Benjamin Cardin

Mr. CARDIN

Mr. CARDIN. Mr. Chairman, let us be truthful with our constituents as to what the circumstances are. You cannot use taxpayer money, Federal funds, to lobby. That has been the law. That is currently the law. Grantees cannot use Federal funds to lobby. What this bill does is punitive against certain groups on their rights to petition their Government: the Cancer Society in dealing with health care issues, special education groups from dealing with the needs of children, the NAACP in dealing with civil rights matters. These are groups that are impacted by this bill. We are right, the defense contractors who receive the largest amount of Federal funds are free to use their funds to lobby Government. Why should not private groups be able to use their own funds to lobby Government? That is their right. They should be able to do it. Let us not be hypocritical and say some groups are subject to these rules and others are not. Vote for the Skaggs amendment. Mr. Chairman, I rise in strong support of the Skaggs amendment. The Istook rider restricts citizens from exercising their first amendment right to petition the Government. The first amendment to our U.S. Constitution states: Congress shall make no law * * * abridging the right of the people * * * to petition the Government for a redress of grievances. Presently, there are adequate laws which guarantees that Federal dollars are not used for lobbying. Therefore, this rider is telling the citizens of the United States that they cannot use their own, non- Federal dollars as they so choose. In addition, the Istook rider is unjust. It applies to the most vulnerable in our society, the poor, the homeless, the elderly, the disabled. Many of these groups were, in fact, founded specifically to advocate on behalf of the disposed. However, the largest recipient of Federal money, Defense contractors, are not covered by this rider. Therefore, the American Red Cross could be barred from advocating for disaster relief, or the National Cancer Society could be barred from advocating for health, but Defense contractors will be free to lobby without limitation. Furthermore, this rider defines public advocacy to include public interest litigation, in which groups advocate change in public policy. Think of the civil rights suits which may not be brought because they are deemed political advocacy. For example, the NAACP receives Federal grants as defined by the rider. Most recently, the NAACP received a grant to participate in an education campaign on fair housing. However, the NAACP also argued Brown versus Board of Education before the Supreme Court, which changed our Nation's policy regarding school segregation. Mr. Chairman, the Istook rider is unconstitutional, unjust, and restricts important public advocacy. I urge my colleagues to vote ``yes'' on the Skaggs amendment.

Mr. CARDIN

Mr. CARDIN. First, Mr. Chairman, let me thank the gentleman from Maryland [Mr. Hoyer] for his leadership on the Helsinki Commission and on human rights issues. Mr. Chairman, by maintaining the status quo and not lifting the arms embargo, we are taking sides. We are taking the wrong side, on the side of the aggressor. The Serbs are clearly the aggressors in Bosnia. We have had hearings before the Helsinki Commission here in Washington that have documented the atrocities that have taken place. The numbers before the most recent aggression by the Serbs indicate over 20,000 rapes, over 151 mass graves holding up to 3,000 remains, over 200,000 deaths, 800 prison camps and detention facilities, 50,000 people tortured. The Serbs are the aggressors, the Serbs are armed, the Bosnians are not. Maintaining the status quo is taking a side; taking the wrong side. Yes, Mr. Chairman, lifting the arms embargo is uncertain. We do not know what will happen by lifting the arms embargo, but we know that by maintaining the arms embargo, the atrocities, the genocide that is currently taking place, will continue to take place. Why should we not let the Bosnians make their own decision? They should have the right to be armed. Recently, at a meeting of the Organization for Security and Cooperation in Europe, I presented a statement on behalf of the Bosnian Government. They were unable to get there, for obvious reasons. I will quote from the government statement less than one month ago. This war continues because UNPROFOR commanders have lacked the political will and the Bosnian army has lacked the means to adequately confront those that willfully defy international law and Security Council resolutions and OSCE decisions and principles in pursuit of an ethnically pure Greater Serbia acheived through genocide. You know that the Bosnian government lacks the means of confront those butchering its civilians and acquiring its territory by force because of the unjust and absurd arms embargo, which is in full contradiction to Article 51 of the U.N. Charter confirming the inherent right to self-defense. Mr. Chairman, the United States has stood up before, and many times alone on human rights issues. We stood very tall against the former Soviet Union and opposed economic sanctions against the advice of many of our allies, and the Soviet Union changed and Soviets were allowed to leave the Soviet Union. We stood tall against South Africa, when many of our allies questioned our actions. We were right and South Africa changed. On the 20th anniversary of the Helsinki Accords, let us stand up for what is right. Vote to lift the arms embargo. Mr. Chairman, I include the statement by the Delegation of the Parliament of the Republic of Bosnia and Herzegovina to the 4th OSCE Parliamentary Assembly for the Record. Statement by the Delegation of the Parliament of the Republic of Bosnia and Herzegovina to the 4th OSCE Parliamentary Assembly, Ottawa, 4-8, 1995--General Committee on Political Affairs and Security Mr. Chairman, the Delegation of the Republic of Bosnia and Herzegovina is pleased to contribute to this debate on political affairs and security our views which have been formulated after years of experience with the United Nations and OSCE security mechanisms, as manifested in UNPROFOR, NATO, as well as numerous political mechanisms, including the International Conference on the Former Yugoslavia and the Contact Group. We must impress upon you the fact that these experiences are first hand and in the most difficult and trying of circumstances. The lessons learned, or better to say, the lessons that have been offered to us, those in the security and political fields, come at the expense of more than 200,000 dead Bosnians, and perhaps at the expense of the credibility of the security and political mechanisms mentioned above. Stability and security in Europe are most threatened by the continuing war of aggression and genocide waged by Karadzic's war criminals and their sponsors in Belgrade against the Republic of Bosnia and Herzegovina and Croatia. This war continues because (1) the Karadzic terrorist Serbs still reject the Contact Group peace plan, and (2) because UNPROFOR commanders have lacked the political will and the Bosnian Army has lacked the means to adequately confront those that willfully defy international law and Security Council resolutions and OSCE decisions and principles in pursuit of an ethnically pure Greater Serbia achieved through genocide. You know that the Bosnian Government lacks the means to confront those butchering its civilians and acquiring its territory by force because of the unjust and absurd arms embargo which is in full contradiction to Article 51 of the UN Charter confirming the inherent right to self defense. You also know that the Karadzic regime continues to reject peace as its totalitarian ambitions have been fulfilled under the current status quo while its territorial ambitions have not. What may not be known to you is why UNPROFOR, despite the courage and commitment of its troops on the ground, has failed to protect Bosnia's civilians and has failed to have an impact in facilitating peace. The answer is not new, rather, it is known to many, but unfortunately ignored by those capable of making it a reality. In October 1993, Mr. Jose-Maria Mendiluce (Former Special Envoy of the UNHCR in Former Yugoslavia) stated that humanitarian efforts in Bosnia and Herzegovina ``were used as a palliative, an alibi, an excuse to cover the lack of political will to confront the reality of the war in Bosnia and Herzegovina with the necessary means (political and perhaps military) . . . generating a great deal of contradictions.'' This problem still exists today and is compounded by the UN Secretariat and some Permanent Security Council members who cling to a policy of ``conflict containment'' in Bosnia and Herzegovina--a policy that is morally corrupt and strategically absurd. In trying to justify their position, these factors have given us a public display of handwashing and rhetorical evasion. Rather than seeing action to implement the mandates, we hear invocations that the neutrality of a peacekeeping mission must not be compromised when there is no peace to keep and when the mandates were established as reactions to the transgressions of the Karadzic Serbs. As this has become more difficult to justify, the relevant factors have engaged themselves in the immoral practice of equating victim and aggressor, and towards that end, have manipulated and suppressed information. An Associated Press wire report of 25 November, 1994 entitled ``Playing Down Bihac'' illustrates: ``A United Nations spokesman. . . repeated assurances that rebel Serbs were respecting the Bihac (safe area) zone. He mentioned in passing, however, that a United Nations observation post had to be abandoned due to shell fire. Afterward, reporters with access to United Nations maps discovered the post was inside the safe zone.'' Mr. Chairman, equation of victim and aggressor, evasion of responsibility, and manipulation of information are no substitute for the rule of law, and in Bosnia and Herzegovina, the law manifests itself in UNPROFOR's mandates. And, again despite the muddying rhetoric of the UN Secretary- General and others, the mandates are clear in their permission, under Chapter VII of the UN Charter, to use force to deliver aid to populations in need and to use force to protect the safe areas and to use force to ensure compliance with the UN/NATO exclusion zones around Sarajevo and Gorazde. It is high time that the relevant factors be held accountable for their evasion of responsibility and manipulation and suppression of information. It is high time the UNPROFOR implement what my government sees as a satisfactory mandate; not just to vindicate the suffering Bosnians, but to vindicate the valiant efforts of UNPROFOR's men and women, who have been short changed by the UN Secretary-General and his representatives. Towards implementing the UNPROFOR mandates, my Government welcomes the deployment of the Rapid Reaction Force. We believe that this force has the capability and the means to help UNPROFOR bridge the gap between what is written in Security Council resolutions and what actually takes place on the ground. We also welcome the positions of those UNPROFOR troop contributing states, like the Netherlands, who have expressed that UNPROFOR's primary responsibility is to the Bosnia's civilian population. More and more UNPROFOR troop contributors hold the view that their troops must carry out their responsibilities in a robust fashion if the mandate is to be successfully implemented and if their troops are to be less vulnerable to Karadzic Serb terrorist reprisals. We believe that you, as Parliamentarians, are in a position to see this concept become reality. However, if UNPROFOR, and the Rapid Reaction Force act only as instruments that maintain the status quo, we cannot accept their continued presence in the RBH. To do so would only prolong our civilians dependence on international subsistence without addressing their protection and how to neutralize those that are responsible for their suffering. It must be remembered that UNPROFOR was deployed in BH in the absence of our inherent right to self defense. While humanitarian aid has prolonged some lives, it has failed to save others from murder and other acts of terror. Only a force with the will to protect civilians can protect civilians. In this regard, UNPROFOR has thus far failed. If the Rapid Reaction Force is unable to make amends for these shortcomings, then the Government of the Republic of Bosnia and Herzegovina must be given the opportunity, as it is legally and morally obliged to protect the civilian population. We can only succeed where others have failed if the arms embargo is lifted. To maintain this embargo under existing circumstances would be nothing less than playing accomplice to the genocidal and territorial designs of the Karadzic terrorist Serbs sponsored by the Milosovic regime. The continuation of this policy is nothing less than inviting other like-minded terrorists to pursue racist and aggressive objectives undermining peace and security in Europe and throughout the world. Thank you Mr. Chairman.

Mr. CARDIN

Mr. CARDIN. Mr. Speaker, I was privileged to serve as a member of the U.S. delegation to the recently concluded 4th annual meeting of the OSCE Parliamentary Assembly, held in Ottawa from July 4-8. Our delegation was co-chaired by Helsinki Commission ranking member, Steny H. Hoyer and Representative Michael P. Forbes, and included our colleagues, Louise M. Slaughter, Robert G. Torricelli, Ronald D. Coleman and Thomas C. Sawyer. The Parliamentary Assembly, created as a result of a United States initiative during the Bush administration, is designed to help integrate newly independent countries and emerging democracies in Central and Eastern Europe and the former Soviet Union into western- style organizations. Through the Assembly, those responsible for crafting the laws which implement civic and economic reforms in the new democracies have the opportunity to share their experiences with, and gain advice from, parliamentarians from established democracies. Participation by parliamentarians from the reforming countries was strong in Ottawa. Forty-seven of OSCE's 52 fully participating States were represented in Ottawa, as [[Page E 1538]] well as observers from Macedonia and Japan. Due to the continuing siege of Sarajevo, parliamentarians from Bosnia-Herzegovina were unable to attend. Their Ambassador to the OSCE was present, however, and at his request, I was pleased to make a statement on behalf of the people of Bosnia during the closing plenary session. Mr. Speaker, in his statement to the Assembly during the closing plenary session Mr. Hoyer reminded us that August 1, 1995 marks the 20th anniversary of the signing of the Helsinki Final Act. In that speech Mr. Hoyer recalled the words of President Gerald Ford upon the signing of the historic accord--``This document will not be measured by the promises made in the Helsinki Final Act, but by the promises kept.'' The tragic overrunning of Srebrenica and Zepa by the Bosnian Serbs, and the creation of thousands of more victims of war crimes perpetrated by the Serb aggressors is a searing reminder to all of us that there are promises to be kept. I agree wholeheartedly with my friend and colleague Steny Hoyer that we can, and must, do more. I commend to you his remarks: Statement of U.S. Representative Steny Hoyer, 4th Annual Session of the OSCE Parliamentary Assembly, July 8, 1995. President Swaelen, Officers of the Assembly, fellow delegates: In twenty-three days, on August 1, 1995, we will celebrate the 10th anniversary of the signing of the Helsinki Final Act. That date also holds significant personal interest for me because, ten years ago, as a new member of the U.S. Helsinki Commission, I attended my first OSCE meeting--a Conference on the Human Dimension--here in Ottawa. When President Gerald Ford signed the historic accord in Helsinki on behalf of the United States he said, ``This document will not be measured by the promises made in the Helsinki Final Act, but by the promises kept.'' Many signatory states viewed the words of the act dealing with human rights and the obligations that each state had toward its own citizens, as well as those of other states, as essentially meaningless window dressing. Their objective was to secure a framework in which their international political position, and the then existing map of Europe would be adjudged a fait accompli. Ten years ago, when I came to the Helsinki meeting in Ottawa, I was told by my Soviet counterparts that the discussion of the rights of Soviet citizens was inappropriate, and an interference with their internal affairs. My delegation rejected that rationale. Words, we strongly maintained, were not enough. Words are not enough today. The relevance of this organization or any international organization must be judged not solely on the merits of its principles, but on the strength of its commitment to those principles and on its unwillingness to witness or permit violation of those principles by signatory states. The Helsinki Final Act, like the United Nations Charter, was an attempt to avoid the egregious mistakes of the past which had allowed so much human suffering and carnage. A history which witnessed too often the rationalization of inaction. President George Bush, in assessing the end of the cold war and the fall of the Berlin Wall, called for a ``New World Order'' in which the international community would act in order to assure a global political environment dependent upon right not might. Today we are confronted within the Helsinki sphere by the actions of those adjudged by my government, as well as by many of yours, to be war criminals. Actions which have repeated genocide on the European continent, and created the largest number of refugees on that continent since the second world war. We have in past meetings condemned these atrocities. As parliamentarians we have urged that such actions be stopped. And many of our members have committed people and resources to relieve the suffering and stop the criminal behavior. But we have not yet succeeded. And we must, therefore, do more. I believe this organization can be an important instrument in realizing a world order based upon law and the principles of the final Act. I, and the members of my delegation, pledge to you our every effort to ensure the full participation of the United States Congress as a partner in the vital quest to ensure that history's judgement of the Parliamentary Assembly, and the OSCE, is that our words of principle were supported by our decisive and effective actions. It is said in America that many can ``talk the talk,'' but only a few are prepared to ``walk the walk.'' The tyrants and terrorists of our world are not dissuaded or intimidated by talk. But they can and must be confronted and confounded by our walk. I believe together we can see the realization of a new world order.

Mr. CARDIN

Mr. CARDIN. Mr. Speaker, we should not be timid in using trade with the United States to stand up for human rights. This Nation has stood tall, sometimes alone, for the rights of people around the world against some very strong governments. Some of the proudest moments in the history of this Nation were when we watched Soviet emigres settle in new homes around the world. We saw the destruction of the Berlin Wall, the historic elections in South Africa, knowing full well the role that we played in the United States to bring about these historic moments. Trade was a critical tool in those changes. MFN and denying it to the Soviet Union played a critical role in the actions of the Soviet Union in Eastern Europe. Trade sanctions against South Africa was a critical tool in bringing about the changes in South Africa. The current conditions in China, as it relates to respect for human rights, is outrageous. We should not be timid in taking economic action as it relates to China. It will work. China, as the Soviet Union of the pre-1990's before it, should not be granted unrestricted MFN. We should stand tall for human rights against these nations. It will work.

Mr. CARDIN

Mr. CARDIN. Mr. Speaker, I rise today to introduce the Access to Emergency Medical Services Act. This legislation would end health plans' ability to deny coverage and payment [[Page E 1418]] for appropriate emergency room visits. In addition, it would require health plans to pay emergency physicians and hospital emergency departments for federally required evaluation and screening exams. I'm sure most of you have heard stories from friends, relatives, or the press of people who received care in the emergency room, but their health plan refused to cover that care. Health plans are able to do this by claiming that the patient's diagnosis did not meet the health plan's definition of emergency. I have attached a recent New York Times article which highlights the problem. A 1992 study of Medicare's HMO claims denials conducted for the Health Care Financing Administration determined that emergency department visits were dispute prone. In fact, the study showed that 40 percent of the claims denied by Medicare HMO's were for emergency care services. The study's author concluded that this was because HCFA's definition of emergency was regulatory and placed patients in the untenable position of having to make quasi-medical judgments about the severity of their symptoms. Unfortunately, for many patients, while their symptoms may suggest that they are experiencing a medical emergency, only a qualified health professional can ultimately make that determination after an appropriate medical evaluation. The State of Maryland has put an end to many of these after-the-fact denials by establishing a uniform definition of emergency that requires payment determinations to be based upon the patient's symptoms, rather than the patients ultimate diagnosis. Virginia and Arkansas have also adopted this definition. My legislation would take this prudent layperson definition of emergency and make it the national, uniform definition. In addition, the bill would do the following: Prohibit health plans from requiring prior authorization for emergency services or requiring that the health plan have a contractual arrangement with the hospital emergency department in order for care to be provided to the plan's enrollees. Require health plans to pay emergency physicians and hospital emergency departments for services they are required by Federal law to provide. Ensure 24-hour access and timely authorization--30 minutes--from health plans for needed care for an enrollee being treated in an emergency department. Assure that health plans promote the appropriate use of 911 emergency telephone numbers and do not create barriers to their appropriate use. Apply these same standards to Medicare and Medicaid. The Access to Emergency Medical Services Act is supported by both health care providers and consumer organizations. First, I would like to thank the American College of Emergency Physicians [ACEP] who have documented the need for this reform, and worked closely with me to develop this legislation. The bill is also supported by Consumers Union, the National Association of EMS Physicians, Citizen Action, the Coalition for American Trauma Care, Public Citizen, the American Ambulance Association, the International Association of Firefighters, and the Emergency Medical Services Section of the International Association of Fire Chiefs. The Access to Emergency Medical Services Act enables those in need to be assured of access to emergency medical care. This legislation provides a reasonable definition that may be applied to emergency situations, and safeguards patients both medically and financially. It is imperative that this Congress join in bipartisan support on this issue. Access to emergency medical service is fundamental to ensuring a viable health care system. What is at stake here is not an issue of governmental regulation, but an issue of protecting patient safety. I urge you, my colleagues, to join me in supporting the Emergency Medical Services Act. [From the New York Times, July 9, 1995] H.M.O.'s Refusing Emergency Claims, Hospitals Assert--2 Missions in Conflict managed care groups insist they must limit costs--doctors are frustrated (By Robert Pear) Washington.--As enrollment in health maintenance organizations soars, hospitals across the country report that H.M.O.'s are increasingly denying claims for care provided in hospital emergency rooms. Such denials create obstacles to emergency care for H.M.O. patients and can leave them responsible for thousands of dollars in medical bills. The denials also frustrate emergency room doctors, who say the H.M.O. practices discourage patients from seeking urgently needed care. But for their part, H.M.O.'s say their costs would run out of control if they allowed patients unlimited access to hospital emergency rooms. How H.M.O.'s handle medical emergencies is an issue of immense importance, given recent trends. Enrollment in H.M.O.' doubled in the last eight years, to 51 million in 1994, partly because employers encouraged their use as a way to help control costs. In addition, Republicans and many Democrats in Congress say they want to increase the use of H.M.O.'s because they believe that such prepaid health plans will slow the growth of Medicare and Medicaid, the programs for the elderly and the poor, which serve 73 million people at a Federal cost of $267 billion this year. Under Federal law, a hospital must provide ``an appropriate medical screening examination'' to any patient who requests care in its emergency room. The hospital must also provide any treatment needed to stabilize the patient's condition. Dr. Tom A. Mitchell, director of emergency care at Tampa General Hospital in Florida, said: ``I am obligated to provide the care, but the H.M.O. is not obligated to pay for it. This is a new type of cost-shifting, a way for H.M.O.'s to shift costs to patients, physicians and hospitals.'' Most H.M.O.'s promise to cover emergency medical services, but there is no standard definition of the term. H.M.O.'s can define it narrowly and typically reserve the right to deny payment if they conclude, in retrospect, that the conditions treated were not emergencies. Hospitals say H.M.O.'s often refuse to pay for their members in such cases, even if H.M.O. doctors sent the patients to the hospital emergency rooms. Hospitals then often seek payment from the patient. Dr. Stephen G. Lynn, director of emergency medicine at St. Luke's-Roosevelt Hospital Center in Manhattan, said: ``We are getting more and more refusals by H.M.O.'s to pay for care in the emergency room. The problem is increasing as managed care becomes a more important source of reimbursement. Managed care is relatively new in New York City, but it's growing rapidly.'' H.M.O.'s emphasize regular preventive care, supervised by a doctor who coordinates all the medical services that a patient may need. The organizations try to reduce costs by redirecting patients from hospitals to less expensive sites like clinics and doctors' offices. The disputes over specific cases reflect a larger clash of missions and cultures. An H.M.O. is the ultimate form of ``managed care,'' but emergencies are, by their very nature, unexpected and therefore difficult to manage. Doctors in H.M.O.'s carefully weigh the need for expensive tests or treatments, but in an emergency room, doctors tend to do whatever they can to meet the patient's immediate needs. Each H.M.O. seems to have its own way of handling emergencies. Large plans like Kaiser Permanente provide a full range of emergency services around the clock at their own clinics and hospitals. Some H.M.O.'s have nurses to advise patients over the telephone. Some H.M.O. doctors take phone calls from patients at night. Some leave messages on phone answering machines, telling patients to go to hospital emergency rooms if they cannot wait for the doctor's offices to reopen. At the United Healthcare Corporation, which runs 21 H.M.O.'s serving 3.9 million people, ``It's up to the physician to decide how to provide 24-hour coverage,'' said Dr. Lee N. Newcomer, chief medical officer of the Minneapolis-based company. George C. Halvorson, chairman of the Group Health Association of America, a trade group for H.M.O.'s, said he was not aware of any problems with emergency care. ``This is totally alien to me,'' said Mr. Halvorson, who is also president of Health-Partners, an H.M.O. in Minneapolis. Donald B. White, a spokesman for the association, said, ``We just don't have data on emergency services and how they're handled by different H.M.O.'s.'' About 3.4 million of the nation's 37 million Medicare beneficiaries are in H.M.O.'s. Dr. Rodney C. Armstead, director of managed care at the Department of Health and Human Services, said the Government had received many complaints about access to emergency services in such plans. He recently sent letters to the 164 H.M.O's with Medicare contracts, reminding them of their obligation to provide emergency care. Alan G. Raymond, vice president of the Harvard Community Health Plan, based in Brookline, Mass., said, ``Employers are putting pressure on H.M.O.'s to reduce inappropriate use of emergency services because such care is costly and episodic and does not fit well with the coordinated care that H.M.O.'s try to provide.'' Dr. Charlotte S. Yeh, chief of emergency medicine at the New England Medical Center, a teaching hospital in Boston, said: ``H.M.O.'s are excellent at preventive care, regular routine care. But they have not been able to cope with the very unpredictable, unscheduled nature of emergency care. They often insist that their members get approval before going to a hospital emergency department. Getting prior authorization may delay care. ``In some ways, it's less frustrating for us to take care of homeless people than H.M.O. members. At least, we can do what we think is right for them, as opposed to trying to convince an H.M.O. over the phone of what's the right thing to do.'' Dr. Gary P. Young, chairman of the emergency department at Highland Hospital in Oakland, Calif., said H.M.O.'s often directed emergency room doctors to release patients or transfer them to other hospitals before it was safe to do so. ``This is happening every day,'' he said. The PruCare H.M.O. in the Dallas-Fort Worth area, run by the Prudential Insurance Company of America, promises ``rock solid [[Page E 1419]] health coverage,'' but the fine print of its members' handbook says, ``Failure to contact the primary care physician prior to emergency treatment may result in a denial of payment.'' Typically, in an H.M.O., a family doctor or an internist managing a patient's care serves as ``gatekeeper,'' authorizing the use of specialists like cardiologists and orthopedic surgeons. The H.M.O.'s send large numbers of patients to selected doctors and hospitals; in return, they receive discounts on fees. But emergencies are not limited to times and places convenient to an H.M.O.'s list of doctors and hospitals. H.M.O.'s say they charge lower premiums than traditional insurance companies because they are more efficient. But emergency room doctors say that many H.M.O.'s skimp on specialty care and rely on hospital emergency rooms to provide such services, especially at night and on weekends. Dr. David S. Davis, who works in the emergency department at North Arundel Hospital in Glen Burnie, Md., said: ``H.M.O.'s don't have to sign up enough doctors as long as they have the emergency room as a safety net. The emergency room is a backup for the H.M.O. in all it's operations.'' Under Maryland law, he noted, an H.M.O. must have a system to provide members with access to doctors at all hours, but it can meet this obligation by sending patients to hospital emergency rooms. To illustrate the problem, doctors offer this example: A 57-year-old man wakes up in the middle of the night with chest pains. A hospital affiliated with his H.M.O. is 50 minutes away, so he goes instead to a hospital just 10 blocks from his home. An emergency room doctor orders several common but expensive tests to determine if a heart attack has occurred. The essence of the emergency physician's art is the ability to identify the cause of such symptoms in a patient whom the doctor has never seen. The cause could be a heart attack. But it could also be indigestion, heartburn, stomach ulcers, anxiety, a panic attack, a pulled muscle or any of a number of other conditions. If the diagnostic examination and tests had not been performed, the hospital and the emergency room doctors could have been cited for violating Federal law. But in such situations, H.M.O.'s often refuse to pay the hospital, on the ground that the hospital had no contract with the H.M.O., the chest pain did not threaten the patient's life or the patient did not get authorization to use a hospital outside the H.M.O. network. Representative Benjamin L. Cardin, Democrat of Maryland, said he would soon introduce a bill to help solve these problems. The bill would require H.M.O.'s to pay for emergency medical services and would establish a uniform definition of emergency based on the judgment of ``a prudent lay person.'' The bill would prohibit H.M.O.'s from requiring prior authorization for emergency services. A health plan could be fined $10,000 for each violation and $1 million for a pattern of repeated violations. The American College of Emergency Physicians, which represents more than 15,000 doctors, has been urging Congress to adopt such changes and supports the legislation. When H.M.O.'s deny claims filed on behalf of Medicare beneficiaries, the patients have a right to appeal. The appeals are heard by a private consulting concern, the Network Design Group of Pittsford, N.Y., which acts as agent for the Government. The appeals total 300 to 400 a month, and David A. Richardson, president of the company, said that a surprisingly large proportion--about half of all Medicare appeals--involved disagreements over emergencies or other urgent medical problems.

Mr. CARDIN

Mr. CARDIN. I yield to the gentleman from Maryland.

Mr. CARDIN. I yield to the gentleman from Indiana.

Mr. CARDIN. Mr. Chairman, I move to strike the requisite number of words. Mr. Chairman, I rise to enter into a colloquy with the gentleman from Indiana [Mr. Myers]. Mr. Chairman, I would ask if my colleague, Wayne Gilchrest, and I might engage with you in a colloquy on the future of beneficial use projects for the disposal of dredge spoils. We are particularly interested in the Poplar Island project, planned for the Chesapeake Bay, which could provide a model for such projects throughout the Nation. As you are well aware, the Port of Baltimore is central to the Maryland, regional, and national economies. An estimated 87,000 jobs are directly or indirectly related to port activity in Maryland. In 1993 a total of 25 million tons of cargo passed through the Port of Baltimore. Over the past 2 years a total of 15 steamship lines have begun or expanded service at the port. Success in maintaining and improving ship channels will help assure the continued growth in activity at the Port of Baltimore into the 21st century and facilitate efficient international trade activity for the United States. In order to maintain shipping channels serving the Port of Baltimore at their existing authorized depths, each year approximately 4 million cubic yards of material must be dredged from the Maryland waters of the Chesapeake Bay. Any new work, such as improvement or deepening of channels, requires dredging additional amounts of material. In the past, the Port, working with the Army Corps of Engineers, has been able to meet its dredge disposal needs through careful use of overboard placement within Chesapeake Bay waters and by use of the Hart-Miller Island disposal site. Although limited overboard placement of dredged material will be continued--if and where it can be done without adversely impacting the marine environment--this option will nevertheless provide relatively little capacity. The remaining capacity of the Hart-Miller Island site is limited. Although we are in the process of developing a new containment site within the port, site constraints are such that its capacity will be relatively limited, too. In sum, in order to meet the dredging needs of the port, we must supplement these measures with other options. Working with many concerned parties, the Corps of Engineers and the State of Maryland have studied a full range of placement options. As a result, four potential beneficial use projects have been identified. Based on a consensus of various Federal, State, and local agencies, our first priority is the Poplar Island project. Poplar Island will provide additional capacity for the placement of dredge materials, while simultaneously enhancing the quality of the Chesapeake Bay. Across the Nation, many ports are facing similar constraints in finding large, new disposal sites for necessary dredging work. Unless methods are developed to allow this work to proceed, the efficiency of our ports is increasingly threatened and the costs of international trade could grow significantly. Mr. Chairman, I know that my colleague, the gentleman from Maryland [Mr. Gilchrest], joins me in this colloquy, and I would say to the chairman, if I might, that we appreciate the subcommittee's report language this year supporting the Poplar Hill projects through the use of section 204 wetlands and aquatic habitat creation funds. In this Congress we will be working with the Committee on Transportation and Infrastructure to shape a comprehensive water resource project authorization package that will include Poplar Island. Recognizing tremendous fiscal restraints facing your subcommittee, I hope we can also work with you to see that Federal resources necessary to move this project forward as a national model will be made available over the coming years.

Mr. CARDIN. Mr. Chairman, let me thank the chairman for the work of his committee.

Mr. CARDIN

Mr. CARDIN. Mr. Speaker, I thank my colleague for yielding me this time. Mr. Speaker, I support Medicare select and will vote for the conference report to extend this program to all 50 States. If it is properly structured, it can provide more competition, choice and cost savings. However I must tell my colleagues I am concerned that the study that was commissioned by HCFA shows that there might be increased costs associated with Medicare Select Programs in at least eight States which currently have the program. But what primarily concerns me: It seems like this Congress is acting or making decisions on what appears to be facts. When we look at the information we may be acting on what we believe to be correct rather than what the facts show. Congress is taking as fact that Medicare select extends managed care into the MediGap marketplace and it will save money. Yet when we look at the study, that may not be in fact the case unless the Medicare select program is properly structured. Is this a preview of what will happen when we get to the budget debate? In the near future we are going to be called upon to act on legislation to cut the Medicare program by $270 billion. Are we going to make these decisions on fact or beliefs? There are very limited ways in which we can reduce the Medicare program by $270 billion. We are going to be calling upon our beneficiaries to pay more, higher copays and deductibles, putting more pressure on the Medicare select program. We are going to be asking our seniors who already as a class pay the highest amount of out-of-pocket costs, on average 21 percent of their income is used for out-of-pocket costs. If we are going to be talking about $27 billion in Medicare cuts, we are going to be asking our seniors to pay more in copays and deductibles. Will we be acting on our beliefs or on facts? I am very concerned about that, Mr. Speaker, and concerned that we will not be looking at what impact those types of cuts will have on our seniors. I am worried that we are going to have to cut benefits. The Medicare program already does not cover prescription drugs and very little benefits for long-term care, really no catastrophic care. Yet we are going to be asked to make cuts in the program that could very well take away benefits from our seniors on the belief that that may be acceptable. I want to act upon fact. We already have inadequate reimbursement levels and cost shifting within the Medicare system, causing in many areas our seniors to be jeopardized from receiving quality care. Are we going to be asked to make additional cuts that could very well cause more cost shifting and less adequate care to our seniors on the belief that that can be absorbed? I want to act upon facts. The consequences of our actions will dramatically affect our Nation's seniors and their health care. It is imperative that we make these changes based upon the best data available, not just data that we choose to believe. I hope in the future when we act upon Medicare that we do it upon the facts.

Mr. CARDIN

Mr. CARDIN. Mr. Speaker, there are many of us who oppose this budget resolution that is before us, but support moving toward a balanced budget within 7 years. Let me remind the House of the coalition budget, which is one example that was on the floor that would have provided for a balanced budget within 7 years with less borrowing than this budget resolution provides and would do it without the draconian cuts in our Medicare system or cuts in student financial assistance. we can do that if we would only give up the tax breaks that are in the budget resolution that provide $245 billion of relief to our wealthiest people. We can have a balanced budget without jeopardizing our Medicare system and without jeopardizing our students' ability for financial assistance. We can do better. We should not put tax breaks for the wealthy ahead of a health care system for our seniors or the need for student assistance. We can do better. We should do better. Let us defeat this budget resolution; let us bring out one that would not jeopardize senior health care and our students.

Mr. CARDIN

Mr. CARDIN. Mr. Speaker, I rise in support of our flag and Constitution and against this constitutional amendment. Mr. Speaker, 2 weeks ago today, on June 14, I rose on the floor of this Chamber to lead the House in the Pledge of Allegiance to the flag. On June 14, of course, we celebrate Flag Day. It will come as no surprise to my colleagues to learn that Flag Day is observed with a great sense of history and pride at Fort McHenry, in Maryland's Third Congressional District, which I have the honor to represent. At 7 p.m. that evening, 8,000 Marylanders gathered at the fort from which Francis Scott Key watched the rockets' red glare, to participate in the Pause for the Pledge. The Pause for the Pledge is organized and directed by the National Flag Day Foundation, which is also based in Baltimore. The foundation began in 1982 to promote Flag Day. Since then, the foundation has received more than 100,000 requests from all over the United States for information on scheduling ceremonies to observe the Pause for the Pledge. This year, more than 600,000 Americans will visit Fort McHenry, seeking to learn more about the stirring events that occurred there in the War of 1812. We are here to debate the very serious issue of amending the Constitution. Since Francis Scott Key peered through the ``dawn's early light'' for a glimpse of the ``broad stripes and bright stars'', we have added only a dozen new provisions to the Constitution, and none that would compromise the Bill of Rights, as the constitutional amendment before us today would do. The overwhelming majority of my colleagues now propose that we provide a measure of constitutional protection for the flag, our most treasured national symbol. I understand their feeling for the flag, and their anger at those few misguided fools who would seek attention by desecrating it. According to the Congressional Research Service, in the past 2 years there have been three instances of individuals burning our flag. The Supreme Court has ruled, wrongly in my judgment, in a 5-to-4 decision, that State statutes aimed at criminalizing such behavior do not stand constitutional scrutiny. Considering the split opinion on the Supreme Court, we should continue to pursue statutory means of protecting our flag. By pursuing a statutory approach, we will protect both our flag and our Constitution. Today we are here debating a constitutional amendment to protect our flag. The Republican leadership has given us no opportunity to vote on a statutory approach. In thinking about whether the flag needs protection, however, I have found no need to look to the Constitution. Instead, I would encourage my colleagues to look to the American people. There they will find the flag in good hands, and well- protected. I have mentioned the events 2 weeks ago at Fort McHenry, and the work of the National Flag Day Foundation. Flag Day provides a special occasion on which Americans proudly show their colors and demonstrate their love of our country and our flag. Next week we will observe another special day for honoring the red, white, and blue. On July 4, Independence Day, millions of Americans will march in parades, attend festivals, wave the flag, watch fireworks, and gather with their neighbors and friends to celebrate our country's birth. These 2 days, Flag Day and Independence Day, provide special opportunities for honoring our country and our flag. But we do not need to look at these 2 days a year to find evidence of the American people's feeling for their flag. This past weekend, more than 180,000 fans filed into Oriole Park at Camden Yards in Baltimore. Before they settled in to watch the Red Sox and the Orioles, they joined in the tradition of singing the national anthem, ``The Star Spangled Banner.'' Every day of the school year, which ended for most Maryland children the day before Flag Day, begins with the Pledge of Allegiance. In my congressional district, nearly 100,000 school children, from kindergartners through high school, know the Pledge of Allegiance and respect the flag. Mr. Speaker, every day, in ball parks, in school classrooms, at historic sites like Fort McHenry, millions of Americans from all parts of the country and all walks of life affirm their affection for their country and their flag. I salute their patriotism. We have nothing to fear from the pathetic handful of misfits who would burn or otherwise dishonor the flag. The Constitution sets forth the freedoms we guarantee to every American. The flag symbolizes the freedoms protected in the Constitution. It has been that way for all of our Nation's history. In the minds and hearts of the overwhelming majority of Americans, the flag and the Constitution stand together. Neither needs protection from the other. Indeed, both the Constitution and the flag derive the protection they need from the American people.

Mr. CARDIN

Mr. CARDIN. Mr. Speaker, will the gentleman yield?

Mr. CARDIN. If the gentleman will continue to yield, I appreciate that. I would ask the leader if he would consider giving us some notice before that is brought to the floor and yield the customary time to the opponent of that type of a resolution in order that we can have a full debate on the floor of the House.

Mr. CARDIN. I would hope the majority leader might be able to give us some indication whether the privileged resolution that was rumored to be taken up this afternoon concerning waivers of the number of committees that a Member is permitted to serve on was going to be brought to the floor. We understand it is not being brought to the floor today. My question is: Do we anticipate a resolution will be brought up next week? If that is the case, can the leader assure us that we will have some opportunity to debate that issue? It is a major concern to many of us, the reforms of the House, as to how many committees a Member can serve on.

Mr. CARDIN

Mr. CARDIN. Mr. Speaker, I take this time, and at the permission of the Speaker, to lead the House in the pledge of allegiance at this time of the day, and let me explain why, if I might. Mr. Speaker, as you are well aware, today is Flag Day and this week is National Flag Week. Each year the National Flag Day Foundation, located in my district, participates in the Pause for the Pledge at Fort McHenry, the birthplace of the Star Spangle Banner at 7 o'clock in the evening on June 14th. The National Flag Day Foundation encourages all Americans to join in the 7 o'clock Pause for the Pledge and this grassroots concept of national unity started in Baltimore in 1980. And I might point out that Presidents have joined in this pause. Due to the voting of the House today, I am unable to be at Fort McHenry to participate in the ceremony. Therefore, I would request that the Members of the House join me and their fellow citizens in a Pause for the Pledge. If I could ask everyone to please rise and to face the flag.

Mr. CARDIN

Mr. CARDIN. Mr. Speaker, I rise today on behalf of Parkville Middle School in my district. I received a large notebook of letters and artwork from Parkville students, requesting a commemorative stamp in honor of the Parent Teacher Association [PTA]'s 100th anniversary in June 1996. Most of us have been PTA members ourselves and we know that this outstanding organization has dedicated itself to strengthening the family-school-community partnership which is essential to quality education. The PTA has an impressive record. It has been involved in working toward achieving better schools, healthier children, and stronger families for out Nation's future. Over the years, it has conducted nationwide campaigns to promote awareness on such issues as drug and alcohol abuse, protection of the environment, teacher appreciation, safety, AIDS, and the promotion of positive self-images. In 1912, the PTA sponsored the first hot-lunch programs in our schools. In 1941, it initiated a nationwide school-lunch program. The PTA is responsible for the organization of field trips, launching health information projects, and sponsoring events which create a more well-rounded, quality educational experience. I would like to read to you a couple of reasons these students want to commemorate the PTA: Also in 1976 they began a nation wide project to combat violence on television. This was needed so that children will behave in play and in class without violence. Remember, children can not vote what they want, that's what the PTA does. I remember when at my old school Villa Cresta Elementary and my big fifth grade trip was coming up, a thrilling three days at Camp Wo-Me-To. The Villa Cresta PTA paid the rent fee for each cabin so all us fifth graders only had to pay for food and activities such as rock climbing and stream study. The camp fee was able to let low income families pay for their child's trip. Do you remember when you were a kid in especially elementary school or even middle or high school when the PTA did something for your school like a Fun Fest or Fiesta? Well I do remember. I believe that the PTA should get a commemorative stamp in honor of the National PTA. My personal experience with the PTA is that in my old Elementary School, Fullerton, our PTA made a day for us kids. The day was called Fun Fest Day. I am sure that many of you have received similar letters from your constituents. I have written to the National Stamp Advisory Committee expressing my support for commemorating the PTA's 100th anniversary next year. [[Page E1199]] I encourage my colleagues to support this effort as well.

Mr. CARDIN

Mr. CARDIN. Mr. Chairman, will the gentleman yield?

Mr. CARDIN. Mr. Chairman, I wanted the gentleman to yield to compliment him on his statement and associate myself with the comments that he has made. I enjoyed my service on the CSCE with him. We had been to Yugoslavia and seen firsthand. It is interesting to point out as we are debating the issue here, the Prime Minister of Bosnia is testifying before the Helsinki Commission as to the necessity to remove the arms embargo now. By enforcing the arms embargo, we are violating international law. We must give the people the right to defend themselves. I compliment the gentleman on his statement.

Mr. CARDIN

Mr. CARDIN. Mr. Chairman, let me thank the gentleman from Utah for yielding time to me. Mr. Chairman, under the arbitrary restrictions that Republicans have imposed on discussing the most important economic document that we are going to vote on, the coalition substitute is by far the best option that we have before us. It provides more deficit reduction without the draconian cuts that are in the Republican budget. How is that accomplished? It is $188 billion actually less borrowing over the 7-year period. It is accomplished by providing earlier deficit reduction, by not giving defense a priority. The Republican budget exempts defense from any of the other cuts. That is not fair. Defense should be treated the same as any other program. And the coalition budget does deficit reduction first and does not provide for the tax breaks for the wealthy. Because of those changes, it allows us to restore $163 billion of the Republican cuts in Medicare and Medicaid, which is desperately needed in order not to reduce the quality of care that our seniors are receiving. It allows us to restore the student loan cuts that the Republicans are suggesting to make it more difficult for students to be able to attend college. This budget removes that cut and restores those funds. It provides more realistic caps on domestic spending so that we can argue Republicans on environmental clean up or commuter rail. We had the opportunity to restore those cuts. Mr. Chairman, there is a clear choice before us. You have a choice to do deficit reduction first before tax breaks for the wealthy. You can do that if you vote for the coalition budget. I urge my colleagues to do that. Mr. Chairman, the annual debate we hold in this Chamber on the budget resolution is the most important statement we make on the role of the Federal Government in the kind of country we want to live in. Given the importance of this debate, it is vital that we have a full range of options to consider. We should present to the American people a broad discussion of each aspect of the budget. The overriding issue, of course, is the direction of fiscal policy we will take. We have strong agreement in this body that the most single important challenge we face remains the need to reduce the Federal budget deficit. We have less agreement on the best set of policies to achieve that goal. We disagree on the mix of spending cuts that should be enacted to reduce the deficit. We disagree on the wisdom of cutting taxes before we have even brought the deficit under control. The point of reducing the deficit is to strengthen the economy. The decision of whether to reduce the deficit by $500 billion, or $700 billion, or $1 trillion over the next 7 years should be driven by what's best for the economy. It should also be driven by consideration of the value of the government programs that will be cut. Unfortunately, the Republican leadership of the House has denied the American people the debate they deserve. The people who promised an open house have made sure that we would not have a full and open debate on this crucial issue. Instead, they set up an arbitrary requirement. They said that it is not enough to propose a budget that dramatically reduces the deficit. They said the magic test is to balance the budget in 7 years or less, using their standards. The Republicans have brought the budget resolution to the floor under a gag rule designed to prevent either substitutes or amendments that do not comply with their narrow notion of sound fiscal policy. By shutting off debate and preventing responsible alternatives, they have denied a debate on the priorities that would reflect the interests of my constituents. The Republican leadership has set up artificial and short-sighted constraints to prevent a full and open debate on budget policy. But within those ideologically driven and extreme limits, one budget proposal has the promise of preserving America's priorities. The coalition budget meets all the requirements. It balances the budget in 7 years. In fact, over the period, it has dramatically lower deficits than the Republican committee budget. Let me emphasize that point. The coalition budget would borrow $188 billion less over the 7-year period than the Republican budget. To those of us who are concerned about excess borrowing and the soaring expense of interest of the debt, the coalition budget is far superior to the Kasich budget. It will save billions of dollars in interest costs. In addition to lower deficits, the coalition budget also gets to a balanced budget without inflicting the harsh damage on important priorities the American people care about. The American people understand the need to make sharp spending reductions to reduce the deficit. But they do not understand making those cuts any deeper or more damaging than is absolutely necessary to achieve the goal. The Republican committee budget cuts Medicare and Medicaid by $475 billion over 7 years. They have tried to justify this draconian plan by saying they are rescuing Medicare. I will work to rescue the Medicare trust fund. But we should do that work in the context of health care reform. This budget will force Medicare recipients to pay more for less. It does so not in the interest of improving or reforming health care for the elderly or anybody else, but to balance the budget and offset $360 billion in tax cuts. The coalition budget substitute will restore $163 billion of the cuts that the committee budget would make in Medicare and Medicaid. The coalition budget refuses to balance the budget on the backs of the elderly and the sick, and it says no to tax breaks until we have brought the deficit under control. When we set priorities to try to ensure our country's economic prosperity, nothing looms larger than the imperative of providing higher education to our young people. Yet the Republican committee budget will cut guaranteed student loans by nearly $19 billion. The coalition preserves full funding for guaranteed student loans, proving that we can balance the budget without turning back on young Americans trying to afford a college education. Another area where the coalition budget is far preferable to the Republican committee plan is in the preservation of valuable domestic priorities. The Republican committee budget will force drastic reductions in high priority programs like mass transit assistance, water treatment, women and children's health care, and the National Institutes of Health research, just to mention a few. When the American people say they want us to get spending under control and eliminate wasteful spending, these are not the types of programs they have in mind. They know better, and the coalition budget will permit us to fund these priorities. Finally, the chairman of the Budget Committee has said that he is especially proud that his budget leaves no aspect of the budget untouched. But under the committee budget, one area of Federal spending escapes the budget axe. Over 7 years, the plan will increase military spending by $76 billion. At a time when every other area of the budget is facing severe restraint, when children and the elderly and students are facing significant cuts in services, we cannot afford to increase spending on defense. For all these reasons, in my judgment, the coalition budget is much the best of a poor set of choices. It is far superior to the Republican committee budget, for all the reasons I have mentioned and many more. Under the arbitrary and unfair ground rules that have controlled this debate, the priorities of my constituents have not been given fair consideration. But the coalition budget comes closest to achieving the goals that are important to my district and to the country, and I will vote for it as a substitute to the badly flawed Republican budget.

Mr. CARDIN

Mr. CARDIN. Mr. Chairman, reclaiming my time, I thank the gentleman for his comments. He is absolutely correct. The nutrients are acting as a suffocation to aquatic life. Non-point pollution is the cause. Education is important. The substitute moves us in that direction to control the issues. The underlying bill would prevent the actions. I appreciate the comments made by the gentleman on this.

Mr. CARDIN. Mr. Chairman, I move to strike the requisite number of words. Mr. Chairman, I rise in support of the Saxton-Boehlert-Roemer substitute amendment. It is far preferable to the underlying bill that has been brought to the floor. Let me comment for a moment, if I might, about the efforts we have made in Maryland in regard to the Chesapeake Bay. This is an effort that has been undertaken now for over 15 years in which the people of Maryland have made a tremendous sacrifice in order to reclaim the quality of the water of the Chesapeake Bay. This has not just been an effort by the people of Maryland. It has been a cooperative effort between the people of Maryland, Pennsylvania, Virginia, the Nation's Capital. It has been an effort between the private sector and the Government working together in order to deal with some very serious pollution problems within the Bay. It has been a model program. Mr. Chairman, we have seen this partnership has worked through some very tough changes in the manner in which we deal with water quality, including land use management, and fishing restrictions and other policies that we have undertaken in order to deal with the Chesapeake Bay, and it has been successful. The underlying bill would be a major step backward on the quality of the Chesapeake Bay. Let me mention 3 significant differences between the underlying bill and the substitute that is before us. First, as it relates to the wetlands protection, the surge of nutrients into the Bay acts as a strangling of the oxygen that is important for the fish life, for the waterfowl, for oysters, crabs, and I could go on. The quality of what we know on the Chesapeake Bay, whether it is for commercial or recreational purposes, is contingent upon us being able to control the level of nutrient in the Bay. That is why under the Bay Agreement we have a commitment to reduce the levels of nutrients by 40 percent by the year 2000. The wetlands operate as a filtering system to remove nutrients and sediment from the Bay. Between 1982 and 1989, in the States of Maryland, Virginia, and Pennsylvania, we lost 37,000 acres of wetlands. That is equivalent to the size of the District of Columbia. The substitute uses the standards helped developed by the National Governors' Association in order to put sensible restrictions on wetlands to protect wetlands. The underlying bill would literally allow the destruction of thousands, tens of thousands of acres of wetlands in our region and around the Nation. A second reason why the substitute is far preferable is the pollution from storm water systems. We have a lot of old urban sewage systems in our State. During heavy storms, pollution, raw sewage, will just literally flow into the tributaries that lead into the Chesapeake Bay. The substitute that is before us offers some hope that we can deal with this issue. The underlying bill does nothing at all to protect us from the problems of storm water pollution. Let me mention a third issue why the substitute is far preferable than the underlying bill, and that is the coastal zone non-pointed source runoff controls. Again, we are dealing with the nutrient level that I mentioned before. The underlying bill will allow the nutrients to continue, which act as a suffocation to the oxygen necessary for aquatic life. The substitute provides protection in this area, again allowing us to deal with the unacceptable level of nutrients that are flowing into the Chesapeake Bay and other waters. Mr. Chairman, the bottom line is this: We have invested an awful lot in cleaning up the Chesapeake Bay in this region. We have put a lot of time, effort, and resources, both governmental and private sector. We have a choice in a few moments whether we are going to move forward in partnership with our States and with our local governments and with the private sector to help clean up the Chesapeake Bay, or whether we are going to move backwards. The Federal Government has been a partner in this effort, a very proud partner in this effort, in helping the region deal with the Chesapeake Bay, which has been a model of a multi-jurisdictional body of water in dealing with pollution. It has acted as a model. I hope the Congress, I hope my colleagues, will continue that fine tradition. Vote for the substitute, vote against the underlying bill. Let us continue that partnership and allow the people of our region to continue their efforts to reclaim one of the most important assets that we have, the Chesapeake Bay.

Mr. CARDIN. I yield to the gentleman from New Jersey.

Mr. CARDIN

Mr. CARDIN. Mr. Speaker, I rise today and join my distinguished colleagues in commemorating the tragedy of the Armenian genocide. During and after the First World War, from 1915 to 1923, over 1.5 million Armenians were deliberately starved, murdered, and drive from their homeland by the Ottoman Turks. It was the first modern example of the gruesome policy of ethnic cleansing. Unfortunately, it was not the last. Since 1923, genocide has frequently become the policy of choice for totalitarian governments and aggressor states. From Adolf Hitler to the Bosnian Serbs, ethnic cleansing has been used by a variety of tyrants. The victims of this horrible act have been as widely different as German Jews, Ukrainian farmers, and Rwandan Tutsis. History has repeated itself time and again. History threatens to repeat itself today. Across the globe, minorities like the Bosnian Muslims are threatened with extinction. As members of the free world, we must not allow these murderous intentions to succeed. We must stand up and tell those who wish to murder whole nations that we will not permit them to follow this gory tradition. It is a tradition that must end now. Mr. Speaker, the world must act now to stop any further repetitions of the Armenian genocide. We cannot allow any other ethnic minorities to be slaughtered as the Armenians were slaughtered. To permit another example of the horrible practice of ethnic cleansing would be to dishonor the memories of those who died at the hands of the Ottoman Turks.

Mr. CARDIN

Mr. CARDIN. Mr. Chairman, looking at the tax bill we have before us today, I can't help feeling a bit like the proverbial kid in a candy store. The store is full of tempting goodies. But there are two problems. The ``goodies'' aren't good for me, and I can't afford them. The bill is loaded wall-to-wall with goodies. It provides a fifty percent exclusion for capital gains. It greatly expands eligibility for Individual Retirement Accounts. It offers needed relief from the alternative minimum tax for corporations trapped in a way never intended when the AMT was designed. In each of these areas, however, the bill's approach is seriously flawed. The capital gains exclusion will help unlock assets and encourage new investment, especially in venture capital enterprises. But the bill also provides indexing of capital gains, which raises serious complexity problems, and, because the bill indexes only gains and not debt, raises the danger of new tax shelter activities. The IRA proposal in the bill is designed to limit the revenue losses in the first five years--the so-called budget ``window.'' That concern has led to a proposal for ``back-loaded'' IRAs. Under traditional IRAs, taxpayers can deduct a contribution, then have earnings accrue on a tax-deferred basis until the funds are withdrawn at retirement. The American Dream Savings Account invites taxpayers to make non- deductible contributions. That feature may restrict the attractiveness of the proposal. The incentive to contribute to an ADSA IRA is that the initial, after-tax contributions, plus all earnings, accrue tax free forever. The bill also provides relief to corporations beset by the alternative minimum tax. I strongly support AMT relief for capital intensive corporations. That's why I have introduced H.R. 1092, which would eliminate the depreciation preference from the AMT. Under the regular tax system, we provide accelerated depreciation to encourage companies to modernize and invest in new plant and equipment. Then, under the AMT, we turn around and punish them for acting on the incentive we have provided. It makes no sense. The problem with this bill is that it goes beyond providing sensible, moderate AMT relief, and completely repeals the corporate AMT. to the days when profitable corporations could completely escape taxation. One proposal in the bill is so atrocious it requires special mention. The so-called ``neutral cost recovery system'' is a potentially disastrous idea masquerading as a simple, fair investment incentive. NCRS, or ``nickers'', as it is known, aims to help solve a real problem for American business. But it is plainly the wrong answer to the right question. The question is, ``What can we do to make the depreciation rules more simple and more favorable to investment?'' The answer provided by NCRS is to add complexity, make depreciation a multiple choice game, raise the prospect of tax shelter activities, and try to hide $120 billion in lost revenues by pushing it outside the budget window. Other provisions in the bill pursue worthwhile goals. For instance, the bill correctly identifies the ``marriage penalty'' as a problem for many American families. Yet the solution it proposes would require these families to plow through a complex set of instructions and calculations, only, at the end, to qualify for a maximum of $145 in relief. The centerpiece of the plan is the proposal to provide tax relief to beleaguered American families through a child credit. But characteristically, the bill goes too far. The bill's sponsors make the case that middle class families making thirty to fifty thousand dollars a year are hard-pressed and deserve relief. But that argument cannot be made with the same force to apply to families making $150,000 to $200,000 a year. Yet they will enjoy the full benefit of this child tax credit. The point here is not that upper income Americans should be punished for their success. The point is that the problem with this entire bill, and the reason we should defeat it, is that we simply can't afford it. Mr. Chairman, the national debt of the United States is fast approaching five trillion dollars. We continue to add two hundred billion dollars a year to that total. This Congress has talked a strong game on deficit reduction. We have talked about amending the constitution. We have talked about making the hard choices. Today, though, we are not making hard choices. We are making easy choices. We have before us a bill that provides specific tax cuts. $630 billion worth, over the next ten years, of very specific tax cuts. Every American knows about the $500 child credit. Every business knows about the AMT relief. Every investor knows about the capital gains exclusion. We have been specific in making the easy choices. But when it comes to spending cuts, we have not been specific. We have passed a package of rescissions. $12 billion dollars. We have passed a welfare reform bill that would, if enacted, cut spending by $62 billion over five years. We have in this package today Medicare savings and reforms of the pension plans for federal employes, Members of the House, and our staff, that will save, combined, $21 billion over five years. The total spending cuts--specific, identified spending cuts--included in this package will save $87 billion over five years. Add in the $12 billion saved in the rescission, and you have $99 billion. That amount is slightly more than half the $189 billion cost of the tax cuts. Where is the rest of it? It comes in the form of a promise. The sponsors of the bill promise they will save the rest of the money by lowering the caps on discretionary spending. They have issued an ``illustrative list'' of spending cuts. But we have no specific cuts. We can tell the American people what taxes we are cutting, and how much of their money we are giving back. We know how much federal revenue we will give up in the process. But when the American people say, ``Thank you very much for the tax cut. But I thought the government was deep in debt. How can you afford to cut taxes?,'' this bill answers ``Don't worry, we'll tell you later.'' Mr. Chairman, that is not good enough. To balance the federal budget will require $1.2 trillion in savings over the next seven years. This bill takes a giant step backwards in achieving that goal. It would add $630 billion in red ink over the next decade. Let's make this clear--we need deficit reduction now--first. If, after we have cut spending and reduced the deficit to the point where it no longer acts as a drag on the economy, then we can talk about further spending cuts to provide tax relief. But the spending cuts have to be specific, not just promises. That's the reason I will vote no on this legislation.