Max Baucus

Mr. BAUCUS

Mr. BAUCUS. Hearing the comments of my good friend from Oklahoma, I have no alternative but to object.

Mr. BAUCUS

Mr. BAUCUS. Mr. President, I object.

Mr. BAUCUS

Mr. BAUCUS. Reserving the right to object, once again, I would ask my friend from Oklahoma if he would amend his consent request along the lines I earlier suggested.

Mr. BAUCUS

Mr. BAUCUS. Mr. President, again, these are measures which will be considered in due course this year. I laud my good friend, but as he knows, Senator Grassley is ranking member of the committee, and there is a process in which to deal with these measures. This is not the process to be engaged in at this moment. So I must object.

Mr. BAUCUS. Mr. President, just a few words to explain what just happened. On behalf of many Senators, I am calling for swift passage of a full tax extenders package, which contains many of the measures that have been referred to in the preceding 4 or 5 minutes. These measures are called tax extenders, and we will pass tax extender legislation later this year. I want quick action on them, including the college tuition deduction, the sales tax deduction, as mentioned by two Senators, and also we must move on provisions to prevent the alternative minimum tax from hitting more taxpayers and the complete set of expiring tax provisions when the House sends that legislation to the Senate. We are all working on this issue. Senator Grassley and I have talked with Chairman Rangel on the other side of Capitol Hill, as well as those on this side of Capitol Hill, to get these measures enacted. I, myself, drafted many of these provisions in the first place. Senator Grassley and myself have advanced, as we always do in working together, in trying to get them all extended. Mr. President, we want to get this done, and I am confident we will get it done, and I urge a little forbearance of my colleagues. We are working expeditiously to get it done. It may not be tomorrow, on Friday, but we are working very expeditiously to get it done, and I am confident it will be done later this year. Mr. President, I yield the floor, and I suggest the absence of a quorum.

Mr. BAUCUS

Mr. BAUCUS. Reserving the right to object, I might say to my good friend that this is another measure that will be considered in due course later this year. I must object.

Mr. BAUCUS

Mr. BAUCUS. Madam President, I ask unanimous consent that the 20 minutes immediately prior to the cloture vote at 4:45 be equally divided and controlled between the leaders, or their designees, and that the majority leader will control the final 10 minutes prior to the vote; further, that the mandatory quorum required under rule XXII be waived.

Mr. BAUCUS. We have 14 minutes remaining and we are going to have to use it, unless the Senator can use 1 or 2 minutes.

Mr. BAUCUS. Madam President, what is the regular order?

Mr. BAUCUS. Madam President, I suggest the absence of a quorum.

Mr. BAUCUS. Madam President, in 1997, Congress enacted the Children's Health Insurance Program--10 years ago. From the beginning, it has been about kids. It has been about trying to give the parents of low-income working families the peace of mind that comes from knowing that health care is there for their children. That is all this is, it is about health care for kids. These are kids in working families, not kids in wealthy families, not kids in middle-income families--kids in working families. These are kids who, through no fault of their own, were born into families having had a hard time buying medical insurance in America, and we are trying to help these kids. A large number of Senators on both sides of the aisle have worked together to try to reach a consensus. Both sides of the aisle--Senator Grassley, Senator Rockefeller, Senator Hatch, and I--met together and worked things out. And when the House failed to muster enough votes to override the President's veto, we worked together with House Republicans to help kids. All four of us--Senator Grassley, Senator Rockefeller, Senator Hatch, and I--met repeatedly with moderate House Republicans to try to find a middle ground. We have made progress. We made a lot of progress, and I believe a compromise is very close, is within reach. I believe given a little more time, Congress could pass a CHIP bill that could achieve the support of more than two-thirds of both Houses of Congress. Unfortunately, today some objected to giving us that time, and I regret that objection. But we met again, all of us--that is, Senator Hatch, Senator Rockefeller, Senator Grassley, and I--with House Republicans at 2 o'clock. We agreed to continue meeting. We will meet again next Tuesday. We will reach an agreement soon. I don't think I will be telling tales out of school to say that the majority leader visited our meeting and he said: If we get a deal, the Senate will take it up. I think we are close to getting that deal. There are only a couple of issues that are outstanding, and we will work through those issues. I regret that the opponents of the Children's Health Insurance Program--and let us be clear, they are truly fighting not just the bill but the Children's Health Insurance Program--that those opponents of CHIP have made it impossible for us to offer an amendment to the bill before us today to get this done. They have succeeded in stopping us today. I am disappointed. I am not discouraged, I am disappointed. We will keep working. Even if the President once again vetoes health care for kids, we will work to get it done. We are still left with a good bill before us. It is a better bill than the one the President vetoed. Before us today is a bill that addresses many of the concerns Senators expressed with the first CHIP bill. The bill before us today focuses more on kids. It focuses more on low-income families. It is a good bill. There is no reason why anyone who supported the first bill on September 27 would not do so again today. It is improved. There is every reason why those who objected to the first bill would support this bill today. I urge my colleagues to join in voting for cloture and then voting for the bill. I urge them to do so because this is still about health care for kids. That is what this is all about, it is for kids. We have a lot of peripheral issues, but they are peripheral; it is noise. We say: Keep our eyes on the ball. It is about helping low-income kids, health care for kids and working families. Measures such as this are why we came to work in public service. Measures such as this are why people for whom we work sent us here. Let us not let them down. Madam President, I yield 3 minutes to my friend from Connecticut.

Mr. BAUCUS. It is possible the Republicans might yield the Senator some time.

Mr. BAUCUS

Mr. BAUCUS. Hearing his response, Mr. President, I must object.

Mr. BAUCUS. Mr. President, again reserving the right to object, would the Senator again amend his consent request to instead allow the consent request I requested just previously?

Mr. BAUCUS

Mr. BAUCUS. Mr. President, I can short-circuit this charade. I object.

Mr. BAUCUS

Mr. BAUCUS. Mr. President, I would like to acknowledge the service of Representative David Tawei Lee, who has given nearly 3 years of exceptional service as Taiwan's principal representative to the United States. Representative Lee recently departed Washington, DC, to take on his next assignment as Taiwan's Representative to Canada. He leaves behind a legacy of friendship, prosperity, and understanding. When Representative Lee arrived in Washington, he came equipped with a wealth of experience and insight. A foremost expert on U.S.-Taiwan relations, Mr. Lee has studied, written, and published on U.S.-Taiwan political and economic ties, including the development of the Taiwan Relations Act. I believe Representative Lee will be remembered not only for his excellent knowledge of history but also for his accomplishments. While serving in Washington, Representative Lee dedicated his energy, intelligence, and spirit to expanding Taiwan-American ties. He raised the cultural and political profile of Taiwan and its people with cultural and education programs. To enhance our economic ties, Representative Lee oversaw the successful acceleration of our bilateral Trade and Investment Agreement talks. And he worked tirelessly to raise awareness of the benefits of a potential U.S.-Taiwan Free Trade Agreement. In these areas alone, he has left a legacy of which he should take pride. Representative Lee's dedication and efforts were also felt far beyond our Nation's Capital. Three years ago, I was delighted to personally welcome Mr. Lee to my home State of Montana. There he witnessed Big Sky Country in all of its glory, making friends with hospitable and generous Montanans. But together we also saw the deep and healthy roots of the Montana-Taiwan economic relationship. At its core are Montana's finest agricultural products, which have long found their way to Taiwanese dinner tables and bakeries. Today, Taiwan purchases over 30 million bushels of Montana wheat annually. Our fine Montana beef is also in demand. This relationship benefits families in both Montana and Taiwan. And I hope it will continue to grow stronger. It has truly been a pleasure to work with Representative Lee. His personal touch to everything he did will not be forgotten. And the value of his contributions will be remembered for many years to come. I wish him luck in all of his future endeavors.

Mr. BAUCUS

Mr. BAUCUS. Mr. President, it is hard to believe that it was 5 years ago today we lost our dear friend and colleague--Paul Wellstone. On a cold Minnesota morning, his life, along with his wife, daughter, three staff members, and two pilots, was cut tragically short. It was a day that is burned into our memories, a day we will never forget. Paul was a good man. He was a man who truly loved being a Senator. It wasn't the power and prestige that he loved, it was his ability to serve the people, to help those in need--especially those who otherwise wouldn't have had a voice. He was a fighter. He fought for the underprivileged. For the downtrodden. For those who otherwise had been forgotten. He fought for the underdog--the little guy. And most of all he fought for what he believed in to be right and true. Paul loved life and lived each day to the fullest. He always had a kind word and a smile to whom ever he came across. And he came to work determined to make our country and world a better place. The Senate has changed a lot since Paul's death. The halls are a little quieter. There is a little less fire and brimstone on the Senate floor. Paul was known for going to the floor and giving an impassioned speech about how we had to provide better health care coverage for the mentally ill, assistance for domestic violence victims, better benefits for our veterans, or education for our children. While Paul was a hard-working, dedicated public servant, he was also a family man who loved his wife, children, and grandchildren very much. His best friend and companion in his life was his wife Sheila. She inspired him, was his constant companion, and she calmed him. Their love was one of a kind. In many ways it is fitting they left this Earth together. While Paul is not here, his spirit lives on. He inspired all of us to be better people. And his memory lives on. Paul's work is continued through his two sons Mark and David, Wellstone Action, and through his staff--many of whom can still be seen in the halls today. Like many of my colleagues in Congress, I miss my Paul. So let us remember him today and honor all of the work he did to make this country a better place for all of us.

Mr. BAUCUS

Mr. BAUCUS. Mr. President, today I am introducing a joint resolution to disapprove of the Medicare National Coverage Decision on cancer care announced by the Centers for Medicare & Medicaid Services on July 30, 2007. I am taking this action out of concern for America's seniors who are afflicted with cancer, a terrible disease that affects thousands of Medicare beneficiaries each year. At the outset, I want to make very clear that Congress should not wantonly second-guess the scientific processes at CMS. The National Coverage Decision process is a very important component of the agency's governance of the Medicare program and its mission to protect the safety of beneficiaries. The agency makes several National Coverage Decisions each year that are implemented without any congressional involvement. Several more coverage determinations are made by regional Medicare carriers at the local level. When scientific evidence supports doing so, CMS clearly has authority to limit Medicare coverage for drugs and other medical products and services to an extent less than the Food and Drug Administration label would otherwise allow. In fact, I am working on a proposal that may provide more clinical evidence to guide CMS in making these decisions. There are some rare occasions, however, when CMS makes a decision that intrudes on the clinical judgment of doctors without the support of scientific evidence, prompting virtually unanimous opposition from the clinicians who treat the patients whose care is at stake. In these cases, I believe that Congress not only may but must intervene. This National Coverage Decision regarding the use of erythropoiesis- stimulating agents, or ESAs, for Medicare beneficiaries with cancer and cancer-related conditions is precisely such an instance. Mr. President, when a cancer patient receives an ESA, the goal is not to manage a person's hemoglobin back to the level of a healthy, non- anemic person. That is because there can be health risks associated with raising the hemoglobin to such a level through ESA use. The FDA label makes it clear that patients may only be administered enough of an ESA to avoid a transfusion, and that ESAs should never be used to bring a patient's hemoglobin level above 12 grams per deciliter. So there can be risks when a patient does not get enough of an ESA, including severe anemia and the need for blood transfusions. And there are risks when a patient gets too much of an ESA. The FDA label establishes parameters to guard against under-utilization and over-utilization of these products. Now let us compare the FDA label with the National Coverage Decision announced by CMS. The National Coverage Decision limits ESA treatment to hemoglobin levels less than 10 grams per deciliter. This cap fails to recognize the natural fluctuations in a patient's hemoglobin. This cap is simply incongruous with the FDA label, which recommends that patients should not be treated over 12. I should note that the FDA label was recently changed, with the addition of new ``black box'' warnings and recent safety information. If the FDA believes that scientific evidence warrants changing the label yet again, then clearly Medicare should not cover treatments that are not consistent with that new label. Furthermore, there are other aspects of the CMS National Coverage Decision that are contrary to accepted standards of care and scientific evidence. CMS imposed 4-week dose limitations that are not based on the clinical needs of patients. The FDA labels allow ESAs to be administered three times a week, every week, every 2 weeks, or every 3 weeks. Also, for patients who are slow to respond to ESAs or do not respond, CMS has created a one-time dose escalation rule of 25 percent of the initial ESA dose. This limitation is contrary to FDA-approved dosing instructions. For instance, the FDA approved labeling allows doubling the dose for some regimens. Mr. President, over the past months, I have seen an outpouring of concern with this National Coverage Decision by patients, providers, and the professional scientific community for many reasons. The American Society of Clinical Oncology, the world's leading professional organization representing physicians of all oncology subspecialties who care for cancer patients, wrote this to CMS: Under the new CMS policy, a patient's hemoglobin could repeatedly fall below 10 following termination of coverage at the end of 4-week periods. This consequence would be inconsistent with the FDA-approved labeling, which, as noted above, states that ESA dosing should be titrated to the individual patient to maintain the hemoglobin level. . . . We strongly urge CMS to reconsider these restrictions in light of the concerns detailed above. The current NCD does not allow for interpretation consistent with clinical practice, national guidelines, or the FDA-approved labels in this area. This reopening [of the National Coverage Decision] should occur as soon as possible to avoid continued confusion and uncertainty [for] both physicians and patients. Until these issues are clarified, we also strongly recommend that CMS delay the effective date for the entire NCD. The American Society of Hematology, the leading clinical authority on disorders affecting the blood, bone marrow, and the immunologic, hemostatic, and vascular systems, has stated: Consequently, the clinical scenario that is problematic is when a patient's hemoglobin goes above 10 g/dL after 4 weeks of treatment because the physician would then need to discontinue the ESA treatment entirely. This is of concern because some patients might then drop below 10 g/dL justifying a renewal of the ESA treatment and leading to a `roller coaster' of treatment potentially involving stopping and starting ESA treatment several times. This is extremely difficult for both the patient and the physician. The Leukemia and Lymphoma Society wrote this in a recent letter to CMS: As a reimbursement authority, CMS and the Medicare program it administers should be guided by science and data in order to achieve the best result for cancer patients. Accordingly, CMS should defer to the expertise of FDA and of the academic scientists who contribute to the ASCO/ASH guidelines. Additionally, I share the concerns of many in the oncology community who worry about exposing seniors to the avoidable safety risks of blood transfusions, as well as the effect of this policy on our nation's blood supply. It has been clearly documented that certain areas of the country are already at risk of running out of their blood supply or have ongoing shortages. Some areas have 24 hours worth of blood left before they completely run out. According to the 2006 Nationwide Blood Collection and Utilization Survey, the number of transfusions of red blood cells in 2004 was nearly equivalent to the number of units collected. This policy, which patients are already telling us are forcing them into transfusion units, could put in jeopardy a U.S. blood supply that is already fragile and stretched thin. The American Red Cross has indicated in their guidelines that transfusions are not appropriate for chemotherapy patients when alternative treatments are available: Red blood cells should not be used to treat anemia that can be corrected with a non-transfusion therapy such as iron or recombinant erythropoietin. To my great concern, the CMS National Coverage Decision responds to this vital issue with the following: The concern about the adequacy of the nation's blood supply is not a relevant factor for consideration in this national coverage determination. Our focus is whether the use of ESA is reasonable and necessary to treat a particular illness. The sole purpose for using ESAs, as stated on the FDA label, is to avoid a blood transfusion. But CMS has decided that this issue is not relevant to a decision regarding the coverage of ESAs. Well, I can guarantee you that it is important to the patients who will now be forced to seek transfusions as a result of CMS' shortsighted decision. Congress continues to demonstrate that it shares the concerns of patients and the clinical community about the new CMS policy and the detrimental effect that it could have on patient care. Earlier this summer, prior to the CMS issuance of the final National Coverage Decision, 52 Senators and 235 Members of the House of Representatives wrote to CMS expressing an overwhelmingly bipartisan, bicameral concern with the CMS policy. CMS, however, ignored these concerns and issued a final National Coverage Decision on July 30 that was even more onerous than the one proposed. On September 4, the Senate sent a strong message of dissatisfaction when we passed S. Res. 305, without one Senator objecting. S. Res. 305 called on CMS to immediately reconsider the National Coverage Decision. But CMS has refused to reopen the National Coverage Decision and work with the clinical community to develop an appropriate patient-centered policy that is consistent with scientific evidence. Because CMS has repeatedly ignored our concerns, we now are forced to take legislative action that compels CMS to change this flawed policy. That is why today I am asking my Colleagues to support this resolution of disapproval. Let me tell you what this resolution does not do. This resolution does not replace the medical judgment of CMS or the FDA with that of Congress. This resolution does not ignore the safety concerns of ESAs used when a patient's hemoglobins are above the FDA label. Finally, this resolution does not reject the notion of any National Coverage Decision related to ESAs. This resolution simply asks CMS to go back to the drawing board. It compels CMS to work with the oncology community-- the experts and clinicians and patients--to come up with a policy that is based on scientific evidence and that the community can support, or at least understand. That is why I ask my Colleagues to join me in supporting this important legislation. Mr. President, I ask unanimous consent that the text of the joint resolution be printed in the Record.

Mr. BAUCUS

Mr. BAUCUS. Mr. President, today I am introducing a joint resolution to disapprove of the Medicare National Coverage Decision on cancer care announced by the Centers for Medicare & Medicaid Services on July 30, 2007. I am taking this action out of concern for America's seniors who are afflicted with cancer, a terrible disease that affects thousands of Medicare beneficiaries each year. At the outset, I want to make very clear that Congress should not wantonly second-guess the scientific processes at CMS. The National Coverage Decision process is a very important component of the agency's governance of the Medicare program and its mission to protect the safety of beneficiaries. The agency makes several National Coverage Decisions each year that are implemented without any congressional involvement. Several more coverage determinations are made by regional Medicare carriers at the local level. When scientific evidence supports doing so, CMS clearly has authority to limit Medicare coverage for drugs and other medical products and services to an extent less than the Food and Drug Administration label would otherwise allow. In fact, I am working on a proposal that may provide more clinical evidence to guide CMS in making these decisions. There are some rare occasions, however, when CMS makes a decision that intrudes on the clinical judgment of doctors without the support of scientific evidence, prompting virtually unanimous opposition from the clinicians who treat the patients whose care is at stake. In these cases, I believe that Congress not only may but must intervene. This National Coverage Decision regarding the use of erythropoiesis- stimulating agents, or ESAs, for Medicare beneficiaries with cancer and cancer-related conditions is precisely such an instance. Mr. President, when a cancer patient receives an ESA, the goal is not to manage a person's hemoglobin back to the level of a healthy, non- anemic person. That is because there can be health risks associated with raising the hemoglobin to such a level through ESA use. The FDA label makes it clear that patients may only be administered enough of an ESA to avoid a transfusion, and that ESAs should never be used to bring a patient's hemoglobin level above 12 grams per deciliter. So there can be risks when a patient does not get enough of an ESA, including severe anemia and the need for blood transfusions. And there are risks when a patient gets too much of an ESA. The FDA label establishes parameters to guard against under-utilization and over-utilization of these products. Now let us compare the FDA label with the National Coverage Decision announced by CMS. The National Coverage Decision limits ESA treatment to hemoglobin levels less than 10 grams per deciliter. This cap fails to recognize the natural fluctuations in a patient's hemoglobin. This cap is simply incongruous with the FDA label, which recommends that patients should not be treated over 12. I should note that the FDA label was recently changed, with the addition of new ``black box'' warnings and recent safety information. If the FDA believes that scientific evidence warrants changing the label yet again, then clearly Medicare should not cover treatments that are not consistent with that new label. Furthermore, there are other aspects of the CMS National Coverage Decision that are contrary to accepted standards of care and scientific evidence. CMS imposed 4-week dose limitations that are not based on the clinical needs of patients. The FDA labels allow ESAs to be administered three times a week, every week, every 2 weeks, or every 3 weeks. Also, for patients who are slow to respond to ESAs or do not respond, CMS has created a one-time dose escalation rule of 25 percent of the initial ESA dose. This limitation is contrary to FDA-approved dosing instructions. For instance, the FDA approved labeling allows doubling the dose for some regimens. Mr. President, over the past months, I have seen an outpouring of concern with this National Coverage Decision by patients, providers, and the professional scientific community for many reasons. The American Society of Clinical Oncology, the world's leading professional organization representing physicians of all oncology subspecialties who care for cancer patients, wrote this to CMS: Under the new CMS policy, a patient's hemoglobin could repeatedly fall below 10 following termination of coverage at the end of 4-week periods. This consequence would be inconsistent with the FDA-approved labeling, which, as noted above, states that ESA dosing should be titrated to the individual patient to maintain the hemoglobin level. . . . We strongly urge CMS to reconsider these restrictions in light of the concerns detailed above. The current NCD does not allow for interpretation consistent with clinical practice, national guidelines, or the FDA-approved labels in this area. This reopening [of the National Coverage Decision] should occur as soon as possible to avoid continued confusion and uncertainty [for] both physicians and patients. Until these issues are clarified, we also strongly recommend that CMS delay the effective date for the entire NCD. The American Society of Hematology, the leading clinical authority on disorders affecting the blood, bone marrow, and the immunologic, hemostatic, and vascular systems, has stated: Consequently, the clinical scenario that is problematic is when a patient's hemoglobin goes above 10 g/dL after 4 weeks of treatment because the physician would then need to discontinue the ESA treatment entirely. This is of concern because some patients might then drop below 10 g/dL justifying a renewal of the ESA treatment and leading to a `roller coaster' of treatment potentially involving stopping and starting ESA treatment several times. This is extremely difficult for both the patient and the physician. The Leukemia and Lymphoma Society wrote this in a recent letter to CMS: As a reimbursement authority, CMS and the Medicare program it administers should be guided by science and data in order to achieve the best result for cancer patients. Accordingly, CMS should defer to the expertise of FDA and of the academic scientists who contribute to the ASCO/ASH guidelines. Additionally, I share the concerns of many in the oncology community who worry about exposing seniors to the avoidable safety risks of blood transfusions, as well as the effect of this policy on our nation's blood supply. It has been clearly documented that certain areas of the country are already at risk of running out of their blood supply or have ongoing shortages. Some areas have 24 hours worth of blood left before they completely run out. According to the 2006 Nationwide Blood Collection and Utilization Survey, the number of transfusions of red blood cells in 2004 was nearly equivalent to the number of units collected. This policy, which patients are already telling us are forcing them into transfusion units, could put in jeopardy a U.S. blood supply that is already fragile and stretched thin. The American Red Cross has indicated in their guidelines that transfusions are not appropriate for chemotherapy patients when alternative treatments are available: Red blood cells should not be used to treat anemia that can be corrected with a non-transfusion therapy such as iron or recombinant erythropoietin. To my great concern, the CMS National Coverage Decision responds to this vital issue with the following: The concern about the adequacy of the nation's blood supply is not a relevant factor for consideration in this national coverage determination. Our focus is whether the use of ESA is reasonable and necessary to treat a particular illness. The sole purpose for using ESAs, as stated on the FDA label, is to avoid a blood transfusion. But CMS has decided that this issue is not relevant to a decision regarding the coverage of ESAs. Well, I can guarantee you that it is important to the patients who will now be forced to seek transfusions as a result of CMS' shortsighted decision. Congress continues to demonstrate that it shares the concerns of patients and the clinical community about the new CMS policy and the detrimental effect that it could have on patient care. Earlier this summer, prior to the CMS issuance of the final National Coverage Decision, 52 Senators and 235 Members of the House of Representatives wrote to CMS expressing an overwhelmingly bipartisan, bicameral concern with the CMS policy. CMS, however, ignored these concerns and issued a final National Coverage Decision on July 30 that was even more onerous than the one proposed. On September 4, the Senate sent a strong message of dissatisfaction when we passed S. Res. 305, without one Senator objecting. S. Res. 305 called on CMS to immediately reconsider the National Coverage Decision. But CMS has refused to reopen the National Coverage Decision and work with the clinical community to develop an appropriate patient-centered policy that is consistent with scientific evidence. Because CMS has repeatedly ignored our concerns, we now are forced to take legislative action that compels CMS to change this flawed policy. That is why today I am asking my Colleagues to support this resolution of disapproval. Let me tell you what this resolution does not do. This resolution does not replace the medical judgment of CMS or the FDA with that of Congress. This resolution does not ignore the safety concerns of ESAs used when a patient's hemoglobins are above the FDA label. Finally, this resolution does not reject the notion of any National Coverage Decision related to ESAs. This resolution simply asks CMS to go back to the drawing board. It compels CMS to work with the oncology community-- the experts and clinicians and patients--to come up with a policy that is based on scientific evidence and that the community can support, or at least understand. That is why I ask my Colleagues to join me in supporting this important legislation. Mr. President, I ask unanimous consent that the text of the joint resolution be printed in the Record.

Mr. BAUCUS

Mr. BAUCUS. Mr. President, back in 1962, Marshall McLuhan wrote, ``The new electronic interdependence recreates the world in the image of a global village.'' Certainly, 40 years later, that concept is truer than ever. As we prepare for the future in this global village, we need to affirm America's leadership role in the world. The United States accounts for one-third of the world's spending on scientific research and development, ranking first among all countries. While this is impressive, relative to GDP, though, America falls to sixth place. And the trends show that maintaining American leadership in the future depends on increased commitment to research and science. Asia has recognized this. Asia is plowing more funding into science and education. China, in particular, understands that technological advancement means security, independence, and economic growth. Spending on research and development has increased by 140 percent in China, Korea, and Taiwan. In America, it has increased by only 34 percent. Asia's commitment is already paying off. More than a hundred Fortune 500 companies have opened research centers in India and China. I have visited some of them. I was impressed with the level of skill of the workers whom I met there. China's commitment to research, at $60 billion in expenditures, is dramatic by any measure. Over the last few years, China has doubled the share of its economy that it invests in research. China intends to double the amount committed to basic research in the next decade. Currently, only America beats out China in numbers of researchers in the workforce. Today, I am pleased to join with my colleague on the Finance Committee, Senator Hatch, to introduce the Research Competitiveness Act of 2007. This bill would improve our research competitiveness in four major areas. All four address incentives in our tax code. Government also supports research through Federal spending. But I am not addressing those areas today. First, our bill improves and simplifies the credit for applied research in section 41 of the tax code. This credit has grown to be overly complex, both for taxpayers and the IRS. Beginning in 2008, our bill would create a simpler credit for qualifying research expenses that exceed 50 percent of the average expenses for the prior 3 years. This simplified credit would phase in over 3 years. Just as important, the bill makes the credit permanent. Because the credit has been temporary, it has simply not been as effective as it could be. Since its creation in 1981, it has been extended 11 times. Congress even allowed it to lapse during one period. The credit last expired in December of 2005. After much consternation and delay, Congress passed a 2-year extension just last month, extending the credit for 2006 and 2007. These temporary extensions have taken their toll on taxpayers. In 2005, the experts at the Joint Committee on Taxation wrote: ``Perhaps the greatest criticism of the R&E credit among taxpayers regards its temporary nature.'' Joint Tax went on to say, ``A credit of longer duration may more successfully induce additional research than would a temporary credit, even if the temporary credit is periodically renewed.'' Currently, there are three different ways to claim a tax credit for qualifying research expenses. First, the ``traditional'' credit relies on incremental increases in expenses compared to a mid-1980s base period. Second, the ``alternative incremental'' credit measures the increase in research over the average of the prior 4 years. Both of these credits have base periods involving gross receipts. Under the new tax bill enacted last month, a third formula was created, which does not rely on gross receipts and is available only for 2007. Our bill simplifies these credits and will move all taxpayers to the ``Alternative Simplified Credit,'' which is based on research spending without reference to gross receipts. The current formulas hurt companies that have fluctuating sales. It hurts companies that take on a new line of business not dependent on research. This new simpler formula in our bill would not start until 2008. That start date would give companies plenty of time to adjust their accounting. The current formula would be available to companies for 2 years, and then it would phase out. The main complaint about the existing credits is that they are very complex, particularly the reference to the 20-year-old base period. This base period creates problems for the taxpayer in trying to calculate the credit. It creates problems for the IRS in trying to administer and audit those claims. The new credit focuses only on expenses, not gross receipts. It is still an incremental credit, so that companies must continue to increase research spending over time. Further, this bill adds a mandate for a Treasury study to look at substantiation issues and ensure that current recordkeeping requirements assist the IRS without unduly burdening the taxpayer. A tax credit is a cost-effective way to promote R&E. A report by the Congressional Research Service finds that without government support, investment in R&E would fall short of the socially optimal amount. Thus CRS endorses Government policies to boost private sector R&E. Also, American workers who are engaged in R&E activities benefit from some of the most intellectually stimulating, high-paying, high-skilled jobs in the economy. My own State of Montana has excellent examples of this economic activity. During the 1990s, about 400 establishments in Montana provided high-technology services, at an average wage of about $35,000 per year. These jobs paid nearly 80 percent more than the average private sector wage, which was less than $20,000 a year during the same period. Many of these jobs would never have been created without the assistance of the R&E credit. Our research bill would also establish a uniform reimbursement rate for all contract and consortia R&E. It would provide that 80 percent of expenses for research performed for the taxpayer by other parties count as qualifying research expenses under the regular credit. Currently, when a taxpayer pays someone else to perform research for the taxpayer, the taxpayer can claim one of three rates in order to determine how much the taxpayer can include for the research credit. The lower amount is meant to assure overhead expenses that normally do not qualify for the R&E credit are not counted. Different rates, however, create unnecessary complexity. Therefore, our bill creates a uniform rate of 80 percent. The second major research area that this bill addresses is the need to enhance and simplify the credit for basic research. This credit benefits universities and other entities committed to basic research. It benefits the companies or individuals who donate to them. Our bill provides that payments under the university basic research credit would count as contractor expenses at the rate of 100 percent. The current formula for calculating the university basic research credit--defined as research ``for the advancement of science with no specific commercial objective''--is even more complex that the regular traditional R&E credit. Because of this complexity, this credit costs less than \1/2\ of 1 percent of the cost of the regular R&E credit. It is completely under-utilized. It needs to be simplified to encourage businesses to give more for basic research. American universities have been powerful engines of scientific discovery. To maintain our premier global position in basic research, America relies on sustained high levels of basic research funding and the ability to recruit the most talented students in the world. The gestation of scientific discovery is long. At least at first, we cannot know the commercial applications of a discovery. But America leads the world in biotechnology today because of support for basic research in chemistry and physics in the 1960s. Maintaining a commitment to scientific inquiry, therefore, must be part of our vision for sustained competitiveness. Translating university discoveries into commercial products also takes innovation, capital, and risk. The Center for Strategic and International Studies asked what kind of government intervention can maintain technological leadership. One source of technological innovation that provides America with comparative advantage is the combination of university research programs, entrepreneurs, and risk capital from venture capitalists, corporations, or governments. Research clusters around Silicon Valley and North Carolina's Research Triangle exemplify this sort of combination. The National Academies reached a similar conclusion in a 2002 review of the National Nanotechnology Initiatives. In a report, they wrote: ``To enhance the transition from basic to applied research, the committee recommends that industrial partnerships be stimulated and nurtured to help accelerate the commercialization of national nanotechnology developments.'' In sum, our bill would boost both applied and basic research. It would boost research by businesses big and small. And it would foster research by for-profit and nonprofits alike. McLuhan's quote about the global village was taken by many at the time as a wake-up call to a changing world. Since then, many more leaders in this village have emerged. Let us work to see that the next big technological advance is discovered here in America. Only through continued commitment to research can we ensure that it is.

Mr. BAUCUS

Mr. BAUCUS. Mr. President, back in 1962, Marshall McLuhan wrote, ``The new electronic interdependence recreates the world in the image of a global village.'' Certainly, 40 years later, that concept is truer than ever. As we prepare for the future in this global village, we need to affirm America's leadership role in the world. The United States accounts for one-third of the world's spending on scientific research and development, ranking first among all countries. While this is impressive, relative to GDP, though, America falls to sixth place. And the trends show that maintaining American leadership in the future depends on increased commitment to research and science. Asia has recognized this. Asia is plowing more funding into science and education. China, in particular, understands that technological advancement means security, independence, and economic growth. Spending on research and development has increased by 140 percent in China, Korea, and Taiwan. In America, it has increased by only 34 percent. Asia's commitment is already paying off. More than a hundred Fortune 500 companies have opened research centers in India and China. I have visited some of them. I was impressed with the level of skill of the workers whom I met there. China's commitment to research, at $60 billion in expenditures, is dramatic by any measure. Over the last few years, China has doubled the share of its economy that it invests in research. China intends to double the amount committed to basic research in the next decade. Currently, only America beats out China in numbers of researchers in the workforce. Today, I am pleased to join with my colleague on the Finance Committee, Senator Hatch, to introduce the Research Competitiveness Act of 2007. This bill would improve our research competitiveness in four major areas. All four address incentives in our tax code. Government also supports research through Federal spending. But I am not addressing those areas today. First, our bill improves and simplifies the credit for applied research in section 41 of the tax code. This credit has grown to be overly complex, both for taxpayers and the IRS. Beginning in 2008, our bill would create a simpler credit for qualifying research expenses that exceed 50 percent of the average expenses for the prior 3 years. This simplified credit would phase in over 3 years. Just as important, the bill makes the credit permanent. Because the credit has been temporary, it has simply not been as effective as it could be. Since its creation in 1981, it has been extended 11 times. Congress even allowed it to lapse during one period. The credit last expired in December of 2005. After much consternation and delay, Congress passed a 2-year extension just last month, extending the credit for 2006 and 2007. These temporary extensions have taken their toll on taxpayers. In 2005, the experts at the Joint Committee on Taxation wrote: ``Perhaps the greatest criticism of the R&E credit among taxpayers regards its temporary nature.'' Joint Tax went on to say, ``A credit of longer duration may more successfully induce additional research than would a temporary credit, even if the temporary credit is periodically renewed.'' Currently, there are three different ways to claim a tax credit for qualifying research expenses. First, the ``traditional'' credit relies on incremental increases in expenses compared to a mid-1980s base period. Second, the ``alternative incremental'' credit measures the increase in research over the average of the prior 4 years. Both of these credits have base periods involving gross receipts. Under the new tax bill enacted last month, a third formula was created, which does not rely on gross receipts and is available only for 2007. Our bill simplifies these credits and will move all taxpayers to the ``Alternative Simplified Credit,'' which is based on research spending without reference to gross receipts. The current formulas hurt companies that have fluctuating sales. It hurts companies that take on a new line of business not dependent on research. This new simpler formula in our bill would not start until 2008. That start date would give companies plenty of time to adjust their accounting. The current formula would be available to companies for 2 years, and then it would phase out. The main complaint about the existing credits is that they are very complex, particularly the reference to the 20-year-old base period. This base period creates problems for the taxpayer in trying to calculate the credit. It creates problems for the IRS in trying to administer and audit those claims. The new credit focuses only on expenses, not gross receipts. It is still an incremental credit, so that companies must continue to increase research spending over time. Further, this bill adds a mandate for a Treasury study to look at substantiation issues and ensure that current recordkeeping requirements assist the IRS without unduly burdening the taxpayer. A tax credit is a cost-effective way to promote R&E. A report by the Congressional Research Service finds that without government support, investment in R&E would fall short of the socially optimal amount. Thus CRS endorses Government policies to boost private sector R&E. Also, American workers who are engaged in R&E activities benefit from some of the most intellectually stimulating, high-paying, high-skilled jobs in the economy. My own State of Montana has excellent examples of this economic activity. During the 1990s, about 400 establishments in Montana provided high-technology services, at an average wage of about $35,000 per year. These jobs paid nearly 80 percent more than the average private sector wage, which was less than $20,000 a year during the same period. Many of these jobs would never have been created without the assistance of the R&E credit. Our research bill would also establish a uniform reimbursement rate for all contract and consortia R&E. It would provide that 80 percent of expenses for research performed for the taxpayer by other parties count as qualifying research expenses under the regular credit. Currently, when a taxpayer pays someone else to perform research for the taxpayer, the taxpayer can claim one of three rates in order to determine how much the taxpayer can include for the research credit. The lower amount is meant to assure overhead expenses that normally do not qualify for the R&E credit are not counted. Different rates, however, create unnecessary complexity. Therefore, our bill creates a uniform rate of 80 percent. The second major research area that this bill addresses is the need to enhance and simplify the credit for basic research. This credit benefits universities and other entities committed to basic research. It benefits the companies or individuals who donate to them. Our bill provides that payments under the university basic research credit would count as contractor expenses at the rate of 100 percent. The current formula for calculating the university basic research credit--defined as research ``for the advancement of science with no specific commercial objective''--is even more complex that the regular traditional R&E credit. Because of this complexity, this credit costs less than \1/2\ of 1 percent of the cost of the regular R&E credit. It is completely under-utilized. It needs to be simplified to encourage businesses to give more for basic research. American universities have been powerful engines of scientific discovery. To maintain our premier global position in basic research, America relies on sustained high levels of basic research funding and the ability to recruit the most talented students in the world. The gestation of scientific discovery is long. At least at first, we cannot know the commercial applications of a discovery. But America leads the world in biotechnology today because of support for basic research in chemistry and physics in the 1960s. Maintaining a commitment to scientific inquiry, therefore, must be part of our vision for sustained competitiveness. Translating university discoveries into commercial products also takes innovation, capital, and risk. The Center for Strategic and International Studies asked what kind of government intervention can maintain technological leadership. One source of technological innovation that provides America with comparative advantage is the combination of university research programs, entrepreneurs, and risk capital from venture capitalists, corporations, or governments. Research clusters around Silicon Valley and North Carolina's Research Triangle exemplify this sort of combination. The National Academies reached a similar conclusion in a 2002 review of the National Nanotechnology Initiatives. In a report, they wrote: ``To enhance the transition from basic to applied research, the committee recommends that industrial partnerships be stimulated and nurtured to help accelerate the commercialization of national nanotechnology developments.'' In sum, our bill would boost both applied and basic research. It would boost research by businesses big and small. And it would foster research by for-profit and nonprofits alike. McLuhan's quote about the global village was taken by many at the time as a wake-up call to a changing world. Since then, many more leaders in this village have emerged. Let us work to see that the next big technological advance is discovered here in America. Only through continued commitment to research can we ensure that it is.

Mr. BAUCUS

Mr. BAUCUS. Madam President, since the year 2000, shortly after news reports attributed hundreds of deaths to asbestos exposure from decades of vermiculite mining in Libby, MT, I have worked hard on behalf of the people there to ensure that they received the care they needed. The Center for Asbestos Related Disease plays an important role in screening Libby residents and providing them with the health care they need as a result of this tragedy. The people living in Libby suffer asbestos-related diseases at a rate 40 to 60 times the national average. They suffer from mesothelioma at a rate 100 times the national average. The culprit for this unprecedented tragedy is a highly toxic tremolite asbestos amphibole. Due to the shipping of Libby asbestos to processing sites in 30 States, and its subsequent use as insulation material in all parts of the country, the toxicity of this amphibole is an issue of national importance. The Department of Health and Human Services and the Environmental Protection Agency have designated the Center for Asbestos Related Disease as a clearinghouse for information that facilitates clinical epidemiological and pathologic studies of asbestos-related diseases. This new role unfortunately comes without adequate funding to accommodate the transition to this national leadership role. This is an issue of national concern to scientists who rely on tremolite asbestos data for their work. Support letters have been sent to Members of this body by researchers at the Mesothelioma Applied Research Foundation from California, Mount Sinai Medical School in New York, Wayne State University in Michigan, North Carolina State University, the University of Vermont, the University of Pittsburgh, the University of Pennsylvania, and Montana State University. These letters all emphasize the importance of the Libby data to the national research efforts on asbestos related disease. That is why I submitted an amendment to the Labor, Health and Human Services, and Related Agencies Appropriations bill for fiscal year 2008. My amendment would provide $250,000 to the Center for Asbestos Related Disease in Libby, MT, so that the clinic can provide its critically important information to clinical researchers and universities across the country. The raw data and data management that the center provides for research institutions will facilitate meaningful research into amphibole asbestos toxicity and health impacts. I suggest the absence of a quorum.

Mr. BAUCUS

Mr. BAUCUS. I thank my colleagues.

Mr. BAUCUS. Mr. President, reserving the right to object, I might ask what the Feingold amendment is and how long he expects to take, and whether he expects to vote on that amendment.

Mr. BAUCUS. Mr. President, further reserving, I wonder--and this is a bit of an imposition--if I could ask unanimous consent to speak on the SCHIP override vote 5 minutes preceding the Senator offering his amendment.