Benjamin Cardin

Mr. CARDIN

Mr. CARDIN. Mr. President, today I introduce the Colon Cancer Screen for Life Act of 2007 along with my colleagues, Senator Collins, Senator Lieberman, and Senator Graham. Many people are aware that colon cancer is the second most deadly cancer in the United States. In 2006 alone, according to the American Cancer Society, more than 150,000 new cases were diagnosed and more than 50,000 Americans died from colon cancer. In my own State of Maryland, nearly 1,000 people lost their lives to this disease last year. What people are not as aware of, however, is that colon cancer is preventable with appropriate screening, highly detectable, and curable if found early. The purpose of our bill is to increase the rate of participation in colon cancer screening and ensure that we are saving every life that we can from this deadly disease. Medicare coverage for colorectal cancer screening through colonoscopy was authorized in the Balanced Budget Act of 1997 and further expanded in 2000 when the colonoscopy benefit was added for high risk beneficiaries. Under this Medicare benefit, a low risk beneficiary is entitled to receive a colonoscopy once every ten years and a high risk beneficiary is entitled to a colonoscopy every two years. Despite this, recent studies have shown that patients are not utilizing coverage of CRC preventive screenings. According to the Government Accountability Office, since the implementation of the benefit in 1998, the percentage of Medicare beneficiaries receiving either a screening or a diagnostic colonoscopy has increased by 1 percent. Since providing coverage for this lifesaving service, Congress has discovered many barriers that stand in the way of patients having access to the colonoscopy benefit. One reason for such low utilization is that the physician reimbursement has been cut by 33 percent since this benefit was enacted. In 1997, a colonoscopy performed in a hospital outpatient department or an ambulatory surgery center was reimbursed at approximately $301. Now, in 2007, that reimbursement is only $198.20. Some may argue that reductions in Medicare payments are necessary to keep the Medicare Program financially viable. While I strongly support efforts to eliminate wasteful spending in Medicare, I can assure my colleagues that is not the case here. To the contrary, providing adequate reimbursement for screening will result in Medicare savings and better health outcomes. Let me explain. Our health care system spends an estimated $8.3 billion annually to treat newly diagnosed cases of colon cancer. The average cost of direct medical care for each cancer episode is estimated to be between $35,000 for early stage detection and $80,000 for later stage detection. So each time that cancer is not detected early, that individual faces an increased risk of developing the disease and needing treatment that costs Medicare Program tens of thousands of dollars. Patient participation has also been is that currently Medicare does not cover a preoperative visit with a physician prior to screening. While it is true that a colonoscopy is a minimally invasive procedure, an anesthetic is used to sedate the patient to make the colonoscopy less uncomfortable. Because the patient is going to be sedated, medical standards require doctors to visit with the patient before surgery to determine and protect against any risks, such as drug interaction, and to give them preoperative instructions. Recognizing the importance of these visits, Medicare does reimburse for a consultation prior to a diagnostic colonoscopy. A preoperative visit is no less medically necessary before a preventive screening, and therefore should be reimbursed in the same manner. Finally, some beneficiaries may delay seeking colorectal cancer screening because they cannot afford Medicare's Part B deductible. Recognizing this, Congress recently took an important step by waiving the Part B deductible for preventive colon cancer screenings, effective January 1, 2007. However, gastroenterologists are now reporting that, if polyps or other signs of cancer are discovered in the course of a preventive colonoscopy, the procedure is then considered to be diagnostic and Medicare requires that the beneficiary pay a deductible. Congress needs to ensure that beneficiaries are not dissuaded from getting this lifesaving procedure by the concern that they might have to pay a deductible if a polyp is discovered. Our legislation clarifies congressional intent to ensure that CMS will waive the deductible in all screenings so that Medicare beneficiaries are not confronted with an unexpected additional expense, should the procedure's coding change. The Colon Cancer Screen for Life Act would eliminate every one of these barriers, and in doing so, save lives. First, this legislation would increase reimbursement for colorectal cancer related procedures to ensure that physicians are able to continue to perform these valuable services. Reimbursement for procedures performed in a physician's office would be increased by up to 10 percent and reimbursement for procedures performed in Hospital Outpatient Department, HOPD, or Ambulatory Surgery Center, ASC, would be increased by up to 30 percent. The bill would also provide Medicare coverage for the preoperative doctor's visit conducted prior to a screening colonoscopy. Finally, the bill contains a technical provision to require that the deductible is waived whether or not the beneficiary's screening was clean or results in a biopsy or lesion removal. More than 50,000 Americans will die from colon cancer this year alone. Ninety percent of these cases might have been prevented. We cannot afford to wait another moment before doing something to eliminate these and other barriers that are standing in the way of preventing colon cancer. I urge my colleagues to join me in support of this important legislation and enact it this year.

Mr. CARDIN

Mr. CARDIN. Mr. President, today I am introducing legislation to restore the authority of State and local governments to protect the environment and ensure public safety with respect to the siting of Liquefied Natural Gas (LNG) terminals within their States. This measure would strike a provision in the Energy Policy Act of 2005 which gave the Federal Regulatory Energy Commission (FERC) power to preempt State and local concerns in the siting, construction and operation of LNG facilities. In recent years, the LNG industry has proposed building dozens of new LNG terminals throughout the United States, as LNG's share of the natural gas market continues to grow rapidly. Many of these terminals are being planned near populated areas or in environmentally sensitive coastal areas. As a highly hazardous and combustible fuel source, LNG poses serious safety concerns to local communities from potential accidents, as well as terrorism risks. Richard Clarke, a former Bush Administration Counter Terrorism official, noted that LNG terminals and tankers present ``especially attractive targets'' to terrorists. Experts have identified anumber of potentially catastrophic events that could arise from an LNG release, including pool fires--an extremely intense fire that cannot be extinguished and can spread over considerable distance, flammable vapor clouds that may drift some distance from the spill site, and flameless explosions. According to the Congressional Research Service, there have been approximately 13 serious accidents at LNG plants around the world over the past six decades, including three accidents which caused fatalities--two in Algeria in 1977 and 2004 respectively, and another at Cove Point, MD; in 1979, which killed one worker and caused some $3 million in damages. In the State of Maryland, which is already home to one of six operating LNG terminals in the United States, AES Sparrows Point LNG, LLC and Mid-Atlantic Express, LLC has proposed building a new terminal near a densely-populated area of Baltimore. Our area Congressional Delegation, Governor O'Malley, Baltimore County Executive Jim Smith and other local officials and community leaders believe this project poses unacceptable public safety, economic and environmental risks and does not serve the public interest. Yet, under current law, the Federal Energy Regulatory Commission now has exclusive authority to approve onshore LNG terminal siting applications. While the law requires FERC to consult with State and local governments regarding safety concerns, they have no role in the final decision. Moreover, while the law permits states to conduct safety inspections of LNG terminals, they do not have the authority to require any safety precautions or to take enforcement actions if they discover problems at a facility during a safety inspection. It is vital, in my opinion, that State and local authorities and the public have a meaningful opportunity to participate in the decision- making process about the siting of these plants. These terminals have the potential for tremendous impacts on the communities in which they would be constructed and would operate. The measure I am introducing today seeks to restore that authority and give Governors the same veto powers for onshore LNG terminal proposals as they currently exercise for offshore terminal proposals under the Deepwater Port Act. I urge my colleagues to join me in supporting this measure.

Mr. CARDIN

Mr. CARDIN. Mr. President, today I introduce the Colon Cancer Screen for Life Act of 2007 along with my colleagues, Senator Collins, Senator Lieberman, and Senator Graham. Many people are aware that colon cancer is the second most deadly cancer in the United States. In 2006 alone, according to the American Cancer Society, more than 150,000 new cases were diagnosed and more than 50,000 Americans died from colon cancer. In my own State of Maryland, nearly 1,000 people lost their lives to this disease last year. What people are not as aware of, however, is that colon cancer is preventable with appropriate screening, highly detectable, and curable if found early. The purpose of our bill is to increase the rate of participation in colon cancer screening and ensure that we are saving every life that we can from this deadly disease. Medicare coverage for colorectal cancer screening through colonoscopy was authorized in the Balanced Budget Act of 1997 and further expanded in 2000 when the colonoscopy benefit was added for high risk beneficiaries. Under this Medicare benefit, a low risk beneficiary is entitled to receive a colonoscopy once every ten years and a high risk beneficiary is entitled to a colonoscopy every two years. Despite this, recent studies have shown that patients are not utilizing coverage of CRC preventive screenings. According to the Government Accountability Office, since the implementation of the benefit in 1998, the percentage of Medicare beneficiaries receiving either a screening or a diagnostic colonoscopy has increased by 1 percent. Since providing coverage for this lifesaving service, Congress has discovered many barriers that stand in the way of patients having access to the colonoscopy benefit. One reason for such low utilization is that the physician reimbursement has been cut by 33 percent since this benefit was enacted. In 1997, a colonoscopy performed in a hospital outpatient department or an ambulatory surgery center was reimbursed at approximately $301. Now, in 2007, that reimbursement is only $198.20. Some may argue that reductions in Medicare payments are necessary to keep the Medicare Program financially viable. While I strongly support efforts to eliminate wasteful spending in Medicare, I can assure my colleagues that is not the case here. To the contrary, providing adequate reimbursement for screening will result in Medicare savings and better health outcomes. Let me explain. Our health care system spends an estimated $8.3 billion annually to treat newly diagnosed cases of colon cancer. The average cost of direct medical care for each cancer episode is estimated to be between $35,000 for early stage detection and $80,000 for later stage detection. So each time that cancer is not detected early, that individual faces an increased risk of developing the disease and needing treatment that costs Medicare Program tens of thousands of dollars. Patient participation has also been is that currently Medicare does not cover a preoperative visit with a physician prior to screening. While it is true that a colonoscopy is a minimally invasive procedure, an anesthetic is used to sedate the patient to make the colonoscopy less uncomfortable. Because the patient is going to be sedated, medical standards require doctors to visit with the patient before surgery to determine and protect against any risks, such as drug interaction, and to give them preoperative instructions. Recognizing the importance of these visits, Medicare does reimburse for a consultation prior to a diagnostic colonoscopy. A preoperative visit is no less medically necessary before a preventive screening, and therefore should be reimbursed in the same manner. Finally, some beneficiaries may delay seeking colorectal cancer screening because they cannot afford Medicare's Part B deductible. Recognizing this, Congress recently took an important step by waiving the Part B deductible for preventive colon cancer screenings, effective January 1, 2007. However, gastroenterologists are now reporting that, if polyps or other signs of cancer are discovered in the course of a preventive colonoscopy, the procedure is then considered to be diagnostic and Medicare requires that the beneficiary pay a deductible. Congress needs to ensure that beneficiaries are not dissuaded from getting this lifesaving procedure by the concern that they might have to pay a deductible if a polyp is discovered. Our legislation clarifies congressional intent to ensure that CMS will waive the deductible in all screenings so that Medicare beneficiaries are not confronted with an unexpected additional expense, should the procedure's coding change. The Colon Cancer Screen for Life Act would eliminate every one of these barriers, and in doing so, save lives. First, this legislation would increase reimbursement for colorectal cancer related procedures to ensure that physicians are able to continue to perform these valuable services. Reimbursement for procedures performed in a physician's office would be increased by up to 10 percent and reimbursement for procedures performed in Hospital Outpatient Department, HOPD, or Ambulatory Surgery Center, ASC, would be increased by up to 30 percent. The bill would also provide Medicare coverage for the preoperative doctor's visit conducted prior to a screening colonoscopy. Finally, the bill contains a technical provision to require that the deductible is waived whether or not the beneficiary's screening was clean or results in a biopsy or lesion removal. More than 50,000 Americans will die from colon cancer this year alone. Ninety percent of these cases might have been prevented. We cannot afford to wait another moment before doing something to eliminate these and other barriers that are standing in the way of preventing colon cancer. I urge my colleagues to join me in support of this important legislation and enact it this year.

Mr. CARDIN

Mr. CARDIN. Madam President, I commemorate April 22--Earth Day 2007, a day set aside to celebrate gains we have made in improving the environment and to renew our commitment to protect our planet. Earth Day was established by Senator Gaylord Nelson of Wisconsin and was first celebrated in 1970. Senator Nelson firmly believed that education was the key to changing people's attitude about the environment. Since then, the Earth Day celebration has spread throughout the nation and to the rest of the world, with more and more people getting involved in efforts to clean and nurture the environment. Despite Earth Day's popularity and the many programs that were created to improve the health of the planet, our world is still wrought with environmental problems. We still face many pressing issues such as global warming, protecting our coastal waters from over-fishing, and preserving America's most precious resource lands from the Alaskan Tongass Rainforest to the Redrock lands in Utah, to our own Chesapeake Bay. Today, we face a serious and growing threat from global warming. Recently I told the Senate Environment and Public Works Committee about the immediate threats that global warming poses to Maryland. A significant part of Maryland is in low-lying areas that would be inundated if global temperatures keep rising. The National Flood Insurance Program has designated more than 12 percent of Maryland as a special flood hazard area, and an estimated 68,000 Maryland homes and buildings are located within a flood plain. We are already seeing the effects. About a third of Blackwater National Wildlife Refuge on the Eastern Shore has been lost to sea level rise in the past 70 years. Smith Island, situated in the Chesapeake Bay, has lost 30 percent of its land to rising sea levels since 1850. I have long supported a comprehensive, environmentally friendly energy policy that emphasizes increasing the availability and use of renewable energy, as well as promoting greater energy efficiency. Energy efficiency and renewable energy will reduce America's dangerous dependency on foreign oil while also dramatically reducing greenhouse gases. Closer to home, we must continue to focus our efforts on restoring the Chesapeake Bay. The Bush administration's budget proposes drastic cuts to vital initiatives, including environmental education, funds to upgrade wastewater treatment plants, and several farm bill conservation programs that help farmers reduce nutrient runoff from entering the Bay. The budget resolution that I helped draft and the Senate passed last month restores many of those dangerous cuts, but we still have much work ahead of us to assure that these critical Federal programs are fully funded. Earth Day celebrations serve as important reminders that we cannot take our natural resources for granted. I urge all Americans to join together to protect, preserve, and restore the planet's natural treasures.

Mr. CARDIN

Mr. CARDIN. Mr. President, first, I thank Senator Harkin for his leadership on this issue and Senator Collins and those who have been responsible in bringing forward S. 5 for us to have an opportunity to vote for the Stem Cell Research Enhancement Act. I join my colleagues. Rarely do we have an opportunity in this body to cast a vote that literally offers hope to over 100 million people in this country. We all have constituents who are suffering from Parkinson's or Alzheimer's disease or juvenile diabetes or ALS or spinal cord injury and other illnesses and injuries that very much the stem cell research offers hope that we will be able to make advancements to improve quality of life. But there is more involved here than just the health and lives of Americans. We also are talking about the United States and its preeminence internationally in medical research. We have led the world in medical research in this country. People from all over the world come to America to get their health care needs met and to train their health care professionals. We have been on the cutting edge. In my own State of Maryland, we have the NIH, we have the Naval Medical Center at Bethesda, we have Johns Hopkins University, the University of Maryland Medical Center--all on the leading edge of research technology. S. 5 will help us maintain our preeminence in medical research, as well as help millions of people as we make advancements in medical research. Let's review quickly the current status of embryonic stem cell research. It offers tremendous promise, we all know that. We all know embryonic stem cells hold the greatest promise for being able to regenerate parts of our organs and bodies that will allow us to deal with horrible diseases and injuries. On August 9, 2001, the President's Executive order restricted embryonic stem cell research. If we could go back to 2001 and look at the situation in 2001, there were many who thought maybe that would be adequate at that time. We didn't know a lot about embryonic stem cell research back in 2001. NIH at that time had predicted, I remind my colleagues, that there were 60 to 78 stem cell lines that would be available under the President's Executive order, when in reality there were only 22, and some have been contaminated with mouse feeder cells. We lack the genetic diversity necessary to perform research today on embryonic stem cells, and the most vulnerable groups are minorities because they are disproportionately affected by the lack of diversity in the stem cells that are available. What is affected? Research dollars are not being made available. Money is not coming forward to deal with the most promising forms of research in our Nation. The role of the United States in medical research is being jeopardized. We are actually losing our best researchers to other countries which don't have these unreasonable restrictions. I think the argument can best be made not by researchers, not by legislators, but by listening to some of our constituents. I had the opportunity to have Josh Basile as an intern in my office. Three years before he was an intern in my office, he was a healthy young person leading a very healthy, very active life--a tennis player and doing all those things that a person his age would do. But then he was on the beaches off the Atlantic, and a wave caught him and he became a quadriplegic overnight. He is determined he is going to walk again. He is determined he is going to make progress. In fact, he is making progress. He is rehabilitating himself the best he possibly can. He has brought back motion where people thought it was impossible for motion to come back because he is determined. He is keeping his body ready, but he is asking us to do our share to allow the medical researchers to have the tools necessary to help him so one day he can walk. One of my closest friends--my closest friend in law school--Larry Katz, when he was a very active attorney in Baltimore, was diagnosed with ALS. I watched him as his body left him and he died a very difficult death. Any of us who have experienced these types of life circumstances know that we have a responsibility to do everything we can to make sure that our scientists have the appropriate tools to do the research to bring about the answers to provide the resources, the money, and the appropriate scientific methods in order to unlock the mysteries of so many diseases. Stem cell research offers tremendous promise. The work being done at the University of Maryland Medical Center and the work being done at Johns Hopkins in my community--Dr. John Gearhart and Dr. Douglas Kerr, I met with these scientists frequently to try to get a better understanding about this. I am not a scientist. I don't know all the technicalities, but I have had a chance to meet with these scientists and see what they are doing and learn firsthand the promise that embryonic stem cell research holds out to all of us. They have been able to implant embryonic stem cell growth in mice and see movement where there was no movement before. It holds out such great promise. We can do better and we have to allow our scientists the ability to do that. Let me quote from one other Marylander, Dr. Elias Zerhouni, who is the Director of the National Institutes of Health and a resident of Baltimore. Last month, he reiterated his support for lifting the current ban, stating that: From my standpoint, it is clear today that American science will be better served and the Nation will be better served if we let our scientists have access to more stem cell lines. There is a lot of fact and a lot of fiction out there as to what this means and what this bill does, what exactly the restrictions are under current law. There are some who argue that this legislation will encourage the creation of in vitro fertilization for research. Nothing could be further from the truth. The only lines that are available are those that are currently in existence. As my colleagues have repeated over and over on this floor, those who claim that this will divert the cell from its original purpose for implantation are wrong. The facts are that these embryos would be otherwise discarded. Those who say we have to protect against abuse, read the language of the bill. The bill requires the donor's consent, and it can't be with compensation. It provides guidelines for the ethically sound use of embryonic stem cell research. In June of 2001, 2 months before President Bush issued his stem cell policy, Sue Stamos and her daughter Faith came to visit me in my House office. At the time, Faith was 3 years old, a very brave little girl who had been diagnosed with juvenile diabetes. She asked me for my support for Federal research to help find a cure for Faith, and I promised back then I would do everything I could to help the Stamos family. Back in 2001, our knowledge of stem cell research was nowhere near what it is today. We didn't know what promise it held at that time. Today, 6 years later, we have a much broader and deeper knowledge about the scientific possibilities of stem cells but much less capacity to research stem cell lines than we had anticipated. Last year, I voted to keep my promise to Sue and Faith Stamos and to the thousands of other Marylanders who are waiting for cures. Today, again for Faith and Josh and thousands of other Marylanders, I will vote to expand the stem cell lines available for federally funded research. I hope my colleagues will join in sending a message to Americans that this Congress will not stand in the way of medical progress through the proper use of embryonic stem cell research. I urge my colleagues to support this legislation, and with that, Mr. President, I yield the floor.

Mr. CARDIN

Mr. CARDIN. Mr. President, today I wish to honor my dear friend and fellow Marylander, the Rev. Dr. John Louis Wright, for his exemplary 35 years of service as pastor of First Baptist Church of Guilford and for his work as a community leader and civil rights activist. Pastor Wright is a native of Baltimore City and a shining product of the Baltimore City public school system. Since 1972, he has served as pastor of the First Baptist Church of Guilford, shepherding the church through periods of tremendous growth while faithfully serving its members and the surrounding community. As a civil rights leader, Pastor Wright is a life member of the NAACP, and he has served as both president of the Howard County Chapter of the NAACP and the Maryland NAACP. He currently serves as director of the Maryland Baptist Aged Home. Following Hurricane Floyd in 1999, Pastor Wright spearheaded flood relief efforts in North Carolina though the ``Twelve Baskets Ministry,'' bringing much needed supplies to people left homeless by the hurricane. Preventing handgun violence is an issue of particular importance to Pastor Wright. A 1997 graduate of the Federal Bureau of Investigation's Citizens' Academy in Baltimore, he is a member of the Maryland State Governor's Commission on Handgun Violence and Marylanders Against Handgun Violence. Pastor Wright's efforts reach far beyond our shores. He has traveled around the world, sharing his warmth and wisdom in countries as diverse as Egypt, Israel, South Africa, Switzerland, and China. While in Israel, Pastor Wright continued his work by baptizing people in the Jordan River. I am extremely proud of Pastor Wright's 35 years of dedicated service to his church and community and wish him many more years of continued success and good health.

Mr. CARDIN

Mr. CARDIN. Mr. President, I thank Senator Conrad for yielding me this time. I take this time to rise in support of the budget resolution and the work of Senator Conrad and the Budget Committee. It has been said frequently it is the most difficult job here to try to put together a budget, when you are trying to deal with all the different priorities. Senator Conrad has done an excellent job in moving the agenda of this Nation. This budget resolution changes the fiscal priorities of America. First, it provides for fiscal discipline. The pay-go rules are real. There are difficult choices our committees will have to make. But we have made it a priority to get our budget back into balance and say that we have to make tough choices. Secondly, there are important priority areas. I compliment the committee for making health care truly a priority, to change the direction of America. It is a national disgrace that we have 46 million people without health insurance in America. We need to do something about it. We need universal health coverage in this country. This budget moves us in that direction by making SCHIP a priority. It gives the committee the ability to expand a very successful program. SCHIP works. It provides health insurance for our children. Over the last 10 years, we have seen improved health care outcomes as a result of the SCHIP program. We know that if a person is covered by SCHIP, they are much more likely to receive primary care and dental care. They are much less likely to use the emergency rooms and much more likely to be immunized and have preventive health care and access to prescription drugs. Those enrolled in the SCHIP program are going to be better off. This budget allows us to move that issue forward. We often talk about it. There was a hearing before the Senate Finance Committee and a family from Maryland was there. I will quote from Mrs. Bedford. She has five children in the SCHIP program. What she said is: Perhaps the greatest impact MCHIP, the Maryland Children's Health Insurance Program, has had on our families medically is that we no longer have to make impossible health choices based on a financial prospective. We no longer have to decide whether a child is ``really sick enough'' to warrant a doctor's visit. We no longer have to decide whether a child ``really needs'' a certain medication prescribed by his pediatrician. The face of CHIP is families such as ours, families who work hard and play by the rules, trying to live the American dream. This budget will allow more families to be able to be in the health program and to live the American dream. Another family in Maryland is the Diver family, where Diamonte Diver died as a result of not getting access to preventive dental care. The toothache became abscessed and spread into his brain. He had emergency surgery costing over a quarter of a million dollars. If he would have had access to preventive oral care, dental care, for $80 he could have had a tooth extraction and that would have saved money in our health care system. By expanding the SCHIP program, more children will be covered by dental care. There are so many reasons why this budget will allow us to move forward regarding our health care priorities. In the 109th Congress, we prevented 17 States from running out of money late in the session. This budget versus the President's budget is a clear choice. The President's budget moves in the wrong direction on health care and the SCHIP program. This allows us to make it truly a national priority. There are other parts of the budget in health care that I support, such as the long-term care reserve fund, so that we can develop a more cost-effective way to take care of long-term care needs, so families can get assisted living help or home health care, and they don't have to spend as much money in nursing care. I could go through many priorities, whether it is veterans health care, education, or whether it is transportation. All these are important priorities that this budget allows us to move forward on in a fiscally responsible way. I know we have had budgets that try to pull back from the pay-go requirements. I am glad we have stood up for the pay-go requirements. We have to balance the budget, but we need to change the priorities of America and move forward with health care and education, and we need to move forward with veterans and transportation. This budget allows us to do it. I urge my colleagues to be cautious on all these amendments that are being offered. They may sound well intended, but they could jeopardize the thrust of the budget. I urge my colleagues to support the underlying resolution. I yield back the remainder of my time.

Mr. CARDIN

Mr. CARDIN. Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. CARDIN. Mr. President, I take this time to rise in support of S. 214, Preserving United States Attorney Independence Act of 2007. This legislation would restore the appointment of our interim U.S. attorneys to how it was prior to the passage of the PATRIOT Act. The PATRIOT Act included a provision many of us did not know was in that legislation. It was a provision that affected the appointment of interim U.S. attorneys. Prior to the passage of that provision, the Department of Justice had the ability to appoint interim U.S. attorneys for up to 120 days, without the confirmation of this body. This legislation will restore that provision, which will establish the right balance between the executive and legislative branches of Government. It will encourage the Department of Justice to work with this body so that interim U.S. attorneys and permanent appointments can be considered timely and the confirmation process can move forward. Most importantly, this legislation is necessary because of the recent actions of the Department of Justice in removing several U.S. attorneys, which is currently under investigation by the Judiciary Committee. I serve on the Judiciary Committee. On March 6, we had a hearing that I think was remarkable. It was unfortunate because we had former U.S. attorneys who appeared before our committee and talked about being intimidated and pressured by the Department of Justice and by the White House. They were fired despite the fact that they had received excellent performance evaluations by the Department of Justice. In several of these cases, the office was involved in high-profile political investigations, some of which the administration was not happy about. The U.S. attorney is the chief Federal law enforcement officer in our States. The U.S. attorneys must work independently. The Attorney General must carry out his responsibility for the entire country. He is not the attorney for the President. The Department of Justice must maintain that independence. A U.S. attorney has enormous power to determine who should be investigated, who should be prosecuted, and what type of punishment should be recommended. It is a tremendous amount of power which must be exercised with total independence. The manner in which these eight U.S. attorneys were removed from office raised many concerns that all of us should be concerned about. This raises concerns about the independence of the U.S. attorney and whether these investigations will be conducted with the public interest in mind or to further a political agenda. It raises concerns as to whether the Department of Justice or the White House was trying to influence the independent judgments of the U.S. attorney in a specific investigation. It raises concerns as to how Congress was kept informed as to how these removals were being handled. Information that was made available to us was inconsistent and certainly raises questions as to whether Congress itself was being misled by the Department of Justice. This raises concerns about the morale within the U.S. Attorney's Offices throughout the country and whether they will be able to attract the best possible people in order to prosecute these activities and get the best people in the U.S. Attorney's Office. The work of this body is continuing as it relates to the U.S. attorneys. The Judiciary Committee is continuing its work. I must tell you that I know there were a lot of documents made available last night to the Judiciary Committee, but what we need to have is the personal appearance of those who were directly involved--Ms. Miers, Mr. Rove, Mr. Sampson. Those testimonies need to take place in the Judiciary Committee, open testimony, so we can get the information as to what exactly happened in regard to the dismissal of these U.S. attorneys and whether it was improper activity, trying to influence the judgment of our U.S. attorneys. It starts with the passage of S. 214. It starts with our restoring the proper balance between the executive and legislative branches of Government as it relates to the use of interim U.S. attorneys and the confirmation process by this body. I urge my colleagues to support S. 214 and to support the work of the Judiciary Committee as we continue our investigation as to the dismissal of U.S. attorneys. I yield the floor.

Mr. CARDIN

Mr. CARDIN. Mr. President, I urge us to move forward and consider the Iraq resolution so that every Member of this body can speak on this issue, we can debate it, and we can cast our votes on what we believe the policy should be for the United States in Iraq. I would like to take us back to October of 2002. I was in the other body in October 2002. I voted against the resolution that gave the President the right to use force in Iraq. Let's remember the basis on which that resolution was passed. We were told that Iraq was in violation of U.N. resolutions concerning weapons of mass destruction and we needed to have the option to use military force in order to enforce that resolution and get rid of weapons of mass destruction. The United States was also concerned about the war against terror, and there were statements made about the war on terror. I might tell you, there was no evidence that Iraq was involved in the attacks on our country on September 11. And, yes, there was a desire by many to get rid of the regime of Saddam Hussein. What has happened since then? Our American troops have been in Iraq. We found no weapons of mass destruction. There are serious questions as to the intelligence information we had and how that was relayed to all of us. Saddam Hussein is gone. He has been removed. The Iraqi Government is now in place. A constitution was adopted. A government was elected. The Maliki government is now responsible for the affairs of Iraq. Times have changed. But the most significant change that has occurred in Iraq during the last year has been the increased sectarian violence--a civil war. That is what is taking place in Iraq today. It is clear the presence of the U.S. military will not end the civil war. Iraqis need to end the civil war through diplomacy and negotiations and the confidence of the people in Iraq. Something else has changed in the last year. We had national elections in our country, midterm elections. The people asked for change. Now there is a change in the Congress, and during the first few months of this Congress, we have held over 40 oversight hearings on what is happening in Iraq. I do not recall these hearings taking place in the last Congress. Those hearings have pointed out--with expert after expert; military expert, foreign policy expert--we are not going to end the sectarian violence in Iraq by increasing American troops. We cannot win it on the battlefield. We have to deal with it and negotiate a settlement in Iraq. We have before us the Reid resolution. We also have before us the President's current policies in Iraq. Do we want more of the same--an escalation of troops, a continuation of U.S. military presence in Iraq in the midst of a civil war--or do we want a change in direction? The Reid resolution represents a change in direction. It is a change in direction as it relates to U.S. troop levels. We have lost almost 3,200 American troops, 68 from my own State of Maryland. There is a civil war in which American troops are not adding to ending that civil war. We need to look at whether we want to increase our troops, as the President wants, or to start redeploying our troops so the Iraqis can stand up and defend their own country so we can look for a political solution to what is happening in Iraq. We can remove the big target on Americans. Public opinion in Iraq says it is OK to kill Americans. We have to remove the American presence so we can move forward. The Reid resolution gives us a well-defined mission which we can achieve, which is in the interest of the United States, that the Iraqis would take responsibility for their own country, would have well- trained security forces. The resolution speaks to what we need to do as far as a surge in diplomacy, to urge more countries to get involved so the Sunnis and Shiites can live together and have confidence in their own government that represents a change, that represents a direction that is in the interest of the United States. I urge us to be willing to debate this resolution and to vote on this resolution. That is our responsibility. It is our responsibility as Members of this body. It is our responsibility to our men and women who are serving our Nation, our Armed Forces. It is a responsibility we owe to our Nation. I urge my colleagues to move forward so we can go on record and change the direction of America's participation in Iraq so we can achieve the objectives that are in the interests of our Nation. Mr. President, I yield back the floor.

Mr. CARDIN

Mr. CARDIN. Mr. President, 30 years ago, the Charter 77 movement was established with the simple goal of ensuring that the citizens of Czechoslovakia could ``live and work as free human beings.'' Today, as cochairman of the Commission on Security and Cooperation in Europe, I join with my colleagues in celebrating the founding of Charter 77 and honoring those men and women who, through their personal acts of courage, helped bring freedom to their country. When the Charter 77 manifesto was issued, three men were chosen to be the first spokespersons of this newly formed movement: a renowned European philosopher, Jan Patocka; Jiri Hajek, who had been Czechoslovakia's Foreign Minister during the Prague Spring; and the playwright, Vaclav Havel. They had the authority to speak for the movement and to issue documents on behalf of signatories. Tragically, Jan Patocka paid with his life for his act of bravery and courage. After signing the charter and meeting with Dutch Ambassador Max van der Stoel, he was subjected to prolonged interrogation by the secret police. It is widely believed this interrogation triggered a heart attack, resulting in his death on March 13, 1977. In spite of the chilling message from the regime, Jiri Hajek and Vaclav Havel continued to work with other chartists, at tremendous personal cost. Two-hundred and thirty signatories were called in for interrogation; 50 houses were subjected to searches. Many supporters lost their jobs or faced other forms of persecution; many were sent to prison. In fact, the harsh treatment of the Charter 77 signatories led to the creation of another human rights group, the Committee for the Defense of the Unjustly Persecuted, known by its Czech acronym, VONS. In October 1979, six VONS leaders including Vaclav Havel, were tried for subversion and sentenced to prison terms of up to 5 years. Perhaps the regime's harsh tactics reflected its knowledge that, ultimately, it could only retain control through force and coercion. Certainly, there was no perestroika or glasnost in Husak's Czechoslovakia, no goulash communism as in neighboring Hungary. And so, the regime was threatened by groups that might have seemed inconsequential elsewhere: by the psychedelic band, ``Plastic People of the Universe;'' by a musical appreciation group known as the Jazz Section; by environmentalists, historians, philosophers and, of course, playwrights. Mr. President, 1989 was an extraordinary year--a year in which the regime sought to control everything and, in the end, could control nothing. In May, Hungary opened its borders. In June, free elections were held for parliamentary seats in Poland for the first time in decades. By August, 5,000 East Germans were fleeing to Austria through Hungary every single week. Demonstrations in East Germany continued to rise, forcing Eric Honecker to resign in October. On November 9, the Berlin Wall was breached. But while Communist leaders in other countries saw the writing on the wall, authorities in Prague continued to believe they could somehow cling to power. Ironically, the regime's repressive tactics were part of its final undoing. On November 17, 1989, significant student demonstrations were held in Prague. Human rights groups released videotapes of police and militia viciously beating the demonstrators and these tapes were rapidly and widely circulated through the underground. Shortly thereafter, VONS received credible information that a student demonstrator had been beaten to death. The alleged death so outraged Czechoslovak society that it triggered massive demonstrations. Within days, Czechoslovakia's Communist regime collapsed like a house of cards. As it turned out, no one had actually been killed during the November 17 protests; the story of the student death had been concocted by the secret police to discredit VONS but was all too believable. As concisely stated by Mary Battiata, a reporter for the Washington Post, ``. . . a half-baked secret police plan to discredit a couple of dissidents apparently boomeranged and turned a sputtering student protest into a national rebellion.'' On December 29, Vaclav Havel--who had been in prison just a few months earlier--was elected President of Czechoslovakia by the Federal Parliament. Jan Patocka once wrote, ``The real test of a man is not how well he plays the role he has invented for himself but how well he plays the role that destiny assigned to him.'' It seems that destiny had a particular role for Vaclav Havel, not one that he invented or envisioned for himself, but one that he has played with courage and grace, with dignity and honor. Today, we honor Vaclav Havel and the Charter 77 movement he helped to found.

Mr. CARDIN

Mr. CARDIN. Mr. President, in just five years, our Nation will observe the bicentennial of a defining moment in our Nation's history-- the war of 1812. Sometimes referred to as America's ``Second War of Independence,'' the War of 1812 played a critical role in shaping our national heritage and identity. To ensure that this anniversary will be commemorated properly and in a timely manner, I am today re-introducing legislation to establish the Star Spangled Banner National Historic Trail and the Star-Spangled Banner and War of 1812 Bicentennial Commission. Joining me in co-sponsoring one or more of these measures are my colleagues Senators Mikulski, Warner, Webb, Levin, and Clinton. I spoke during the 109th Congress about the significance of the War of 1812, its impact on our Nation's history and culture and the rationale for these two measures. I want to highlight some of those principal points today. The United States declared war on Britain in June 1812, after enduring years of naval blockades, trade restrictions with the European continent, and seizure of American ships and sailors in the ongoing war between Britain and France. With only a small army and practically no navy, our young Nation was ill-prepared to face Britain--then the world's preeminent naval power. By the summer of 1814 defeat seemed certain, with the British combined land and sea invasion of the Chesapeake region and the burning of the Capitol, the White House and much of the federal city. But in their attack on Baltimore, the British met stiff resistance. American patriots successfully defended Fort McHenry and the British invasion was repelled. It was during this battle that Francis Scott Key witnessed our flag flying intact, despite the continuous bombardment, and wrote the words which were to become our National Anthem. Today, many historians see the War of 1812 as the definitive end of the American Revolution--a war which preserved and strengthened our democracy, brought America to the international stage, and helped forge our national identity through the symbols of the National Anthem and the Star Spangled Banner. To commemorate the historic events associated with the War of 1812, eight years ago I joined with my predecessor, Senator Paul Sarbanes, in sponsoring legislation directing the National Park Service to conduct a study of the feasibility and desirability of designating the routes used by the British and Americans during the Chesapeake Campaign of the War of 1812 as a National Historic Trail. That study was completed in March 2004 and recommended that the proposed Star Spangled Banner National Historic Trail ``. . . be established by the Congress as a national historic trail with commemorative recreation and driving routes and water trails.'' The study found that the proposed series of land and water trails fully meet the eligibility criteria for designation as a National Historic Trail--they retain historic integrity, are nationally significant, and have significant potential for public recreational use and historic interpretation. The study recommended that the trail be managed through a partnership between the National Park Service, a trail organization and state and local authorities and concluded that the costs of implementing the proposed trail would be minimal. The study also recommended that the Congress''. . . establish a War of 1812 Bicentennial Commission to coordinate the 200th anniversary of the War of 1812.'' The two pieces of legislation I am reintroducing today would implement these two recommendations of the National Park Service. The first measure would authorize the establishment of the Star Spangled Banner National Historic Trail, an approximately 290-mile series of land and water trails tracing the story of the only combined naval and land attack on the United States and the events leading up to the writing of the Star Spangled Banner. Sites along the National Historic Trail would mark some of the most important events of the War of 1812 including battles between the British Navy and the American Chesapeake Flotilla in St. Leonard's Creek in Calvert County; the British landing at Benedict; the Battle of Bladensburg; the burning of the Nation's Capitol, White House and Washington Navy Yard; the British naval feints up the Potomac River to Alexandria and on the upper Chesapeake Bay; the Battle of North Point; and the successful American defense of Fort McHenry on September 14, 1814, which inspired the poem that became our National Anthem. The second measure would authorize the establishment of a ``Star Spangled Banner and War of 1812 Bicentennial Commission'' to plan, coordinate and facilitate programs and other efforts to commemorate the historic events associated with the War of 1812. Made up, in part, by citizens from the thirty states involved in the War, the Commission is tasked with planning, encouraging, developing, executing and coordinating programs to ensure a suitable national observance of the War of 1812. Both these measures were approved by the full Senate during the 109th Congress, but unfortunately were not acted upon by the House Committees of jurisdiction. With the bicentennial of the War of 1812 quickly approaching, it is vital that the Congress move swiftly to approve these measures and enable the proper commemoration of this important period in our nation's history. The legislation will help provide Americans and visitors alike with a better understanding and appreciation of our heritage. I ask unanimous consent that the text of the two measures I am introducing be printed in the Record.

Mr. CARDIN

Mr. CARDIN. Mr. President, in just five years, our Nation will observe the bicentennial of a defining moment in our Nation's history-- the war of 1812. Sometimes referred to as America's ``Second War of Independence,'' the War of 1812 played a critical role in shaping our national heritage and identity. To ensure that this anniversary will be commemorated properly and in a timely manner, I am today re-introducing legislation to establish the Star Spangled Banner National Historic Trail and the Star-Spangled Banner and War of 1812 Bicentennial Commission. Joining me in co-sponsoring one or more of these measures are my colleagues Senators Mikulski, Warner, Webb, Levin, and Clinton. I spoke during the 109th Congress about the significance of the War of 1812, its impact on our Nation's history and culture and the rationale for these two measures. I want to highlight some of those principal points today. The United States declared war on Britain in June 1812, after enduring years of naval blockades, trade restrictions with the European continent, and seizure of American ships and sailors in the ongoing war between Britain and France. With only a small army and practically no navy, our young Nation was ill-prepared to face Britain--then the world's preeminent naval power. By the summer of 1814 defeat seemed certain, with the British combined land and sea invasion of the Chesapeake region and the burning of the Capitol, the White House and much of the federal city. But in their attack on Baltimore, the British met stiff resistance. American patriots successfully defended Fort McHenry and the British invasion was repelled. It was during this battle that Francis Scott Key witnessed our flag flying intact, despite the continuous bombardment, and wrote the words which were to become our National Anthem. Today, many historians see the War of 1812 as the definitive end of the American Revolution--a war which preserved and strengthened our democracy, brought America to the international stage, and helped forge our national identity through the symbols of the National Anthem and the Star Spangled Banner. To commemorate the historic events associated with the War of 1812, eight years ago I joined with my predecessor, Senator Paul Sarbanes, in sponsoring legislation directing the National Park Service to conduct a study of the feasibility and desirability of designating the routes used by the British and Americans during the Chesapeake Campaign of the War of 1812 as a National Historic Trail. That study was completed in March 2004 and recommended that the proposed Star Spangled Banner National Historic Trail ``. . . be established by the Congress as a national historic trail with commemorative recreation and driving routes and water trails.'' The study found that the proposed series of land and water trails fully meet the eligibility criteria for designation as a National Historic Trail--they retain historic integrity, are nationally significant, and have significant potential for public recreational use and historic interpretation. The study recommended that the trail be managed through a partnership between the National Park Service, a trail organization and state and local authorities and concluded that the costs of implementing the proposed trail would be minimal. The study also recommended that the Congress''. . . establish a War of 1812 Bicentennial Commission to coordinate the 200th anniversary of the War of 1812.'' The two pieces of legislation I am reintroducing today would implement these two recommendations of the National Park Service. The first measure would authorize the establishment of the Star Spangled Banner National Historic Trail, an approximately 290-mile series of land and water trails tracing the story of the only combined naval and land attack on the United States and the events leading up to the writing of the Star Spangled Banner. Sites along the National Historic Trail would mark some of the most important events of the War of 1812 including battles between the British Navy and the American Chesapeake Flotilla in St. Leonard's Creek in Calvert County; the British landing at Benedict; the Battle of Bladensburg; the burning of the Nation's Capitol, White House and Washington Navy Yard; the British naval feints up the Potomac River to Alexandria and on the upper Chesapeake Bay; the Battle of North Point; and the successful American defense of Fort McHenry on September 14, 1814, which inspired the poem that became our National Anthem. The second measure would authorize the establishment of a ``Star Spangled Banner and War of 1812 Bicentennial Commission'' to plan, coordinate and facilitate programs and other efforts to commemorate the historic events associated with the War of 1812. Made up, in part, by citizens from the thirty states involved in the War, the Commission is tasked with planning, encouraging, developing, executing and coordinating programs to ensure a suitable national observance of the War of 1812. Both these measures were approved by the full Senate during the 109th Congress, but unfortunately were not acted upon by the House Committees of jurisdiction. With the bicentennial of the War of 1812 quickly approaching, it is vital that the Congress move swiftly to approve these measures and enable the proper commemoration of this important period in our nation's history. The legislation will help provide Americans and visitors alike with a better understanding and appreciation of our heritage. I ask unanimous consent that the text of the two measures I am introducing be printed in the Record.

Mr. CARDIN

Mr. CARDIN. Mr. President, I ask unanimous consent the pending amendment be set aside.

Mr. CARDIN. Mr. President, if I might, I will take a moment to describe each of these three amendments I offered to S. 4, the 9/11 Commission's recommendations bill. My staff is working with the committee staff and I am hoping these three amendments can be cleared. I think they strengthen the underlying bill. They deal with issues that are particularly of concern to the capital region, the States of Maryland, Virginia, and the Nation's Capital. My first amendment requires the Department of Homeland Security to study whether modifying and updating the national capital region boundaries would improve coordination among the State and local governments within the region, enhance regional governments and the Federal Government's ability to prevent and respond to a terrorist attack within the region, and affect the distribution of funding under the Homeland Security Grant Program. Congress created the national capital region boundaries as part of the National Capital Planning Act of 1952. We now use this definition in dealing with our homeland security. Obviously, there have been significant demographic changes since 1952. We all know if there is a problem in the Nation's Capital, it goes well beyond the immediate counties that surround the Capitol, in Virginia and Maryland, yet the national capital region is restricted to just a few counties. The purpose of this amendment is to have a study to see whether it would make sense for us to expand that region for the purposes of being better prepared to respond to emergencies. If the Department of Homeland Security determines it is appropriate to have new boundaries, we would have a chance to look at that. Those recommendations would be submitted to Congress. My second amendment is a commonsense technical amendment that corrects an oversight in the Intelligence Reform and Terrorist Prevention Act of 2004. That act contains provisions for cooperation along the national capital region's jurisdictions in the event of a regional or national emergency. As the jurisdictions began working on a mutual aid agreement authorized by the statute, a concern arose that water and wastewater utilities were not included in the original language. Therefore, if there were a problem in Montgomery County dealing with a sanitation issue, someone from Fairfax County would not be allowed to come in to help. That obviously makes no sense whatsoever. We should be able to allow the local governments to proceed with that type of arrangement. The mutual aid provisions in the 2004 law allow this type of exchange of jurisdictions between firefighters, police, and various other emergency responders. The 2004 bill also explicitly allowed for employees at WMATA and the Airports Authority to work between jurisdictions under the provisions of a mutual aid agreement. My amendment would allow water and wastewater authorities to similarly share staff resources during an emergency and under the provisions of the mutual aid agreement. The need for this amendment was brought to my attention by the Metropolitan National Council of Governments. All the water and wastewater authorities in the Greater Washington area support this amendment. My third amendment deals with a problem that is preventing the Maryland Department of Transportation and Amtrak from negotiating a new contract for MARC trains access to the Northeast corridor and operation by Amtrak. The problem stems from the repeal in the Amtrak Reform and Accountability Act of 1997 of a provision which requires the laws of the District of Columbia to govern all Amtrak contracts. The original provision was done to create uniformity. Amtrak followed longstanding industry practice of agreeing to resolve disputes by arbitration. There is an inconsistency between that provision and the laws of Maryland, if they were to apply to dispute settlement procedures. We need to clarify that provision in order to move forward with these agreements. The repeal of the DC provision created a conflict with the dispute resolution clause in Maryland procurement law that requires the Board of Contract Appeals hear all disputes applied to all procurement contracts. Amtrak will not enter into an agreement with Maryland until the State agrees to abide by the same DC law that is still accepted in all other States. Amtrak and Maryland both requested that Congress clarify that Amtrak contracts and the laws of the District of Columbia govern these contracts and leases uniformly. It is critical that Congress act swiftly to address this problem. Maryland's current contract with Amtrak expires in 16 months and therefore we need to move quickly on this issue. I have conferred with the staffs of the committees. To my understanding, we may still need some technical clarifications to the technical amendment, and if that is necessary I will seek the appropriate consent in order to adjust the amendment to meet the needs and concerns that are being raised by the committee. I am hopeful the bill managers on both sides will find these amendments acceptable. I look forward to working with them. S. 4 is a good bill. My amendments, if agreed to, will make it better for Maryland, Washington, DC and Virginia. I hope we will be able to move accordingly. I yield the floor and suggest the absence of a quorum. The clerk will call the roll.

Mr. CARDIN. I ask unanimous consent that it be in order for me to offer three amendments; that once they are reported by number, the reading be dispensed with and the amendments be set aside.

Mr. CARDIN

Mr. CARDIN. Mr. President, I ask unanimous consent to speak as in morning business for up to 10 minutes.

Mr. CARDIN. Mr. President, yesterday, the Washington Post brought to the Nation's attention the story of a young boy, Deamonte Driver, who died Sunday, February 25, at the age of 12. Our thoughts are with the Driver family. Deamonte's death, the result of a brain infection brought on by a tooth abscess, is a national tragedy. It is a tragedy because it was preventable. It is a tragedy because it happened right here in the United States, in a State which is one of the most affluent in the Nation. It happened in a State that is home to the first and one of the best dental schools in the Nation, the University of Maryland. It happened in Prince George's County, whose border is less than 6 miles from where we are standing in the United States Capitol. By now, most of my colleagues are familiar with Deamonte's story. Through a sad confluence of circumstances and events, the disjointed parts of our health care system failed this child. The Driver family, like many other families across the country, lacked dental insurance. At one point his family had Medicaid coverage, but they lost it because they had moved to a shelter and the paperwork fell through the cracks. Even when a dedicated community social worker tried to help, it took more than 20 phone calls to find a dentist who would treat him. Deamonte began to complain about headaches just 8 weeks ago, on January 11. An evaluation at Children's Hospital led beyond basic dental care to emergency brain surgery. He later experienced seizures and a second operation. Even though he received further treatment and therapy, and he appeared to be recovering, medical intervention had come too late. Deamonte passed away on Sunday, February 25. At the end, the total cost of Deamonte's treatment exceeded $250,000. That is more than 3,000 times as much as the $80 it would have cost to have a tooth extraction. It is not enough for the community and the State, and even the Senate, to mourn Deamonte's death. We must learn from this appalling failure of our broken health care system, and we must fix it. Former Surgeon General C. Everett Koop once said: ``There is no health without oral health.'' The sad story of the Driver family has brought Dr. Koop's lesson home in a painful way. Our medical researchers have discovered the important linkage between plaque and heart disease, that chewing stimulates brain cell growth, and that gum disease can signal diabetes, liver ailments, and hormone imbalances. They have learned the vital connection between oral research advanced treatments like gene therapy, which can help patients with chronic renal failure. Without real support for government insurance programs like SCHIP and Medicaid, however, all this textbook knowledge will do nothing to help our children. Here are some basic facts: According to the American Academy of Pediatric Medicine, dental decay is the most chronic childhood disease among children in the United States. It affects one in five children aged 2 to 4, half of those aged 6 to 8, and nearly three-fifths of 15- year-olds. Tooth decay is five times more common than asthma among school-aged children. Children living in poverty suffer twice as much tooth decay as middle and upper income children. Thirty-nine percent of Black children have untreated tooth decay in their permanent teeth. Eleven percent of the Nation's rural population has never visited a dentist. An estimated 25 million people live in areas that lack adequate dental care services. One year ago, the President signed into law the so-called Deficit Reduction Act. I voted against that bill. It included dangerous cuts to Medicaid that provide only short-term savings while raising health care costs and the number of uninsured in the long term. That law allows States to increase copayments by Medicaid beneficiaries for services, putting health of America's most vulnerable residents like the Drivers at risk. The new law also removes Medicaid's Early and Periodic Screening, Diagnostic, and Treatment Program guarantee, which provides children with vital care, including dental services. This became effective as of January 1. What does this mean? Before the Deficit Reduction Act, Medicaid law required all States to provide a comprehensive set of early and periodic screening and diagnostic treatment benefits to all children. Now States can offer one of four benchmark packages instead, and none of these packages include dental services. According to the Congressional Budget Office, as a result of this provision, 1.5 million children will receive less benefits by 2015. The last few years have also produced budgets that have crippled health initiatives in this country. This is the result of an agenda that does not give priority to health care, science, and education. After doubling NIH's budget in 5 years, at about a 15-percent annual growth ending in 2003, we are now looking at increases that don't even equal the rate of inflation. With flat funding in the President's NIH budget this year, we are not doing more, we are treading water. When it comes to research project grants, we are doing less. At the same time, overall appropriations for the Health Resources and Services Administration are declining. The agency's principal responsibility is to ensure that primary care health care services and qualified health professionals are available to meet the health needs of all Americans, particularly the underserved. The President's fiscal year 2008 budget cuts this program by $251 million. President Bush, once again, proposes to almost wipe out programs that educate non-nurse health professionals. This is happening at a time when more than 20 percent of our dentists are expected to retire in the next decade. The 2008 Bush proposal would also cut more than $135 million from health professions training programs. Programs that help prepare minority high school and college students for dentistry would be shut down, as would grants to help support training of primary care doctors and dentists. Scholarships for minority and disadvantaged children would be cut significantly. Dental reimbursement for programs within the Ryan White CARE Act, which help dental schools train doctors to care for HIV patients, is not increased sufficiently to meet our communities' needs. We cannot let this happen. These training programs provide critically important training and health education services to communities throughout the country, including those in my own State of Maryland. We need to do more to make the public and the administration understand that dental care must be part of a comprehensive medical approach in this country, and we need to find ways to provide dental coverage as part of health insurance plans. This comes back to a fundamental question: What should the role of the Federal Government be in these matters? We cannot end these vital health education resource programs; we must strengthen them. Deamonte's death should be a wake-up call to all of us in the 110th Congress. This year we will be called upon to make important decisions about Medicaid funding and we will be called upon to authorize the SCHIP program. We must ensure that the SCHIP reauthorization bill we send to the President for his signature includes dental coverage for our children. I call upon my colleagues, as we begin this debate in the spring, to remember Deamonte. I also ask them to remember his brother, DaShawn, who still needs dental care, and the millions of other American children who rely on public health care for their dental care needs. That is the least we can do. I urge my colleagues to give these matters the attention they need. I yield the floor.

Mr. CARDIN

Mr. CARDIN. Mr. President, I suggest the absence of a quorum.

Mr. CARDIN. I move to reconsider the vote.

Mr. CARDIN

Mr. CARDIN. Mr. President, I take this time, first, to commend the majority leader, Senator Reid, for doing everything in his power to bring up the most important issue we face as a nation, and that is the future of Iraq. I must tell you, as I travel through the State of Maryland, the citizens of my State ask: What are we doing to change the course in Iraq? What are we doing? Senator Reid has proposed a way that we can have an up-or-down vote on the most pressing issue of our time, and that is whether we are going to introduce more American troops, escalate our presence in Iraq--an up-or-down vote. The other body will be holding that vote some time tomorrow. Every Member of that body will go on record either for or against the President's proposal to escalate our presence in Iraq with additional American troops. We need to have that same vote in this body, and we should not be looking at procedural obstacles that prevent us from going on record whether we favor or oppose the President's proposals. I look at what the President is suggesting, putting additional troops in Iraq, as more of the same, not a new plan. If we learned anything at all from the elections last November, it was that the people of this Nation want to see a change in direction in Iraq. They understand our plans have not worked, that we need to look for a new direction. And yet the President is giving us more of the same. What we need to do is start by saying no to the escalation of additional troops, and then we need to look at what are the right policies in Iraq. Quite frankly, to me, we need to have the Iraqis stand up and defend their own country, with Iraqis assuming principal responsibility and American troops starting to come home. We need to engage diplomacy. We are in the middle of a civil war. We need to engage the international community to look for a political solution so that Iraqis have confidence in their own Government and Sunnis and Shiites can live together in one country. We need to engage the international community to help rebuild Iraq. They need help in the rebuilding of their country, and they certainly need the help of the international community in training Iraqis to take care of their own needs. Americans have made a significant investment in this country. We have given so much. Four years ago, I opposed the military presence of America in Iraq. I voted against it in the other body. I said at that time: I have grave concerns about the consequences of a unilateral preemptive military attack by the United States. Such a course of action could endanger our global coalition against terrorism, particularly from our moderate Arab allies. It also may increase terrorism activities around the world. Unfortunately, I was right. I remember the predictions that were made 4 years ago that this would be a relatively brief military operation, that we would be welcomed by the Iraqis, that the Iraqis would be able to take care of the security of their own country, that the standard of living for the average Iraqi would increase dramatically. Unfortunately, that has not come true. The reality of the situation is that over 3,100 American soldiers have lost their lives in Iraq. Over 20,000 American soldiers have had life-changing injuries as a result of their service in Iraq. Hundreds of billions of dollars of U.S. taxpayer money has been spent in Iraq, and terrorism is on the increase in that region, not diminished. And we are in the middle of a civil war, with sectarian violence increasing. The Iraqis, having passed their constitution, have elected their Government, and it is time for the Iraqis to take responsibility for controlling the sectarian violence in their own country. More troops will not solve the problem. More American troops will not solve the problem in Iraq. I am a member of the Foreign Relations Committee. We completed over 3 weeks of hearings concerning the current status in Iraq. We heard from military experts and foreign policy experts, generals and policy people. I must tell you, they raise serious questions as to whether we can win the war in Iraq on the battlefield. They are telling us over and over again that what we need is a surge in diplomacy, not additional American troops. We need to signal the Iraqi Government, the international community, and, most importantly, the American people that our presence in Iraq is not indefinite. More American troops will not bring about victory in Iraq. More diplomacy might. More engagement of the international community might. But more American troops will not. It is time for this body to act. It is time for us to debate the current circumstances in Iraq and the President's policy, and it is time for us to take action on the President's plan to escalate. That should be our first vote, and that is what Majority Leader Reid is attempting to do. But my colleagues on the other side of the aisle are trying to use procedural roadblocks so we cannot have an up-or-down vote on the President's plan. We should never play politics with our American troops who are in harm's way. We shouldn't be doing that. But let us have a vote up or down on the President's policy, and then we need to look at other options. The majority leader indicates that we will certainly be taking up the recommendations of the 9/11 Commission, to implement their recommendations, and we will have an open debate and the opportunity to offer amendments as to how we can bring our troops home with honor, how we can engage the international community, how we can move forward in the Middle East. That we need to do. But we first must stop the escalation of American troops, and that is the vote the other body will be having as early as tomorrow, and I hope, with the support of my colleagues, we can have that vote by Saturday. That is what we should do. I urge my colleagues to allow us to have the debate on this floor and an up-or-down vote on the President's plan to add additional American troops. Then I hope we will find some way to listen to what the experts are telling us, to listen to what the American people are telling us, that they want to see from our country a changed policy in Iraq. They want America to exercise its international leadership that only we can do. They want us to find a way to honorably bring our troops home, to energize the international community on diplomacy and on rebuilding Iraq. And they want the Iraqis to stand up and defend their own country in the midst of a civil war, and we will help end that civil war by allowing the Iraqis to take control of their own country and by energizing a diplomatic solution so that all the people in Iraq have confidence that their Government will protect their rights, and then working with the international community, helping build a type of country where the people can live in peace and prosperity. That should be our mission. But let us start by removing the procedural roadblocks. Let us start by having an up-or-down vote, as the other body will have, on whether we support or oppose the President's plans to escalate American troops.

Mr. CARDIN

Mr. CARDIN. Mr. President, the people of the Darfur region of Sudan are crying out for help during their time of despair. It is time for the U.S. Government to exercise greater international leadership and take greater strides to stave off a humanitarian disaster. Darfur has been identified as genocide and the international community is permitting it to continue. This is not acceptable. It is not enough to posture and threaten the government in Khartoum. It is time to exercise moral leadership and exercise more muscular diplomacy in an area where so little has been accomplished for so many. The conflict in Darfur has been raging for 4 years. Since 2003, the Sudanese Government and its allied Janjaweed militia have been fighting the rebel Sudanese Liberation Army--SLA, and the Justice and Equality Movement--JEM. The SLA and the JEM claimed their aim was to force the Sudanese Government to address the underdevelopment and political marginalization in the region. In response, the government and the Janjaweed targeted the region's civilian population and the ethnic groups from which the rebels draw their support. Since the fighting began, over 200,000 people have been killed. Approximately 3 million people have fled to internal displacement camps within Darfur, or to neighboring Chad and the Central African Republic--C.A.R. None of these options have shielded them from violence as the Janjaweed has patrolled outside the camps and Sudanese warplanes have attacked inside Chad and C.A.R. In the face of these horrendous conditions, an estimated 14,000 aid workers risk their lives to provide basic human services and comfort to one-third of the population in Darfur. The majority of these aid workers are Sudanese nationals who have banded together to create an unprecedented relief operation. For its part, the United States provides approximately $1 billion in food aid to the Darfur region. This contribution is one of the few positive developments for the people in Darfur as we have been able to increase the daily nutritional intake. Nonetheless, the violence rages and many aid agencies working in Darfur are unable to gain access to vast areas because of the fighting. Thus far only the African Union--AU--has responded to the call to protect civilians. Unfortunately, the AU troops have been deployed in a slow and limited manner. The Darfur region is roughly 160,000 square miles, and the AU force is far too small to cover this vast territory. The AU should be commended for shouldering the burden this long. In August 2006, the United Nations Security Council adopted Resolution 1706, to expand the mandate of the U.N. mission in Sudan-- UNIMIS--to include Darfur. The resolution ``invites the consent of the Sudanese Government'' to allow U.N. forces into Darfur and ``authorizes use of `all necessary means' to protect U.N. personnel and civilians under threat of physical violence.'' Resolution 1706 calls for a total of 27,000 armed personnel for Sudan. The breakdown includes the 7,000 AU soldiers, 17,000 U.N. blue helmets and 3,000 police officers. This is a significant mission by the United Nations and one that underscores significant international concern about Darfur. Without question, U.N. Resolution 1706 caused concern and then foot dragging by the Khartoum Government. Khartoum is wary of a robust U.N. troop presence on its soil for two reasons. First, it fears the investigators from the International Criminal Court--ICC--who will have greater latitude under a U.N. presence. Second, it fears the presence of the U.N. will force them to follow through on the oil revenue sharing agreement with the southern Sudanese. Khartoum views a U.N. presence as a surrender of sovereignty. However, what it really fears is the ICC investigators being able to gather evidence within its borders. Since the ICC accepted the responsibility of looking into genocide in Sudan, Khartoum has maneuvered mightily to keep its investigators away, out of the country. Sudan's President Omar al-Bashir has resisted the U.N. force since its inception. As he has done repeatedly throughout the Darfur crisis, he commits and later reneges on commitments and pledges of cooperation in Darfur. For this reason, former U.N. General Secretary, Kofi Annan, gave us a viable Plan A to implement the U.N. force in Sudan. Plan A implements a hybrid U.N.-AU force which the government of Sudan initially agreed to. Plan A is a workable option and a win-win for everybody. Unfortunately, President al-Bashir has back pedaled from his initial embrace of Mr. Annan's plan. On November 18, 2006, it was reported Sudan's U.N. ambassador declared ``there will be no U.N. peacekeepers in Darfur.'' The ambassador's comments came as Sudanese war planes and Sudanese- backed militias staged fresh attacks in neighboring Chad and the Central African Republic. It is imperative the United States and the international community reinvigorate diplomacy with Sudan in order to move Khartoum to reason. This is what I would describe as the administration's potential Plan B. The immediate next steps for Darfur are complex, yet achievable. These include securing a cease fire and protecting humanitarian relief corridors, establishing the hybrid U.N.-AU peacekeeping operation and advancing the political dialogue in Darfur. Additionally, President Bush and Secretary of State Condoleezza Rice must place Sudan higher on the U.S.-Chinese agenda. Sudan produces some 500,000 and 600,000 barrels of oil per day. China purchases 80 percent of this oil and invests heavily into Sudan's oil producing infrastructure. As China continues its diplomatic and economic courtship of African nations, she should be clear about how she intends to deal with despotic and authoritarian governments. The international community has worked hard over the past 20 years for greater progress on democracy and human issues in Africa. Having China thumb its nose at these accomplishments would set a bad precedent for Africa and should have consequences in the West. China should be afforded an opportunity to become part of the solution in addressing Sudan's humanitarian concerns. Diplomacy and economic leverage should be applied to Sudan with the cooperation of China. The United States has clearly shown what can be accomplished through sustained and concerted diplomatic efforts. After 21 years of fighting we were able to persuade Khartoum to negotiate with the Sudanese People's Liberation Front--SPLF. This administration was able to marshal international humanitarian support and the attention of the world to what is happening in Darfur. The United States must provide the vision and the leadership to protect innocent civilians in Darfur. I yield the floor.

Mr. CARDIN. Madam President, today I will vote in favor of the continuing resolution not because it is perfect but because it is the responsible course of action for Congress to bring some fiscal sanity back to our Federal budget. The alternative, letting Government come to a screeching halt and blocking services to millions of Americans, is unacceptable. The resolution we vote on today was drafted under the guidance of a Republican Congress and Republican President. Yet that same Congress, the 109th, refused to make difficult fiscal decisions and instead simply passed the buck to the current 110th Congress. So today we meet our constitutional responsibility to determine the Nation's budget and provide funding for programs that millions of hard-working Americans rely on to make ends meet. Perhaps most unfortunate, today we are voting for appropriating funds for fiscal year 2007 that for most agencies are the same as fiscal year 2006 levels. In addition, it concerns me that this resolution gives too much power to Federal agencies. Under the formula prescribed in this resolution, each agency seemingly has wide discretion to determine which specific programs get slashed and which receive additional funds. I fear this widespread Federal discretion could have a negative impact on programs critical to Maryland, like the Chesapeake Bay Gateways and Small Watersheds Programs, the consolidation of the FDA Headquarters at White Oak, and the Ocean City hurricane protection project, to name only a few. I encourage the agencies to do the right thing and allocate appropriate funds for programs with track records of success because Congress will be watching. Despite the shortcomings in this resolution, it does include some modest increases for important programs. In Maryland, scientists at the National Institutes of Health are on the cutting edge of unlocking some of our most complicated and devastating diseases. The additional $620 million that this resolution allocates to NIH may lead to a groundbreaking cure or vaccine. We must continue to do more to make a college education a reality for all families, and I am pleased to see that Pell grants will be expanded to help students afford college. In Maryland, the cost of receiving a public education has increased by nearly 40 percent at some State universities. A college education is key to achieving the American dream, and we must continue to make sure all children regardless of what zip code they live in or how much money their parents make have that opportunity. Although some of Maryland's environmental programs might be affected, the increased funding in the Clean Water State Revolving Fund will enable Maryland communities to continue upgrading sewage treatment plants to help cleanup the Chesapeake Bay. This is a step in the right direction. Maryland's transportation systems will also receive a much-needed boost, with an additional $86 million in highway funds and $14 million more for transit funds. Amtrak will also receive much-needed funding so it can continue to help thousands of Marylanders get to work each day. Again, this continuing resolution is far from perfect, and the circumstances under which we are passing it are far from ideal. It is unfortunate that this Congress was forced to finish the work of the prior Congress, but it is our responsibility to do so. Therefore, I support the continuing resolution and encourage my colleagues to do the same.

Mr. CARDIN. Mr. President, I ask unanimous consent that I be allowed to speak for up to 10 minutes.

Mr. CARDIN

Mr. CARDIN. Mr. President, I understand that S. 574, introduced earlier today by Senator Reid, is at the desk. I ask for its first reading.