Thomas Coburn

Mr. COBURN

Mr. COBURN. Mr. Speaker, I would just say that I agree with the gentleman from Minnesota (Mr. Minge), that there should not be the first tax cut until we have secured our children and the seniors in this country and what has been promised to them. But there also should not be the first penny left in Washington for us to spend that does not go towards those two goals. So, I will agree with the gentleman and he will find my vote lining right up there. But that does not say that we should not do the right thing now. Because somebody else is going to do the wrong thing does not mean that we should follow them down that road. Mr. Speaker, we should, without a doubt, pay for any supplemental spending to help our farmers and ranchers.

Mr. COBURN

Mr. COBURN. Mr. Speaker, for over fifty years, health authorities have used partner notification programs to stem the spread of contagious diseases. Such an approach helps to identify those at risk, provide them with counseling and testing as well as treatment, if necessary, thereby breaking the cycle of transmission. During the first years of the AIDS epidemic, however, partner notification programs were suspended and replaced with extraordinary privacy protections in the hope that such an approach would encourage high risk individuals to come forward and be voluntarily tested. Because of this decision, if you have been unknowingly exposed to HIV, the deadly virus which causes AIDS, you have no right to know that your life may be in danger--even if public health authorities know that you are in danger. While every state is required to have a procedure to notify those who may have been exposed, only 30 states have enacted HIV notification laws, and most do not mandate a duty to notify. Because of this inconsistency, most of those exposed to HIV do not find out until they have been infected for some time and are already sick with AIDS-related disease. By this point, they have been denied the medical care that can prolong their lives and stave off illness and may have infected others unknowingly. Due to this abhorrent policy, it is not shocking that nearly 400,000 Americans have died from AIDS in the short period since the disease was discovered in 1981 and another one million Americans are believed to be infected with HIV today. And despite billions of dollars spent on prevention and research, more than 40,000 new infections are estimated to occur each year in the United States and no cure or vaccine appear to be on the horizon. We do, however, know enough about the virus to prevent its spread, but the response of the federal government and the public health community has contributed to the growth of the epidemic. From its onset, proven public health practices which have been successful in helping to curtail other contagious diseases were abandoned in our efforts against HIV. Due to the unfair stigmas associated with the populations most at risk, it was decided that HIV would be treated as a civil rights issue instead of a public health crisis. As a result, our response has been based almost exclusively on the rights of those infected to the detriment of the uninfected. But times have changed. Women and communities of color are now the fastest growing casualties of HIV. New drug therapies have been developed that offer hope for many of those who are infected to lead longer and healthier lives, especially when they are diagnosed early. And federal, state and local laws, including the Americans With Disabilities Act have been enacted to protect the civil rights of the afflicted. Due to these changes, many who initially opposed public health measures such as partner notification have now reconsidered. Just this year, the New York Assembly overwhelming passed legislation, which is now state law, which would mandate notification of those who may have been exposed to HIV. Even civil libertarians such as Senator Ted Kennedy have advocated partner notification. In 1990, Senator Kennedy, stating that ``there is a duty to warn,'' proposed HIV partner notification legislation which was approved by the Senate. The HIV Partner Protection Act gives Congress another opportunity to enact this important procedure which would alert those at risk and save lives. This bill introduced by Rep. Gary Ackerman (D-NY) would guarantee that everyone who is diagnosed with HIV receives appropriate counseling for preventing infecting others and information regarding treatment to protect their own health. It would also protect those who seek HIV testing by forbidding insurance companies from discriminating against anyone who receives a test for HIV, regardless of the results. But most importantly, the HIV Partner Protection Act would require that anyone who may have been exposed to HIV by a past or present partner be notified. Partner notification is extremely important to disease control because it is the only timely way to alert those in danger of infection. It is the standard public health procedure for curtailing the spread of virtually all other sexually transmitted diseases and has been credited in part for the fact that syphilis cases in the U.S. have fallen to the lowest levels in U.S. history. Partner notification essentially requires two steps. The first is to counsel all infected individuals about the importance of notifying their partner or partners that they may have been exposed. The second is for their doctor to forward the names of any partners named by the infected person to the Department of Health where specially trained public health professionals complete the notification. In all cases, the privacy of the infected is--and must be--protected by withholding the name of the infected person from the partner being notified. Because names are never revealed, the infected retain their anonymity. Partner notification has proven to be highly effective and there is no evidence that partner notification programs discourage individuals from being tested. Between 50% and 90% of those who tested positive cooperate voluntarily with notification. Further, even higher proportions of those partners contacted--usually 90% or more voluntarily obtain an HIV test.\1\ But only 10% or less of people who have recently tested HIV-positive manage, by themselves, to notify their partners.\2\ Federal law already requires spousal notification (Public Law 104- 146). Since it applies only to those partners who are or had been married, it makes perfect sense to expand notification to all of those who may have been exposed to HIV. Partner notification is especially important for women because many HIV-infected women (50% to 70% is some studies) do not engage in high risk behaviors but were infected by a partner who does.\3\ Recent studies also indicate that AIDS develops more quickly in women who would therefore benefit from being alerted to their condition as early as possible. In addition to saving lives, partner notification also saves money. The Centers for Disease Control and Prevention (CDC) has concluded that even if only one in 80 notifications results in preventing a new case of HIV-infection, given the huge medical and social costs of every case (liftime cost for HIV treatment is $154,402), notification pays for itself.\4\ Jack Wroten, who heads the Florida partner notification program, said that ``I would hope that the controversy surrounding partner notification would cease'' because ``it works'' and ``it's very, very productive. And the fact is that the majority [of people], if you ask them, `Do you want to be notified?'--absolutely.'' \5\ A poll published in the New York Post \6\ supports his statement with an overwhelming number of Americans stating that the rights of partners of those infected with HIV should outweigh the privacy rights of the infected. Clearly, this important piece of legislation is long overdue. Every day we put off enacting this life saving policy, HIV will continue to claim more innocent victims whom could have been saved.

Mr. COBURN

Mr. COBURN. Mr. Chairman, let me reclaim my time, if I may, and tell the gentleman that I am sorry, I did not mean to mistake, in what I said, about the gentleman's intention. What I think we need to be focusing on is we need to solve the drug problem. That is the real issue. Washington has this wonderful habit of fixing the wrong problems. The problem is drug addiction. It is not clean needles, it is not dirty needles, it is not HIV. It is drug addiction. We need to not confuse what the two issues are. There is no question in the D.C. drug program that they left 45,000 needles out there last year that they did not re-collect. So 45,000 more needles are out there than were there at the beginning of the year previously, that are contaminated, that are dirty needles. So I would want this body to know, we should not enable failure on drug addicts. And we should make sure we know that the issue is drug addiction and not enabling drug addiction. And that, in fact, clean needle studies, the only two reputable studies that have, in fact, been done that are cohort prospective longitudinal studies, that have the exact same people at the end of the study as they had at the beginning of the study, are the studies in Montreal and Vancouver, and they show increased HIV.

Mr. COBURN. I yield to the gentleman from California.

Mr. COBURN. Mr. Chairman, I move to strike the requisite number of words. Mr. Chairman, I could not help hearing the numbers floated around by the studies. I dare to say that nobody in this body besides myself have actually read the studies on this; have actually read the scientific studies. There have been two long-term prospective studies on this issue. And it is not about whether we feel it does something good, it is about whether scientifically it does. There have only been two studies done in North America that are long-term, large quantity studies in which the people who are studied at the end of the study are the same people who were studied at the beginning of the study. Those two studies are Montreal and Vancouver. They are the only two studies in the world that are prospective, long-term, large quantity studies that have the same patients in them at the end of the study as they had at the beginning. All the other studies, that is not true. They have a different set of people in them. And both those studies, the only two studies that are truly reputable under scientific standards that I have read, and I dare to say nobody else in this body has read, show without a doubt that needle exchanges increase HIV infection. They do not decrease it.

Mr. COBURN. Mr. Chairman, I am happy to have this time to address this issue, and I would want the people who are proposing this amendment to know that there is no disrespect for me in their position and their thought on this. We just happen to differ a great deal on this issue. I want to clarify something first. I want to read the U.S. Constitution to my colleagues. It says the Congress is to exercise exclusive legislation in all cases whatsoever over the seat of the government of the United States. It is absolute. It is unequivocal. The gentlewoman from the District, in her opening comments, said that the real test of a democracy is whether or not we will allow someone to make a choice that we would not make. Well, I disagree with that statement. I think the real test of a democracy is whether or not it will stick with the moral base under which it was founded. Abortion is a moral question. I understand what the Supreme Court has said. What the Supreme Court has said is wrong. It is wrong morally, it will always be held wrong morally. We heard the gentlewoman from Oregon talking about this issue, and I know she made a mistake when she said it, but she said children in utero. And that is exactly what they are. The Supreme Court, when they ruled in Roe v. Wade, they said they did not know when life began. But we do know, and we can now prove the presence of life. And we never get an answer to this question. In our country we define death as the absence of brain waves and the absence of a heartbeat. That is in all 50 States, all Territories and the District of Columbia. Scientifically it is proven that at 19 days post conception there is a heartbeat. We can measure it. We can see it. At 41 days post conception we can measure the brain waves of our unborn children. Most women do not know they are pregnant when those two events have occurred. So we really are faced with a choice. Is our definition of death wrong, and are we not dead when we do not have a heartbeat or brain waves? Or are we not alive if we do have a heartbeat and brain waves? The reason we are in this quagmire is because we have not addressed what abortion really is. Abortion is the making of one moral error because we have previously made a moral error. Now, I know the people who believe in choice do not agree with that. And I respect that. But if we are going to continue to have the foundation of our society that is based on moral truth, we cannot disregard the fact that we can measure life. I personally believe life begins at the moment that a sperm and an egg unite. I cannot prove it yet. Some day we will prove that and we will show that to the Supreme Court, and Roe v. Wade then will be meaningless. In the meantime, we should do everything we can to protect the lives of those children in utero, as the gentlewoman from Oregon so rightly mentioned. We take great pains today to repair unborn babies. We spend great amounts of our money saving lives in utero, operating on children while they are still in their mother's womb. How do I know this? Because I have been involved in it. I have delivered over 3,500 babies. I have seen every complication and I have seen the way we sometimes handle those complications by choosing death of the baby instead of what life is there. It is not a lack of sensitivity on the part of the ``Republicans'' and the ``pro-life Democrats.'' It is a sensitivity to the very moral foundation under which our documents of democracy and our Republic were founded. As we abandon those moral principles, we abandon democracy. I would urge my colleagues to vote down this amendment.

Mr. COBURN

Mr. COBURN. I yield to the gentleman from New Hampshire.

Mr. COBURN. Mr. Chairman, reclaiming my time, I probably do not have an explanation other than to say that there are no clean hands when it comes to soft money, not on either side.

Mr. COBURN. I yield to the gentlewoman from Michigan.

Mr. COBURN. Mr. Chairman, I move to strike the last word. Mr. Chairman, I rise in strong support of the Bass amendment. I want to take this in a little bit different direction. Last night this House voted to support the Shays-Meehan amendment to eliminate soft money contributions. I thought it would be interesting for us to look at the grantees from the ATP program and their soft money contributions, because there happens to be a very good correlation. So if we really believe in corporate welfare, then we are going to not support the Bass amendment; but if we do not believe in corporate welfare, if we truly recognize that over 60 percent of the money in ATP grants goes to non-small business but goes to Fortune 500 companies, then in fact we can support this amendment. Let me relate some of the details. IBM has been mentioned. Since 1990 it has received $134 million in taxpayer grants, including over $15,000 last year. In the same period, IBM had $6 billion in profits last year. They spent well over $5 million of this money on research and development. IBM was one of the top soft money givers. General Motors, since 1990, received $105 million in taxpayer funds for research and development. GM had profits of $6.8 billion last year. General Motors also was in the top 100. General Motors did slightly better with relationship to ATP than Ford or Chrysler. Over the same period of time, GM received $105 million, Ford only $68 million, Chrysler a pittance of $30 million. But it was General Motors, and not Ford or Chrysler, who made the list of top 100 soft money contributors. General Electric, over the 1995 election cycle, gave over $1 million in soft money but received $11 million in ATP program money. AT&T, which over the same election period contributed $2.7 million in soft money to our two political parties, has received $69 million in ATP funds. What I would like this body to consider, if we really do not believe in soft money and we really do not see a connection between ATP grants and soft money, and we really want to get rid of soft money, we ought to get rid of one of the reasons that soft money is there. It is the corporate welfare that we see. Let me just mention a few more. Sun Microsystems had a net profit last year of $762 million; received over $50 million in ATP grants over the last 7 years. United Technologies had over $1 billion profit. They received over $4 million in grants in 1995. 3-M, $1.626 billion in profits. They received almost $2 million in grants. I think what we need to do is be honest with the American public. There is a place for ATP. It is to small business and small entrepreneur business, not the Fortune 500 companies who are well endowed with their own profits and can afford their own research.

Mr. COBURN. Mr. Chairman, my question would be, that may very well be true. Why are we increasing overhead 19 percent? The point is, we are disproportionately increasing overhead. Let us agree to trim the overhead down and give the money to the communities rather than consume it in Washington.

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

Mr. COBURN. Mr. Chairman, Washington, D.C. saves between $4,000 and $9,000 per participant; Bartow, Florida, saves $531,000; Gainesville, $200,000; Kalamazoo, Michigan, $300,000; Klamath Falls, Oregon, $86,000; Beaumont, Texas, saves half a million dollars annually because of drug courts. This is not about cutting the EDA. It is about limiting its growth and prioritizing our resources into something that makes a difference in the lives of people. Mr. Chairman, I include for the Record the letter from Mr. Swindle. The letter referred to is as follows: August 3, 1998. Representative Tom Colburn, House of Representatives, Washington, DC. Dear Representative Coburn: As President Reagan's Assistant Secretary of Commerce for Economic Development from 1985- 1989, I strongly support your amendment to the FY 1999 Commerce, Justice, State Appropriations Bill that will cut $25 million from the Economic Development Administration (EDA). EDA is one of those examples of a dedicated group of federal employees being trapped in a bad system and being manipulated by political decision-making, which too often has ignored the legal basis and criteria for the agency's existence and operation. A small example... As you know, EDA was created in 1965 as part of President Johnson's Great Society. Its original aim was to assist in the economic development of depressed areas and encourage job creation (in theory) through government loans and grants. Of course, the funds given to one region has to be taken from another. A program was established to fund small regions of the country (in cities or groups counties) as ``economic development districts.'' These areas, buy definition being under severe economic distress (high unemployment, underemployment, job losses, low average income, etc.,) would receive funding to assist in hiring staff to work on economic development planning with local communities. One aspect of the staffing assistance was that frequently the staff became an advocate for more federal funding, not an uncommon phenomena within EDA programs where federal funds directly or indirectly go toward lobbying for more federal funds. I believe it was Will Rogers who once commented that all government programs have three things in common: a beginning , a middle and no end. For years now, EDA has apparently considered the vast majority of the continental United States (maybe as high as 90%) to be under severe economic distress-- even today in what is widely proclaimed as the period of our greatest prosperity. Funded ``economic development districts'' continue to cover the map! I can speak from personal knowledge on the belief that EDA has strayed from its original mission and has been for some time simply a cookie jar for pork barrel projects, many of which have become infamous. Last year, The Heritage Foundation authorized a compelling book entitled ``Ending the Era of Big Government.'' They argued that: ``EDA's development functions duplicate the activities of programs within the Departments of Agriculture, Defense, Housing and Urban Development, and Interior, as well as the Appalachian Regional Commission, Small Business Administration, Federal Emergency Agency, and Tennessee Valley Authority. On these grounds alone, the program should be eliminated.'' I couldn't have said it better myself. Some of these agencies definitely could be eliminated. For all of the reasons put forth above, I endorse your amendment to cut EDA's funding by $25 million at a minimum. I urge every Member of the House to support your effort. Sincerely, Orson Swindle, Former Assistant Secretary of Commerce for Economic Development.

Mr. COBURN. Reclaiming my time, I think the defining words are that there would be a consensus that there are many programs duplicated by the EDA. That may not be the case in the gentleman's particular district. Let us talk about drug courts, reclaiming my time. Drug courts offer us tremendous savings, and there are some real data that needs to be shared with our body. They open up prison space for violent offenders. Most State and local jails as well as Federal jails are operating above capacity. This is largely due to the high number of incarcerated drug offenders, many of whom are nonviolent. Drug courts provide a structured alternative to prison for those nonviolent offenders. Not only does this program save money, it helps to ensure that adequate prison space is available to house the most violent offenders in our society. I want to give the gentleman some savings from drug courts from some of the areas across the country. Denver, Colorado, saves between $1.8 and $2.5 million per year because of drug courts; Phoenix, Arizona, reported this last year a saving of $112,000.

Mr. COBURN. I am sorry?

Mr. COBURN. Mr. Chairman, I move to strike the requisite number of words. Mr. Chairman, Will Rogers said that government programs have three things in common: a beginning, middle, and no end. That is true of the EDA. I will include for the Record a letter from Mr. Orson Swindle, who was Assistant Secretary of Commerce for Economic Development under President Reagan from 1985 to 1989. I will enter this entire document in the Record, but I will quote from it, that the findings of many people would be as follows: EDA's development functions duplicate the activities of programs within the Departments of Agriculture, Defense, Housing and Urban Development, and Interior, as well as the Appalachian Regional Commission, Small Business Administration, Federal Emergency Agency, and Tennessee Valley Authority. On these grounds alone, the program ought to be eliminated. We are not proposing to eliminate the program. As a matter of fact, we are proposing to limit the increase to that which is adjusted for inflation. We also are very much opposed to a 19 percent increase in administrative overhead for this program, where in fact this agency has not proved its need for that. Let us be clear what this amendment is about. It is not about cutting EDA, it is about increasing EDA, just not increasing it as much. It is about limiting the increase in the overhead for the administration of EDA. Why would we want to do that? Because we know that our discussions on appropriations bills are about priorities. We know where the savings are. The other thing we might also know is that as far as EDA's charge, we seem to have been in this past year in one of the greatest times of our productivity, success, industrial growth rate, increase in standard of living that this country has seen. Yet, in 90 percent of our communities, EDA is active because there is supposedly a problem with lack of jobs in all of those communities. I do not deny that there are significant areas in our country that have a need for EDA grant money, but not 90 percent of the country.

Mr. COBURN. I yield to the gentleman from West Virginia.

Mr. COBURN. I do not know that he actually headed it. He was Assistant Secretary of Commerce.

Mr. COBURN. The other agencies that had duplicative functions?

Mr. COBURN. The Appalachian Regional Commission, the Small Business Administration, the Federal Emergency Agency, the Tennessee Valley Authority, the Departments of Defense, Housing and Urban Development, Interior, and the Department of Agriculture all have programs that are duplicated by EDA in one form or another.

Mr. COBURN. Mr. Chairman, reclaiming my time, I would just summarize by saying that we should recognize what corporate welfare is. Everybody talks that word. Everybody says it. But now it is time to vote. It is time to take the money away from the richest corporations in this country and let them stand on their own two feet. It is called competition. It is called allowing them to use their own insight and own assets to compete in the world.

Mr. COBURN

Mr. COBURN. Mr. Chairman, I could not agree with the gentleman. As a matter of fact, in my district we have gone through a transition in a veterans hospital, Muskogee Veterans Hospital, in which we have seen a redirection in the change. But that does not negate the fact that there is not enough dollars to meet the obligations. Yes, we have increased it, but we have not increased it to what we need to meet the obligations for our veterans. I would love to give the gentleman some examples.

Mr. COBURN. Yes, Mr. Chairman, I do object.

Mr. COBURN. Absolutely.

Mr. COBURN. Mr. Chairman, I offer an amendment.