jeremy R. Horton from Erie, PA, died
on May 21, 2004. His tour was extended. He was a 24-year-old
Pennsylvanian. His tour was extended. He joined the Army right out of
high school, hoping to get money for college. This is what his uncle
said about him: He certainly loved his family, and he loved his
country, and he loved the military. It was what he wanted to do. We
need more like him.
No one could have said it better than that. We do need more people
like him, like Jeremy. He is survived by his wife Christie, whom he
married shortly after joining the Army.
I will do one more because I know we are short on time. SSG Ryan S.
Ostrom, from Liberty, PA. He was at one point in his life a baseball
coach. One of his players quoted the story about his life: He was a
good leader and a good person to look up to. And he had that special
smile we used to see in the locker room.
That is what they said about him as a coach. This man, Mr. Ostrom,
was 25 years old when he died. Here is what another member of the
military said, SSG Craig Stevens said about Ryan: He was a soldier you
could give a task to and know it would get done. You could just look at
him and know he was a leader.
Ryan would have started his senior year at Mansfield University this
fall, meaning then the fall of 2005. He is survived by his father Scott
and his mother Donna.
I will add one more. We have a minute. Our last biographical sketch
is LCpl Nicholas B. Morrison, from Carlisle, PA. He died August 13,
2004. He was 23 years old.
He joined the Marine Corps 16 months ago and planned to become a
state trooper in the State of Pennsylvania. He was a 2000 graduate of
Big Spring High School, where he was a linebacker on the football team.
I hope we can all remember his family as well today.
Here is what one of his friends said: He was the glue. When he would
come home, we would all make an effort to go out. He would make us
laugh about stories from when we were growing up.
And on and on and on, stories such as that from so many families and
so many communities across our Commonwealth and indeed our country.
I conclude with this thought: There are a lot of great lines in
``America the Beautiful.'' We could spend a lot of time talking about
each one of them. One of those lines, when we talk about ``America the
Beautiful,'' says: ``Oh beautiful for patriot dream that sees beyond
the years.''
That is what a lot of these soldiers did. They not only volunteered
for service knowing they could lose their lives, knowing they had to
make a full commitment of their life and their time and their family's
time, but they had dreams, dreams of serving their country and
hopefully dreams to go beyond that.
But they were patriots and they had dreams and it is those dreams we
remember and celebrate today. It is those dreams that go well beyond
the years we see before us.
So we remember these troops today and as always we ask God's
blessings on their lives, those who gave, as Abraham Lincoln said, the
last full measure of devotion to their country.
We remember them today and their families. May God bless them.
Mr. President, I ask unanimous consent that newspaper accounts about
these soldiers be printed in the Record.
There being no objection, the material was ordered to be printed in
the Record, as follows:
Pfc. Adam J. Chitjian, Somerton, PA--Died October 24, 2007
Somerton Native Killed in Northern Iraq (Philadelphia Inquirer),
October 27, 2007
A Philadelphia native due to end his second tour of duty in
Iraq next month died Thursday of injuries sustained from
enemy small-arms fire in Balad, northern Iraq.
Pfc. Adam J. Chitjian, 39, raised in Somerton, had joined
the Army 4 years ago in response to 9/11, his older brother,
Martin, said last night.
When it came to his country's defense, ``he wanted to act,
rather than just talk,'' Martin, 41, of Buckingham, Bucks
County, said.
A stocky 5-foot-11-inches, Adam Chitjian ``appeared bigger
than he was,'' Martin said. To his brother, Adam seemed
invincible.
``I would have bet my life he would have come back without
a scratch,'' said Martin, a lawyer, who was struggling last
night to grasp his brother's death. ``I don't really believe
it happened.''
Their father, Martin, who lives in Furlong, and sister,
Kara Spatola of Warrington, were too distraught to talk,
Martin said. Their mother, Edith, died 10 years ago of
cancer.
Chitjian was assigned to Third Battalion, Eighth Cavalry
Regiment, Third Brigade Combat Team, First Cavalry Division
based in Fort Hood, Texas.
It was in Texas where he met Shirley, who would become his
wife. They married in the summer of 2006, after he returned
from his first tour of duty in Iraq. The couple have no
children.
Martin said his brother had been a commercial painter since
graduating from Northeast Philadelphia's George Washington
High School. He had talked of possibly joining a private
security firm at the end of his duty in Iraq.
____
Sgt. Nicholas A. Tomko, Pittsburgh, PA--Died November 9, 2003
Pittsburgh-area soldier killed in attack in Iraq (Associated Press,
November 11, 2003)
Pittsburgh.--An Army reservist from Pennsylvania who was
due home in a little more than a month was killed Nov. 9 when
a convoy he was escorting in Baghdad was attacked, Defense
Department officials and his father said.
Sgt. Nicholas A. Tomko, a 24-year-old in the 307th Military
Police Company out of New Kensington, Pa., was fatally shot
in the shoulder and chest when the Humvee he was riding in as
a door gunner was attacked by mortar and small arms fire,
according to his father, Jack Tomko, and his fiancee, Jessica
Baillie.
``He was a great kid, brave as hell, he didn't take no
chances, he knew his stuff,'' said Jack Tomko, 58, of Evans
City. ``I guess that day he didn't know what was going on or
something.''
Tomko and Baillie said Nicholas Tomko was scheduled to
leave Iraq in 2 weeks and arrive home on Dec. 22.
Baillie, of Shaler, the mother of their 2-year-old son
Ethan, said she had talked to Nicholas Tomko on Saturday and
was stunned by his death.
``I didn't think it was going to happen, you know, he had
too much to come home to,'' Baillie told Pittsburgh
television station WTAE. ``We had too much of a future.''
Nicholas Tomko, who was working as an armored car driver
near Pittsburgh, joined the Army Reserves 3 years ago hoping
to get a head start on a career in law enforcement, his
father said. He was stationed in Bosnia for 6 months and had
2 months off before his unit was reactivated in February.
[[Page S176]]
Jack Tomko, who served in the Marine Corps from 1966 to
1970, said he and his son didn't talk about the war or
conditions in Iraq.
``I told him you don't tell me what is going on, you tell
me when you get home,'' Tomko said.
Tomko described his son as an average boy growing up and
remembered how he would occasionally get into food fights
with a friend, placing overripe apples and tomatoes on sticks
and hitting each other. But he said his son never got into
serious trouble.
Baillie said she thought their son was too young to tell
about his father's death.
``I'm gonna make sure that Ethan knows that is dad is a
hero and that he did, you know, what he wanted to do and that
he went over there to fight for his country,'' Baillie said.
``There is nothing negative you can say about that.''
____
Staff Sgt. Jeremy R. Horton, Erie, PA--Died May 21, 2004
Pennsylvania soldier killed in Iraq (Associated Press, May 2004)
Pittsburgh.--A soldier from Erie, Penn., whose tour was
extended last year, was killed in Iraq by a roadside bomb,
according to his family.
Staff Sgt. Jeremy R. Horton, 24, died Friday near
Iskandariyah, Iraq. Defense officials did not release further
details, but relatives said Horton apparently was killed when
his convoy was stopped for another roadside bomb.
Horton reportedly stepped from his vehicle and a second
bomb went off, killing him and wounding three other soldiers,
said his uncle, Rich Wittenburg, 54, of Erie. Horton died
from shrapnel in his head, Wittenburg said.
Horton joined the Army right out of high school, hoping to
get money for college, but ended up finding his place in the
military. He was a member of Company B, 2nd Battalion, 6th
Infantry Regiment, 1st Armored Division, based in Baumholder,
Germany.
``He certainly loved his family and loved his country and
loved being in the military. It was what he wanted to do. We
need more like him,'' Wittenburg said.
Horton played both the saxophone and drums in high school
and played in bands where he was stationed, his uncle said.
Horton is survived by his wife, Christie, whom he married
shortly after joining the Army.
A memorial service was planned for Thursday in Germany and
he will be buried June 2 in Erie, his uncle said.
____
Staff Sgt. Ryan S. Ostrom Liberty, PA--Died August 9, 2005
Student remembers Pa. National Guard soldier as a mentor (Associated
Press, August 2005)
When Broc Repard was playing junior high basketball, Ryan
S. Ostrom was his coach. But he was so much more.
``He taught people skills as much as he taught
basketball,'' said Repard.
``He was a good leader and a good person to look up to. And
he had that special smile we used to see in the locker
room.''
Ostrom, 25, of Liberty, Pa., died Aug. 9 from small-arms
fire in Habbaniya. He was assigned to Williamsport.
``He was a soldier you could give a task to and know it
would get done. You could just look at him and know he was a
leader,'' said SSG Craig Stevens.
Ostrom captained his high school's soccer and basketball
teams and won a Pennsylvania Interscholastic Athletic
Association sportsmanship award. He was a Youth Leader of
Tomorrow candidate.
A 1999 high school graduate, Ostrom would have started his
senior year at Mansfield University this fall, studying
chemistry. Professor Scott Davis said Ostrom was one of the
few science students who aspired to be a teacher.
``He would have been a good one,'' Davis said.
He is survived by his father, Scott Ostrom, mother, Donna
Ostrom, and stepmother, Anice Ostrom.
____
Lance Cpl. Nicholas B. Morrison, Carlisle, PA--Died August 13, 2004
Pennsylvania Marine Killed in Iraq (Associated Press, August 2004)
Carlisle, PA.--A North Carolina-based Marine killed in Iraq
complained about the food and the heat, but nothing else, his
mother said.
LCpl Nicholas B. Morrison, 23, Carlisle, Pa., died Friday
during hostile action in Iraq's Anbar province.
He joined the Marine Corps 16 months ago and planned to
eventually become a state trooper, said his mother, Peggy
Morrison, of West Pennsboro Township in Cumberland County.
``He cared about what he was doing,'' Peggy Morrison said.
``He believed in the war. He was afraid, but not afraid to do
what was right.''
Morrison died when an explosive hit the Humvee in which he
was riding, his mother said.
``They were on a scouting mission or something,'' said
Morrison, adding that she expected more detailed information
from military officials Monday.
Morrison was assigned to the 2nd Battalion, 2nd Marine
Regiment, 2nd Marine Division, II Marine Expeditionary Force
at Camp Lejeune, N.C.
``We sent him a digital camera and he'd take pictures
during a gunfight,'' Peggy Morrison said. ``We'd holler and
he'd say, `It's not that bad.' I think he tried to downplay
it.''
Morrison was a 2000 graduate of Big Spring High School,
where he was a linebacker on the football team and had many
close friends, said schoolmate Matt Swanger, 22.
``He was the glue. When he would come home we would all
make an effort to go out,'' Swanger said. ``He would still
make us laugh about stories from when we were growing up. I
was really looking forward to when he came home.''
The PRESIDING OFFICER (Ms. Cantwell). The Senator from Florida.
Mr. NELSON of Florida. I ask unanimous consent to speak as in morning
business.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. NELSON of Florida. Let me say to Senator Casey before he leaves
the floor, the kind of speech he has made is the kind of speech none of
us wants to make. It happens with each of us in each of our States. As
the Senator from Pennsylvania was speaking, it caused me to reflect
back that one of the more painful duties as an active-duty U.S. Army
captain in the late 1960s was that of going and informing the family
members, next of kin, about the loss of their loved one. That was
during Vietnam. That was usually the occasion for the notification of
next of kin. How difficult a task it is personally to do it because you
realize how difficult it is for the family to receive that news. I
thank the Senator from Pennsylvania for his obviously heartfelt
comments about the Pennsylvania citizens who have fallen in combat and
for his words and expression of appreciation for the patriotism of
these young men and women.
Coral Reef Ecosystems
I rise today to speak about another subject, the fact that two of the
committees on which I sit have recently reported out important
legislation to protect delicate coral reefs off the coast of our
country. It is called the Coral Reef Conservation Amendments Act and
the Tropical Forest Conservation Act.
Mr. President, 84 percent of all of the coral reef ecosystems in the
country happen to be off the coast of Florida. It is important that we
protect them because--and a lot of people don't realize this--they
protect us. Coral reefs are fragile, slow-going, slow-growing, and
long-lived ecosystems. Corals themselves are easily damaged and they
are vulnerable to severe weather, ship damage, pollution,
nutrification, and changes in temperature. Even with all of those
environmental and physical challenges, coral reef ecosystems provide
invaluable services to us. They protect our shorelines. They enhance
our economies because of all of the wonderful exploration in dive
shops. They shelter fisheries, and they are a very valuable ecosystem
for a variety of marine life.
Beyond the current ecosystem services and known capacities, coral
reefs also hold the promise for new discoveries, new and beneficial
drugs coming from the coral reefs, improved understanding of disease
and, even now, understanding of new species. As we reauthorize in this
legislation the Tropical Forest Conservation Act, we are going to take
an important and significant new step to preserving and restoring
global natural resources and marine systems. This reauthorization will
continue our efforts to preserve the world's forests, the coral reefs,
and now the coastal marine ecosystems. This act will create an
invaluable debt for nature exchange that benefits both the global
economy and the global environment.
We have an aquarium in Tampa, FL that is offering its expertise in
coral conservation and coral health certification in these
international efforts that are ongoing. Developing countries are now
participating in this debt relief initiative, and it will greatly
benefit from the research that is going on at the Florida aquarium.
The legislation that is coming forth is a reauthorization that
strengthens the authority of the Secretary of Commerce. It gives the
Secretary the ability to address threats to coral reef ecosystems in
U.S. waters. It expands NOAA's authority to respond to stranded and
grounded vessels that threaten the coral reefs. The bill also allows
for NOAA to negotiate agreements with coral reef research institutes
such as the Institute at Nova Southeastern University in my State in
the city of Fort Lauderdale. This bill also provides
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mechanisms for the Government to recoup costs and damages from the
responsible parties and then apply those funds to coral restoration
efforts in damaged areas.
We have another potential devastation of coral reefs. Many of these
reefs are right off the Florida Keys. It is an area of endangered,
critical concern. There are these beautiful coral reefs that do all of
these protections I talked about for the delicate keys: protection from
storms, housing the fisheries, a place for research and development
with regard to disease, and so forth. But let me tell you about a new
destructive potential for the coral reefs. Remember, 84 percent of the
Nation's coral reefs are in Florida. Since there is no treaty between
Cuba and the United States with regard to the operation of the waters
between the two, there have been exchanges between the Government of
the United States and Cuba, through the facilities of the Swiss
Embassy, an exchange of letters that has been going on for 20 years,
designating a line halfway between Key West and Cuba, which is only 90
miles, or a line 45 miles off the coast of Cuba, which happens to be 45
miles off of Key West, as a line at which the jurisdiction of the
waters in each respective part is the jurisdiction of that country.
Here is the problem. Cuba, combined with foreign oil companies, now
including PDVSA, the oil company of Venezuela, is starting to explore
for oil out in the waters off of Cuba. There has been some exploration
already near the shore. But unless that agreement is modified, the
Venezuelan oil company could be drilling for oil 45 miles off of Key
West. Right off of Key West is the gulf stream. The gulf stream comes
up through the west side of Cuba and the Yucatan peninsula, goes into
the Gulf of Mexico, turns eastward and southward and comes down below
Key West, between Key West and Cuba, and then follows the keys
northward, hugs the coast of Florida only a couple of miles off the
coast, all the way up to the middle of Florida at Fort Pierce, and then
turns and leaves the coast of Florida going across the Atlantic and
goes all the way over to northern Europe. If we don't call back this
letter that most recently the Bush White House has sent to Cuba to
ratify the agreement, which is done every 2 years, it gives perfect
license for the Castro government to go in and drill. If there is an
oil spill that is caught up in that gulf stream, you can see the
potential for destruction of the delicate coral reefs all lining the
Florida Keys and then right up the east coast of the State of Florida.
I have written to the President today asking him to recall the
letter. The letter has been delivered by the State Department to the
Swiss Embassy, but it has not been responded to by the Government of
Cuba. It is not too late to withdraw that letter from the United States
Government setting that boundary, and instead a new letter should be
sent, perhaps with regard to what this initially started a couple of
decades ago, on the fishing rights of each country, but one that would
exempt out the rights of Cuba to drill in such a dangerous area. At
least this ought to be an issue that is negotiated to keep the oil
drilling away from the gulf stream which could damage these very coral
reefs which I have been talking about in this act, this legislative act
which has come out of the committee on which the Presiding Officer and
I serve. It is not too late, if the Bush administration will do this.
This happened 2 years ago and the Bush administration ignored the
calls. But in the last 2 years, it has become much more apparent that
oil companies sometimes that may not be safe in their drilling
practices are in fact going to drill. The United States needs to have a
say in those drilling operations not being out there close to the gulf
stream which is only 30 or 40 miles off of the city of Key West which
is at the lower end of the Florida Keys.
I come here happily to embrace this legislation protecting coral
reefs, but I come here with an urgent message asking the White House to
protect our coral reefs by withdrawing this letter sent to the Castro
government of Cuba.
I yield the floor.
Mr. REID. I suggest the absence of a quorum.
The PRESIDING OFFICER. The clerk will call the roll.
The assistant legislative clerk proceeded to call the roll.
Mr. REID. Madam President, I ask unanimous consent that the order for
the quorum call be rescinded.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. REID. Madam President, there has been a lot of progress made on
this Indian health bill that is now before the Senate. A number of
amendments have been filed. The staff are negotiating further
provisions and discussing a list of amendments for consideration when
we return to the bill.
I extend my appreciation to Senator Dorgan and Senator Murkowski, the
chairman and ranking member, for their leadership on the floor.
Many compromises have been made to accommodate my Republican
colleagues--on Federal Torts Claims Act coverage of traditional health
care practitioners, on urban Indian programs, and on the need for an
Assistant Secretary of Indian Health. We even accommodated our
colleagues when we learned of their midweek retreat, which has
interrupted debate time on this important bill.
The caucuses are discussing some final issues, and I will be
developing a list of amendments that we should consider relating to
this legislation. I hope these conversations continue so we find a way
to complete the bill in a timely and efficient manner.
As an original cosponsor of the Indian health bill, I am committed to
seeing an Indian health bill signed into law and will continue to work
with Senator Dorgan, Senator Murkowski, and my Republican counterpart
to complete this legislation as soon as possible.
Mr. FEINGOLD. Madam President, I am pleased to support the Indian
Health Care Improvement Act Amendments of 2007. This bill is long
overdue, and I hope that we in the Senate can ensure this bill's quick
passage.
There are significant unmet needs in Indian Country throughout this
Nation, and addressing the unmet health care needs ranks as one of the
most significant issues that we must address. The Federal Government
has a well-established trust responsibility with regard to American
Indian affairs, and this trust responsibility extends to providing good
health care to communities throughout Indian Country.
I am impressed with the bipartisan work that Senator Dorgan and the
Senate Indian Affairs Committee have put into moving this bill forward,
and I commend the committee for its dedication to significant
consultation with Indian Country in drafting and negotiating this bill.
Because of the strong consultation with individual tribes and
collective organizations like the National Tribal Steering Committee
and the National Indian Health Board, the Senate Indian Affairs
Committee has put together a comprehensive reform bill that will help
improve the health care services available to American Indians around
the country.
This bill has the support of tribal governments throughout the
Nation, including the 11 federally recognized tribes in my State of
Wisconsin. I have heard from a number of constituents in Wisconsin
about the need to pass this important piece of legislation and the
improvements that the legislation will make to various Indian Health
Service programs including clinical programs, on the various
reservations throughout the State and the urban Indian program in the
city of Milwaukee.
Health care is consistently the No. 1 issue that I hear about all
over my home State of Wisconsin. When I hold my annual townhall
meetings across the State, many people come to tell me about problems
with our overall health care system, and data shows us that these
problems are often most acutely felt in Indian Country. Lack of access
to good health care is a problem that disproportionately affects
American Indians throughout the United States. According to the Indian
Health Service, American Indians and Alaska Natives are 200 percent
more likely to die from diabetes, more than 500 percent more likely to
die from alcoholism, and approximately 500 percent more likely to die
from tuberculosis.
I was disappointed to hear one of my colleagues say yesterday on the
floor that American lives do not depend on whether we pass the Indian
health care bill by the end of the month. The staggering health
statistics I cited earlier show just how imperative it is that we
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pass this legislation, which is long overdue. These statistics also
help illustrate the vast amount of work that needs to be done to
improve the quality of health care in American Indian communities. This
piece of legislation takes an important first step toward addressing
these health care disparities through the many reforms it makes to
Indian health care programs. Contrary to what my colleague asserted
yesterday, American lives do depend on this legislation. Modernizing
Indian Health Services programs through this legislation will help to
address the diabetes and suicide crises that exist on reservations--
just two examples of the many health care issues that impact the daily
lives of American Indians across the country.
Reauthorization of this bill will help encourage health care
providers to practice at facilities in Indian Country and encourage
American Indians to enter the health care profession and serve their
communities. Recruiting talented and dedicated professionals to serve
in IHS facilities, whether urban or rural, is a key challenge facing
many tribal communities in Wisconsin and around the country. I hope
these provisions will help bring additional dedicated doctors, nurses,
and other health care professionals to our tribal populations.
This bill also reauthorizes programs that assist urban Indian
organizations with providing health care to American Indians living in
urban centers around the country. The Urban Indian Health Program
represents a tiny fraction of the Indian Health Services budget, but
the small amount of resources given to the urban programs provide
critical health services to those Indians living in urban areas.
Contrary to what some people may think, the majority of American
Indians now live in urban areas around the country, including two urban
areas in my State--Milwaukee and Green Bay. Throughout our Nation's
history, some American Indians came to urban centers voluntarily, but
many were forcibly sent to urban areas as a result of wrongheaded
Federal Indian policy in the 1950s and 1960s and have since stayed in
urban areas and planted roots in these communities.
As a result of this movement to urban centers, Congress created the
urban Indian program in the late 1970s to address the growing urban
Indian population around the country. The Federal Government's
responsibility to American Indians does not end simply because some
American Indians left their ancestral lands and moved to urban
locations--particularly when some of them had little choice in the
matter.
While this legislation takes important steps toward improving urban
Indian health care programs, we need to do much more to support these
urban programs, including fighting for increased appropriations. I have
been disappointed that the President has proposed zeroing out the urban
Indian program in past budgets, and I fear that this year's upcoming
budget will be no different. As in years past, I will join with my
colleagues in efforts to restore funding for urban Indian programs to
the Federal budget, and I hope this year we can also provide a much
needed boost in funding for the urban Indian programs.
While this bill is a good first step towards reforming and improving
access to health care in Indian Country, I also look forward to working
with my colleagues to examine better ways to address the disparities
that exist in the funding allocated to various IHS regions, including
the Bemidji region, which covers Wisconsin, Minnesota, Michigan,
Indiana, and Illinois. According to the latest available data compiled
by the Great Lakes Inter-Tribal Epidemiology Center, the Bemidji Indian
Health service area has lower funding rates than other Indian Health
Service areas around the country. Even though the Bemidji region's
funding rates are lower than other areas, the region has higher rates
of heart disease and cancer than other regions and has the second worst
diabetes rate in the IHS system. Not only do we need to provide more
funding for all IHS regions, we also need to better address disparities
that exist within the system, and I look forward to working with my
colleagues in the coming months to address those disparities.
This bill is a solid first step toward improving access to health
care in Indian Country. Unfortunately, the Senate was not able to
finish work on this important bill before we had to move to debate
another matter. I understand the majority leader has made a commitment
to return to the Indian health care bill after we finish that other
debate, and I look forward to working with my colleagues to pass the
American Indian Health Care Improvement Act Amendments of 2007 in the
near future. We need to move forward on this critical bill, and I urge
all my colleagues, whether Republican or Democrat, to work together
quickly to ensure its swift passage.
Indian Country has made many compromises in order to move this bill
forward, and passage of this bill is long overdue. This bill takes
important steps toward addressing some of the health care needs facing
American Indian communities around the country, and I look forward to
working with my colleagues to build on this legislation in the coming
months and years. I also hope that we can continue to work together in
a bipartisan way to pass the reauthorization of the Native American
Housing and Self-Determination Act, work on legislation to address the
education needs of American Indian youth, and address other legislative
areas in order to help ensure stronger futures for American Indians
throughout the country.
Mr. ENZI. Madam President, I rise in support of renewing and
reinvigorating the Indian healthcare programs. For too long, we have
neglected our duty to review this program and ensure that it continues
to efficiently deliver high quality health care. As a part of that
effort, last Congress Senator McCain, Senator Dorgan, Senator
Murkowski, and I introduced comprehensive legislation to do just that.
I am pleased that a great portion of the bill we are discussing today
includes provisions from that bill, S. 4122.
In crafting that legislation last Congress, we kept in mind the 80-20
rule. Eighty percent of the time we were going to agree on a topic. It
is only 20 percent that we are going to disagree. Therefore, to gain
broad support, we focused on the 80 percent to ensure that it was
strong, bipartisan legislation.
However, there are a few ways in which the bill before us deviates
from the language in S. 4122. Sometimes, those changes are improvements
as we all review the language again. Unfortunately, some issues still
remain.
Those issues include Federal liability coverage for traditional
healthcare practices. If we don't correct this, the Federal Government
could be telling Americans how to practice their own religious beliefs.
In addition, we need to more fully understand the appropriate role for
providing services to urban Indians. I do think there is middle ground,
or a third way--as I like to call it--to be found. In addition, there
must be an appropriate offset to the legislation. Given the pay-go
rules in both Chambers, in addition to our own Senate procedural
hurdles, it is necessary and fiscally appropriate to have a responsible
offset.
I have also heard from my colleagues that there are at least two
outstanding issues within the Finance Committee's title of this
legislation. I hope those can also be discussed and resolved.
Specifically, the concerns center around the elimination of Medicaid
copays and removal of particular citizenship requirements.
As the optimist and the Senator advocating for the ``third way,'' I
am hopeful that we all can continue discussing these issues and come to
an agreement as to how we move forward. Individuals depending on the
Indian Health Services for their health care deserve no less.
Mr. WEBB. Madam President, the Senate is in the midst of an important
debate to extend and improve health care to our Nation's federally
recognized Indian tribes. I support the Indian Health Care Improvement
Act and I commend all those, including the distinguished chairman,
Senator Dorgan, for their work on it.
As we work to extend health care to more Native Americans, some of
our oldest and most historically significant Indian tribes will be left
outside the process, ineligible to participate in either the health
care services or other programs authorized by the Federal Government.
I bring to your attention my strong support of a bill passed last
year by the
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U.S. House of Representatives, which would grant Federal recognition to
six Native American tribes from the Commonwealth of Virginia. That bill
is the Thomasina E. Jordan Indian Tribes of Virginia Federal
Recognition Act, H.R. 1294.
Once the Senate passes that bill and the President signs it into law,
these six federally recognized tribes would become eligible for the
benefits conferred under the Indian Health Care Improvement Act, which
the Senate currently is debating. I hope that the Senate will pass the
Indian Health Care Improvement Act this week. Just as importantly, I
hope that during this session of Congress, the Senate will pass the
Thomasina E. Jordan Indian Tribes of Virginia Federal Recognition Act,
thereby bestowing Federal benefits to these six tribes that have waited
over 15 years for recognition.
The six tribes affected by the Federal Recognition Act are (1) the
Chickahominy Tribe; (2) the Chickahominy Indian Tribe--Eastern
Division; (3) the Upper Mattaponi Tribe; (4) the Rappahannock Tribe,
Inc.; (5) the Monacan Indian Nation; and (6) the Nansemond Indian
Tribe.
All six tribes included in the Federal Recognition Act have attempted
to gain formal recognition through the Bureau of Indian Affairs, BIA. A
lack of resources, coupled with unclear agency guidelines, have
contributed to a backlog that currently exists at the BIA. Some
applications for recognition can take up to 20 years.
Virginia's history and policies create barriers for Virginia's Native
American Tribes to meet the BIA criteria for Federal recognition. Many
Western tribes experienced Government neglect during the 20th century,
but Virginia's story is different. Virginia's tribes were specifically
targeted by unique policies.
Virginia was the first State to pass antimiscegenation laws in 1691,
which were not eliminated until 1967.
Virginia's Bureau of Vital Statistics went so far as changing race
records on many birth, death and marriage certificates. The elimination
of racial identity records had a harmful impact on Virginia's tribes in
the late 1990s, when they began seeking Federal recognition.
Moreover, many Virginia counties suffered tremendous loss of their
early records during the intense military activity that occurred during
the Civil War.
After meeting with leaders of Virginia's Indian tribes and months of
thorough investigation of the facts, I concluded that legislative
action is needed for recognition of Virginia's tribes. Congressional
hearings and reports over the last several Congresses demonstrate the
ancestry and status of these tribes. I have come to the conclusion that
this recognition is justified based on principles of dignity and
fairness. I have spent several months examining this issue in great
detail, including the rich history and culture of Virginia's tribes. My
staff and I asked a number of tough questions, and great care and
deliberation were put into arriving at this conclusion.
Last year, we celebrated the 400th anniversary of Jamestown America's
first colony. After 400 years since the founding of Jamestown, these
six tribes deserve to join our Nation's other 562 federally recognized
tribes.
As I mentioned, the House overwhelming passed the Thomasina E. Jordan
Indian Tribes of Virginia Federal Recognition Act, with bipartisan
support. Virginia Governor Tim Kaine and the Virginia legislature
support Federal recognition for these tribes. I look forward to working
with my colleagues in the Senate, especially those on the Indian
Affairs Committee, to push for passage of the Thomasina E. Jordan
Indian Tribes of Virginia Federal Recognition Act.
At a time when we are debating how to effectively promote Indian
health care, it is important that we grant these six Virginia tribes
the access to these essential Federal health programs.
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