[Congressional Record (Bound Edition), Volume 153 (2007), Part 9]
[Senate]
[Pages 12618-12623]
[From the U.S. Government Publishing Office, www.gpo.gov]




          STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

      By Ms. STABENOW (for herself and Ms. Snowe):
  S. 1408. A bill improve quality in health care by providing 
incentives for adoption of modern information technology; to the 
Committee on Finance.
  Ms. STABENOW. Mr. President, the evidence showing the ability of 
health IT to reduce costs and improve quality of care is simply 
overwhelming.
  That is why Senator Olympia Snowe and I are reintroducing our Health-
Tech legislation to accelerate the adoption of health information 
technology.
  Businesses across the country are struggling to remain competitive in 
a global market with skyrocketing health care costs.
  The use of electronic medical records could save more than $80 
billion annually, reducing costs for businesses and taxpayers alike. We 
should be putting these systems in place immediately!
  And, despite the best doctors, nurses, hospitals, and other health 
care providers in the world, some patients just are not getting the 
care they need.
  Often times that is because our health care providers do not have the 
information they need about their patients, when they need it and where 
they need it.
  And, our health care system are not current1y set up to prevent 
errors; the most common medical errors include medication errors and 
the extra costs of treating drug-related injuries amount to at least 
$3.5 billion a year.
  As compelling as the cost savings is the promise health IT holds for 
improving the quality of our health care system.
  Getting health IT into the hands of our doctors, hospitals, nursing 
homes and community clinics will mean patients get the care they need, 
at the right time, and in the best setting.
  The value of health IT--saving lives and saving money--is well-known.
  So why is it not being used more widely?
  Health care providers are struggling to keep up with their daily 
needs; a major barrier to widespread use of IT is the initial 
investment cost.
  The costs of implementing health IT can be staggering.
  For example, the cost of an integrated electronic health record 
system for a three- to six-member physician practice is estimated to be 
$70,000-$100,000.
  And, the savings from using health IT go primarily to the patients, 
employers, and insurers, not the providers.
  If a patient needs one less x-ray because a hospital can pull up the 
x-ray performed by a radiologist in a different setting, that is one 
less co-payment for the patient, and one less bill to the patient's 
employer or insurer, or to the Medicare program.
  It only makes sense for the Federal Government to invest some seed 
money.
  Every day we delay providing Federal dollars, we delay getting health 
information technology systems in place, and businesses, taxpayers and 
patients pay in both dollars and lives.
  The bill that Senator Snowe and I are reintroducing today would 
address just that: It would put IT systems in the hands of providers by 
establishing a 5-year, $4 billion grant program for health care 
providers and by providing tax incentives and adjusting Medicare 
payments for providers who use these systems.
  The bill will be referred to the Finance Committee; Senator Snowe and 
I are both members of the committee and will work to include our 
legislation in any appropriate package the committee considers.
  We have made an important change to our bill this Congress.
  A patient's right to health information privacy is paramount, and is 
essential to the health care provider-patient relationship.
  Therefore we have added a requirement that health IT systems funded 
by our legislation ensure the privacy and security of personal medical 
information, and that patients be informed if there is a breach in the 
privacy of their medical record.
  We need to get this done. Widespread use of health information 
technology can revolutionize our health care system. Getting systems 
into the hands of providers is the first step.
  Our legislation has the support of many consumer, provider, labor and

[[Page 12619]]

business groups including: AFL-CIO, Altarum, American Academy of 
Pediatrics, American College of Cardiology, American College of 
Emergency Physicians, American College of Physicians, American Health 
Care Association, American Heart Association, American Society of 
Health-System Pharmacists, Ascension Health, Automation Alley, 
BlueCross/BlueShield of Michigan, DaimlerChrysler, Detroit Medical 
Center, e-Health Initiative, Families USA, Federation of American 
Hospitals, Ford Motor Company, General Motors Corporation, Greenway 
Medical Technologies, Healthcare Information and Management Systems 
Society (HIMSS), HR Policy Association, IBM, Marquette General Health 
System, McLaren Health Care Corporation, Michigan Health and Hospital 
Association, Michigan State Medical Society, National Association of 
Children's Hospitals, National Association of Community Health Centers, 
National Business Coalition on Health, National Business Group on 
Health, National Partnership for Women and Families, National Rural 
Health Association, Oracle, Saint John Health, Saint Joseph Mercy 
Health System--Ann Arbor, Michigan; Saint Joseph Mercy Oakland--
Pontiac, Michigan; Saint Mary's Health Care--Grand Rapids, Michigan and 
Trinity Health.
  I urge my colleagues to support this legislation.
  Ms. SNOWE. Mr. President, today I join my colleague, Senator Stabenow 
of Michigan, in introducing the Health Information Technology Act of 
2007, which will serve to improve the quality of health care through 
implementation of information technology, IT, in hospitals, health 
centers and physician practices throughout the country. Our legislation 
is necessary because as a nation we face two stark problems.
  The first of these is a serious patient-safety problem. Indeed if 
most Americans were told today that 98,000 lives were lost needlessly 
last year and a cure was available they would undoubtedly call for 
action. Yet the Institute of Medicine, IOM, has reported that medical 
errors inflict that toll every year, and we have the technology at our 
disposal to dramatically reduce those deaths.
  The good news is that solutions exist. We have the technological 
ability to dramatically reduce medical errors and thus save lives. Many 
of us have heard about how drug interactions can be avoided by software 
systems which check a patient's prescriptions for hazards. Yet there 
are so many other applications which can improve health. For example, 
by reviewing and analyzing information, a health provider can help a 
patient better manage chronic diseases such as diabetes and heart 
disease, and avoid adverse outcomes.
  Our second major problem is the escalating cost of health care. Our 
health spending now comprises 16 percent of GNP, and the price of 
coverage has grown so high that the number of Americans without health 
insurance reached nearly 47 million last year. Those trends are 
threatening our economic competitiveness in the world and each 
American's health security as well. The answer is not to simply expand 
coverage, because on our current trajectory, escalating costs would 
simply erode our ability to provide care. It is clear that some 
fundamental changes must be made in health care.
  One of those changes must be the application of modern data 
technology to save lives and reduce costs. Indeed consider the savings 
when a physician can locate information efficiently. Tests do not have 
to be repeated and data is not delayed. In fact, a patient may obtain 
faster, higher quality care when, for example, multiple practitioners 
can review diagnostic test results right at their desktops. In an age 
where millions of Americans share family pictures over the internet in 
seconds, is it not long past time that a physician should be able to 
retrieve an x-ray just as easily?
  The President certainly recognizes the disparity in technology in 
health versus other parts of our economy. He has declared a goal for 
every American to have an electronic medical record within ten years. I 
concur, we need this and more. In fact, once that record is in place we 
can do so many things better. From preventing drug interactions, to 
managing chronic diseases, to simply helping providers operate more 
efficiently. Most of us have been told at one time or another, ``we're 
waiting to get the test results mailed,'' or ``we're still waiting for 
your chart.'' Health care is one of the last bastions of such 
inefficiency. Indeed it is often easier to track the service history on 
one's automobile than to see your own health history.
  The bad news is that the cost of new systems and a lack of standards 
have prevented us from reaping the benefits of new technologies. The 
President has made technology implementation a priority, and there is 
no doubt that a lack of standards has played a role in slowing IT 
adoption by many health care providers. One must know that a system 
purchased will be compatible with others, and that, no matter what may 
happen in the future to a vendor, the huge investment one makes in 
building an electronic medical records would not be lost. In other 
words, your system must be able to communicate with other systems, and 
your investment in building electronic medical records must be 
preserved. So when a patient moves, their electronic ``chart'' should 
be able to move right along with them, and their continuity of care 
shouldn't be interrupted.
  Yet standards alone aren't enough. Today many providers are 
struggling to make these investments, and for those which serve 
beneficiaries of Medicare, Medicaid and SCHIP, it can be exceedingly 
difficult. Our physicians, for example, have seen recent Medicare 
payment updates which have not even kept pace with inflation . . . and 
at the same time some expect that they will make a major investment in 
health IT.
  The failure of that logic is clear because we know where the benefits 
are realized. The benefits to patients are evident, in fewer delays, in 
better outcome, lives saved. Health IT reduces costs as well, but 
primarily to those who pay for services, not to providers. Indeed it 
has been estimated that 89 percent of cost savings accrue to those who 
pay for services. It should be obvious then that the Federal Government 
would invest in health IT to reduce its expenditures on Medicare, 
Medicaid and SCHIP.
  That is precisely what this legislation would do. Because as we look 
to the many studies and reports on health IT, one thing is clear. The 
annual cost savings actually exceeds the price of implementation. With 
that kind of return, it is indisputable that the Federal Government 
must employ health IT to see not only the savings in lives, but also 
better management of health care spending.
  This legislation does that by providing grants to spur adoption among 
physicians, hospitals, long term care facilities, and both federally 
qualified health centers and community mental health centers. These 
grants are targeted to help provide the health IT resources providers 
need to serve our Federal beneficiaries. In fact, the size of an 
allowable grant for each provider is keyed to the proportion of the 
patient care which they deliver to Federal beneficiaries. So we will 
help these providers deliver better care to those on Medicare, Medicaid 
and SCHIP . . . while working to see costs reduced in those programs. 
That is simple common sense.
  The legislation supports reasonable expenditures for a variety of 
expenses required to implement health care information technology. 
These include such components as computer hardware and software, plus 
installation and training costs. In addition, when installed we require 
that every system must meet the HHS Secretary's interoperability 
standards.
  Our new legislation even provides an alternative to those for-profit 
providers who do not wish to apply for a grant. Under this bill, such 
providers will be able to expense the cost of a qualified system.
  I again want to stress the first goal of this legislation: to help 
build a safer medical-delivery system. The great successes of our 
health care system are largely due to our highly committed and talented 
health care professionals.

[[Page 12620]]

The problem we are addressing today is not theirs, but is an endemic 
weakness of the system they depend upon. However, to utilize the 
solution, the Federal Government must step forward and provide the 
leadership necessary to make system changes a reality.
  When the Medicare and Medicaid Programs began, we could only have 
dreamed about computerized clinical information systems. Now, today, we 
have this technology at our disposal, and I strongly believe that we 
cannot afford to delay implementation. In fact, as we face challenges 
in the financing of health entitlements, this is exactly the sort of 
initiative which will enable us to achieve the fundamental improvements 
to make these benefits more fiscally secure.
  I hope my colleagues will join us in support of this legislation so 
we may soon achieve the goals of improving patient safety and reducing 
our escalating health care costs.
                                 ______
                                 
      By Mr. LAUTENBERG (for himself and Ms. Snowe):
  S. 1411. A bill to amend the Clean Air Act to establish within the 
Environmental Protection Agency an office to measure and report on 
greenhouse gas emissions of Federal agencies; to the Committee on 
Environment and Public Works.
  Mr. LAUTENBERG. Mr. President, I am pleased to introduce the Federal 
Government Greenhouse Gas Registry Act. This bill will create an 
inventory of the greenhouse gas emissions associated with the Federal 
Government. This includes the Government's buildings, automotive fleets 
and other sources of emissions. Understanding the ``footprint'' of the 
Federal Government's emission is essential to reducing those emissions.
  The Federal Government is one of the largest emitters of greenhouse 
gases in the world. In particular, the largest owner or renter of 
buildings and owns the single largest fleet of cars in the United 
States. The buildings and the transportation sectors account for nearly 
two-thirds of all of the greenhouse gases in the country. The Federal 
Government must lead by example by reducing its own emissions.
  Understanding the extent of an entity's emissions, through the 
development of a registry, is important to ultimately reducing 
emissions. The private sector already understands this. It has found 
that tracking and monitoring corporate emissions creates an opportunity 
to easily reduce emissions by seeing where energy is inefficiently 
used. According to a recent report by the Pew Center on Global Climate 
Change, ``the first step in developing a climate strategy is to analyze 
a company's GHG emissions profile . . .''
  My bill uses the GHG protocol, a rigorous standard developed by 
experts and used by companies, States and trading regimes around the 
world, including Johnson & Johnson, the California Climate Action 
Registry and the EU's emission trading schemes. Utilizing such a well 
known and frequently used standard is important because it allows for 
comparison and benchmarking with other large emitters.
  The Government Accountability Office, GAO, has also recognized the 
importance of measuring greenhouse gas emissions. According to a GAO 
report from April 2007--``Energy Audits Are Key to Strategy for 
Reducing Greenhouse Gas Emissions''--conducting emissions assessments 
would ``. . . include information on cost-effectiveness and potential 
for reducing emissions.''
  In closing, the Federal Government has an obligation to lead by 
example and this bill is a critical first step in reducing its 
emissions.
  I ask unanimous consent that the text of the bill be printed in the 
Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                S. 1411

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Federal Government 
     Greenhouse Gas Registry Act of 2007''.

     SEC. 2. FEDERAL GREENHOUSE GAS EMISSIONS.

       The Clean Air Act (42 U.S.C. 7401 et seq.) is amended by 
     adding at the end the following:

             ``TITLE VII--FEDERAL GREENHOUSE GAS EMISSIONS

     ``SEC. 701. DEFINITIONS.

       ``In this title:
       ``(1) Agency emission baseline.--The term `agency emission 
     baseline', with respect to a Federal agency, means such 
     quantity of the aggregate quantity of direct emissions, 
     energy indirect emissions, and indirect emissions used to 
     calculate the emission baseline as is attributable to the 
     Federal agency.
       ``(2) Direct emission.--The term `direct emission' means an 
     emission of a greenhouse gas directly from a source owned or 
     controlled by the Federal Government, such as from a fleet of 
     motor vehicles.
       ``(3) Emission allowance.--The term `emission allowance' 
     means an authorization to emit, for any fiscal year, 1 ton of 
     carbon dioxide (or the equivalent quantity of any other 
     greenhouse gas, as determined by the Administrator).
       ``(4) Emission baseline.--The term `emission baseline' 
     means a quantity of greenhouse gas emissions equal to the 
     aggregate quantity of direct emissions, energy indirect 
     emissions, and indirect emissions for fiscal year 2005, as 
     determined by the Office in accordance with section 
     702(b)(3).
       ``(5) Energy indirect emission.--The term `energy indirect 
     emission' means an emission of a greenhouse gas resulting 
     from the production of electricity purchased and used by the 
     Federal Government.
       ``(6) Greenhouse gas.--The term `greenhouse gas' means any 
     of--
       ``(A) carbon dioxide;
       ``(B) methane;
       ``(C) nitrous oxide;
       ``(D) hydrofluorocarbons;
       ``(E) perfluorocarbons; and
       ``(F) sulfur hexafluoride.
       ``(7) Indirect emission.--
       ``(A) In general.--The term `indirect emission' means an 
     emission of greenhouse gases resulting from the conduct of a 
     project or activity (including outsourcing of a project or 
     activity) by the Federal Government (or any Federal officer 
     or employee acting in an official capacity).
       ``(B) Inclusions.--The term `indirect emission' includes an 
     emission of a greenhouse gas resulting from--
       ``(i) employee travel; or
       ``(ii) the use of an energy-intensive material, such as 
     paper.
       ``(C) Exclusion.--The term `indirect emission' does not 
     include an energy indirect emission.
       ``(8) Office.--The term `Office' means the Federal 
     Emissions Inventory Office established by section 702(a).
       ``(9) Protocol.--The term `protocol' means the Greenhouse 
     Gas Protocol Corporate Accounting and Reporting Standard 
     developed by the World Resources Institute and World Business 
     Council on Sustainable Development.

     ``SEC. 702. FEDERAL EMISSIONS INVENTORY OFFICE.

       ``(a) Establishment.--There is established within the 
     Environmental Protection Agency an office to be known as the 
     `Federal Emissions Inventory Office'.
       ``(b) Duties.--The Office shall--
       ``(1) as soon as practicable after the date of enactment of 
     this title, develop an emission inventory or other 
     appropriate system to measure and verify direct emissions, 
     energy indirect emissions, indirect emissions, and offsets of 
     those emissions;
       ``(2) ensure that the process of data collection for the 
     inventory or system is reliable, transparent, and accessible;
       ``(3)(A)(i) not later than 1 year after the date of 
     enactment of this title, establish an emission baseline for 
     the Federal Government; or
       ``(ii) not later than 180 days after the date of enactment 
     of this title, if the Office determines that Federal agencies 
     have not collected enough information, or sufficient data are 
     otherwise unavailable, to establish an emission baseline, 
     submit to Congress and the Administrator a report describing 
     the type and quantity of data that are unavailable; and
       ``(B) after establishment of an emission baseline under 
     subparagraph (A), periodically review and, if new information 
     relating to the base year becomes available, revise the 
     emission baseline, as appropriate;
       ``(4) upon development of the inventory or system under 
     paragraph (1), use the inventory or system to begin 
     accounting for direct emissions, energy indirect emissions, 
     and indirect emissions in accordance with the protocol;
       ``(5) ensure that the inventory or other appropriate system 
     developed under paragraph (1) is periodically audited to 
     ensure that data reported in accordance with the inventory or 
     system are relevant, complete, and transparent;
       ``(6) not later than 1 year after the date of enactment of 
     this title--
       ``(A) develop such additional procedures as are necessary 
     to account for emissions described in paragraph (3), 
     particularly indirect emissions; and
       ``(B) submit to Congress and the Administrator a report 
     that describes any additional data necessary to calculate 
     indirect emissions;

[[Page 12621]]

       ``(7) coordinate with climate change and greenhouse gas 
     registries being developed by States and Indian tribes; and
       ``(8) not later than October 1 of the year after the date 
     of enactment of this title, and annually thereafter, submit 
     to Congress and the Administrator a report that, for the 
     preceding fiscal year, for the Federal Government and each 
     Federal agency--
       ``(A) describes the aggregate quantity of emissions 
     (including direct emissions, energy indirect emissions, and 
     indirect emissions); and
       ``(B) specifies separately the quantities of direct 
     emissions, energy indirect emissions, and indirect emissions 
     comprising that aggregate quantity.

     ``SEC. 703. AUTHORIZATION OF APPROPRIATIONS.

       ``There are authorized to be appropriated such sums as are 
     necessary to carry out this title.''.
                                 ______
                                 
      By Mr. HARKIN:
  S. 1412. A bill to amend the Farm Security and Rural Development Act 
of 2002 to support beginning farmers and ranchers, and for other 
purposes; to the Committee on Agriculture, Nutrition, and Forestry.

  Mr. HARKIN. Mr. President, today, along with Senators Grassley, 
Brown, and Baucus, I am introducing legislation that will expand 
opportunities for our next generation of farmers and ranchers. Over the 
next two decades, an estimated 400 million acres of agricultural land 
will be transferred to new owners. Today, farmers over the age of 65 
outnumber those below the age of 35 by a margin of nearly two to one. 
The future structure, health and vitality of our Nation's food and 
agriculture system depend on sound public policies that provide the 
next generation of farmers and ranchers the help they need to 
successfully enter farming and ranching.
  The next generation of farmers and ranchers need access to training 
and mentoring which will help them obtain the critical management and 
marketing skills vital to their success. The Beginning Farmer and 
Rancher Program, created in the Farm Security and Rural Investment Act 
of 2002, is the first USDA program other than credit financing to focus 
specifically on beginning farmers and ranchers. The Beginning Farmer 
and Rancher Opportunity Act of 2007 would reauthorize this program and 
provide $25 million a year in mandatory funding. We also propose to 
make beginning farmer issues, such as land transition, farm transfer 
and succession, and entry into farming priority research areas within 
the Initiative for Future Agriculture and Food Systems.
  Beginning farmers and ranchers who are unable to obtain credit from 
commercial sources are eligible for Farm Service Agency direct farm 
ownership and operating loans up to an amount of $200,000 for each type 
of loan. This limit has not been adjusted in nearly two decades despite 
the rising cost of land, equipment and energy, and thus it is no longer 
sufficient. We propose to increase direct farm ownership and operating 
loan limits from $200,000 to $300,000 to reflect economic realities. 
The authorization of appropriations for direct loans is adjusted in the 
bill to reflect the new loan limits. It is important to increase direct 
loan authorization levels and appropriations, along with adjusting the 
direct farm ownership and operating loan limits or the net result may 
well be larger loans to fewer borrowers out of a constant pool of loan 
funds.
  We propose several adjustments to the beginning farmer and rancher 
down payment loan program. This loan combines the financial resources 
of the beginning farmer, the Farm Service Agency and commercial or 
private lenders. Throughout the 1990s this program was very successful, 
but in recent years it has not been widely used due to low interest 
rates on traditional direct farm ownership loans. The interest rates on 
the down payment loan and direct farm ownership loan have been 
comparable so qualified borrowers have chosen to use the traditional 
FSA direct farm ownership loan for which no down payment is required.
  The Beginning Farmer and Rancher Opportunity Act of 2007 would adjust 
the current interest rate of 4 percent for beginning farmer and rancher 
down payment loans to a floating rate of 4 percent below the regular 
FSA direct farm ownership interest rates, or 1 percent, whichever is 
greater. It would also reduce the beginning farmer's down payment from 
10 percent to 5 percent of the total price of land and increase the FSA 
portion of the loan to 45 percent from 40 percent. A commercial lender 
or private seller would still be required to supply the remaining 
portion of the partnership loan.
  These changes, along with a few others, would make the program more 
attractive for beginning farmers and ranchers. Creating more attractive 
incentives in this beginning farmer and rancher down payment loan 
program should result in limited Federal dollars supporting more 
qualified borrowers since the government's portion of financing a farm 
purchase is only 45 percent as opposed to the traditional direct farm 
ownership loan where the government finances 100 percent of the loan.
  The Beginning Farmer and Rancher Opportunity Act of 2007 creates a 
new beginning farmer and rancher individual development account pilot 
program. This program is designed to help beginning farmers and 
ranchers with limited resources establish savings. Eligible program 
participants agree to save money which is matched by federal and local 
money. The savings may be used by a participant for capital 
expenditures for farm and ranch operation, including the purchase of 
land, buildings, equipment and livestock. This program will help 
participating beginning farmers and ranchers save and invest in assets 
that will increase their long-term equity and likelihood of success.
  The challenges beginning farmers and ranchers face are immense. The 
cost of land and equipment, obtaining credit, turning a profit and 
building equity in a highly uncertain business are just a few of the 
challenges. The Beginning Farmer and Rancher Opportunity Act of 2007 
will help address the big challenge facing America's next generation of 
farmers and ranchers. This bill is a comprehensive initiative which 
provides farmers and ranchers critical help they need to enter and 
succeed in farming and ranching, to be good stewards of the land, to be 
innovative and entrepreneurial and to respond to rapidly changing 
markets and economic realities. I encourage my colleagues to support 
this important legislation and help enact it this year.
                                 ______
                                 
      By Mr. ALEXANDER (for himself and Mr. Kennedy):
  S. 1414. A bill to amend the National Assessment of Educational 
Progress Authorization Act to require State academic assessments of 
student achievement in United States history and civics, and for other 
purposes; to the Committee on Health, Education, Labor, and Pensions.
  Mr. KENNEDY. Mr. President, I am pleased to join Senator Alexander 
this year in introducing the American History and Civics Achievement 
Act. The bill is part of a continuing effort to renew the national 
commitment to teaching history and civics in the Nation's public 
schools. It lays the foundation for more effective ways of teaching 
children about the Nation's past and the importance of civic 
responsibility. It contains no new requirements for schools, but it 
does offer a more frequent and effective analysis of how America's 
students are learning these important subjects.
  The NAEP U.S. History and Civics results released today, for example, 
show that 86 percent of America's high school seniors cannot explain 
why this country was involved in the Korean war.
  Nearly all eighth graders struggle to explain how the fall of the 
Berlin Wall affected our foreign policy.
  Nearly 75 percent of eighth graders cannot explain the historical 
purpose of the Declaration of Independence.
  We can't allow this trend to continue. While some progress has been 
made in improving student achievement in these subjects, too many 
students are still unable to grasp their importance.
  Our economy and our future security rely on good schools that help 
students develop specific skills, such as reading and math. But the 
strength of our democracy and our standing in the world

[[Page 12622]]

also depend on ensuring that children have a basic understanding of the 
Nation's past and what it takes to engage in our democracy. An 
appreciation of the defining events in our Nation's history can be a 
catalyst for civic involvement.
  Instilling such appreciation, and teaching the values of justice, 
equality, and civic responsibility should be an important mission of 
our public schools. Thanks to the hard work of large numbers of history 
and civics teachers in classrooms throughout America, we are making 
progress. Research conducted in history classrooms shows that children 
are using primary sources and documents more often to explore history, 
and are being assigned historical and biographical readings by their 
teachers more frequently.
  But much more remains to be done to improve students' understanding 
of both of these subjects, and see to it that they are not left behind 
in their classrooms.
  Good standards matter. They are the foundation for teaching and 
learning in every school. With the right resources, time, and 
attention, it is possible to develop creative and effective history and 
civics standards in every State.
  Meeting high standards in reading and math is important, but it 
should not come at the expense of scaling back teaching in other core 
subjects such as history and civics. Integrating reading and math with 
other subjects often gives children a better way to master literacy and 
number skills, even while studying history, geography, and government.
  That type of innovation deserves special attention in our schools. 
Making it happen requires a focus on good standards and student 
achievement, which we're proposing today. But it also requires added 
investments in teacher preparation and teacher mentoring, so that 
teachers are well prepared to use interdisciplinary methods in their 
lesson plans.
  Our bill today takes several important steps to strengthen the 
teaching of American history and civics, and raise the standing of 
these subjects in school curriculums. Through changes in the National 
Assessment for Educational Progress, schools will be better able to 
achieve success on this important issue.
  First, we propose a more frequent national assessment of children in 
American history under the NAEP--every 4 years. NAEP is the gold 
standard for measuring progress by students and reporting to the Nation 
on that progress. It makes sense to measure the knowledge and skills of 
children on the NAEP more frequently than every 5 or 6 years, to obtain 
a more timely picture of student progress and better address gaps in 
learning.
  The bill also proposes to strengthen state standards in American 
history and civics, through a new State-level pilot assessment of these 
subjects under NAEP. The assessment would be conducted on an 
experimental basis in 10 States in grades 8 and 12. The National 
Assessment Governing Board will ensure that States with model 
standards, as well as those whose standards are still under 
development, will participate in this assessment.
  Moving NAEP to the State level does not carry any high stakes for 
schools. But it will provide an additional benchmark for States to 
develop and improve their standards. It is our hope that States will 
also be encouraged to undertake improvements in their history curricula 
and in their teaching of civics, and ensure that both subjects are a 
beneficiary and not a victim of school reform.
  America's past encompasses great leaders with great ideas that 
contributed to our heritage and to the principles of freedom, equality, 
justice, and opportunity for all. Today's students will be better 
citizens in the future if they learn more about that history and about 
the skills needed to participate in our democracy. The American History 
and Civics Achievement Act is an important effort to reach that goal, 
and I urge my colleagues to support it.
                                 ______
                                 
      By Mr. HARKIN (for himself and Ms. Snowe):
  S. 1415. A bill to amend the Public Health Service Act and the Social 
Security Act to improve screening and treatment of cancers, provide for 
survivorship services, and for other purposes; to the Committee on 
Finance.
  Mr. HARKIN. Mr. President, I am honored to join with the 
distinguished Senator from Maine, Ms. Snowe, to introduce the Cancer 
Screening, Treatment an Survivorship Act of 2007.
  Last summer, Lance Armstrong came to Iowa to testify at a field 
hearing on cancer research. He is a national hero for winning the Tour 
de France 7 years in a row. But he has become a national treasure as 
America's No. 1 advocate for cancer research, detection, and treatment. 
I deeply appreciate his advocacy and tireless efforts to fight this 
disease. Lance is one of the millions of people across America who has 
been touched by cancer.
  The bill I am introducing today is personal with me. I have lost 4 of 
my 5 siblings to cancer. And, with better detection and screenings, 
perhaps my siblings would have had a better outcome.
  I believe passionately in doing our best to prevent cancer, by 
encouraging appropriate lifestyle choices. But I am equally passionate 
about the need to do a better job of detecting cancer as early as 
possible, so we have a better chance of beating it.
  And that is the aim of the Cancer Screening, Treatment, and 
Survivorship Act of 2007. We have simple goals: To detect cancer 
earlier. To reduce cancer mortality rates. To improve the quality of 
life for those diagnosed with cancer. And, yes, to save health care 
dollars.
  As I said, my hope is that the bill we are introducing today will 
take us to the next level and begin addressing survivorship and people 
that are living with this chronic disease. Together, we can work to 
improve the quality of life for those diagnosed with cancer and save 
lives. I look forward to working with my colleagues to ensure that this 
legislation is passed and signed into law.
  Ms. SNOWE. Mr. President, today I am pleased to join my colleague, 
Senator Harkin of Iowa, to introduce the Cancer Screening, Treatment 
and Survivorship Act of 2007. This legislation will help us to realize 
a long-held vision--to see cancer conquered within our lifetimes.
  Today nearly half of all Americans can expect to suffer from an 
invasive form of cancer. So it is indisputable that cancer research, 
screening, and treatment should continue to be a high public health 
priority. Many have called for an elimination of cancer death and 
suffering by 2015, and I supported that ambitious goal along with 91 of 
my Senate colleagues. Yet it is concrete action which is required if we 
are to make progress towards that objective.
  Indeed, we have already seen remarkable progress in the diagnosis and 
treatment of cancer. Today, for example, more women are surviving 
breast cancer. Early diagnosis and modern treatments are saving lives. 
We have even seen that drug treatment can substantially reduce the 
recurrence of breast cancer.
  And it is the strides which we have made in scientific discovery is 
fueling those advances. Senator Harkin and I both worked to support the 
doubling of NIH funding--and the landmark work to map the human 
genome--and today we sit poised to make the progress of which 
generations have dreamed.
  Yet, no matter what we learn, no matter what cures are developed--
without access to screening and treatment, no cure is possible. And if 
one does not even know that the need for cure exists, no action can be 
taken. So cancer is one of a number of areas where we see stark 
disparities in health.
  That is why I have joined with Senator Harkin to introduce this 
legislation. As co-chairs of the Senate Prevention Coalition, we 
recognize that if we are to fundamentally improve both the quality and 
the cost of health care, we cannot continue to use a band-aid approach. 
Indeed to address illness late is only to increase the risk that 
individuals will not survive, and that we will provide only the most 
expensive tertiary care.
  So we need a new approach--a new mind set. Part of that is 
prevention,

[[Page 12623]]

but not just prevention of the disease, but also avoidance of the 
negative consequences of disease.
  In no case is this so clear as with cancer. Because we know that 
early detection is so crucial to successful treatment, and this 
legislation recognizes that.
  Under our legislation we will see cancer screening extended to those 
who today, too often are without such care. This act would provide 
grants to states to employ screening programs to detect cancer early--
when it is most treatable. Under our legislation, the HHS Secretary 
will examine those diagnostics which meet the standards of the U.S. 
Preventive Services Task Force and select those with highest promise in 
order to see that we can reduce the toll of cancer.
  Those receiving grants will see that the public's awareness of 
screenings improves, that health professionals receive additional 
training in cancer detection and control, and that as new and better 
diagnostics are developed, Americans will have access to those advances 
without regard to their inability to pay. That is the first step in 
reducing the toll of cancer.
  Those who do receive a positive diagnosis as a result of this act 
will obtain treatment referrals, and states will have the option to 
provide treatment to those individuals without access to care under 
Medicaid. States which elect to do so would receive an enhanced Federal 
match to provide the very treatment which we know not only saves lives, 
but reduces costs as well.
  I know that some will argue that we cannot afford to add additional 
coverage to Medicaid. Yet to that I must answer that without coverage, 
many will simply see their disease progress, and ultimately end up 
Medicaid-eligible--but at a point when therapy is so much less 
effective. The cost of such deferral of care in both lives and health 
expenditures is enormous. So I hope that many states will elect to 
cover treatment, just as many already have for those women screened 
under the Breast and Cervical Cancer Screening program today.
  This is a milestone moment, because today we begin to move forward in 
how we address cancer--giving the HHS Secretary the authority to work 
in cooperation with the states to see that we work to see every 
American has access to screening and treatment for cancer.
  The step we are taking forward today is the product of so much work 
through the years. And this week, as cancer advocates--including Lance 
Armstrong and representatives of his foundation--press for action to 
achieve our vision of ending cancer in our lifetime, I am heartened by 
the promise before us.
  I hope my colleagues will join us in support of this legislation so 
we may soon achieve the vision of our long war on cancer.

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