Kent Conrad

Mr. CONRAD

Mr. CONRAD. Mr. President, let me thank the Senator from South Carolina. This country could have avoided an awful lot of the pain of the 1980s and 1990s if this country had listened to the Senator from South Carolina on budget matters. There has been no Member of this body who has had a better handle on the budget problems of this country than the Senator from South Carolina. Years ago, if we would have followed the Hollings plan and put in place a budget freeze, we could have avoided the massive deficits that came in the 1980s and the early 1990s, and this country would have been in a far better fiscal position. He has been an activist and a leader on the Budget Committee of every effort to provide fiscal discipline to this country. I venture to say, in this Chamber there is no single Member who has made a greater contribution moving this country from massive deficits to now surpluses than the Senator from South Carolina. Senator Hollings has been, I think, a model of what a United States Senator should be, in terms of budget discipline for this country. This country owes him a debt of thanks for the leadership he has provided.

Mr. CONRAD. I yield 10 minutes to the Senator from South Carolina.

Mr. CONRAD. To privatize it or raid it in some other way. We really do not know. I was very interested to listen to the Senator from Texas say--say--that they had reserved every penny of Social Security surplus for Social Security. That is what we said.

Mr. CONRAD. Mr. President, I yield 15 minutes to the Senator from Washington.

Mr. CONRAD. Social Security is clearly in danger. Clearly, the priority on the other side is a tax cut, a massive tax cut at all costs. That is their priority. Looking at this budget, the budget that is before us, the major problem with it is that it does not represent the priorities of the American people. I think the best way to understand this is we now have projected a surplus over the next 10 years of $2.6 trillion. Our friends on the other side say all of the non-Social Security surplus-- virtually all of it--ought to go for a tax cut. Nothing, not a dime out of that surplus is for Medicare--not a dime--even though it is in greater danger than Social Security. They do not have the resources available for the high-priority domestic concerns of education, health care, defense, because if you look over time, they are going to have massive cuts in those categories. They are disguised, they are hidden, but they are there. Mr. President, I think perhaps it would be useful to recount a little bit of the budget history, how we got to where we are today and where we are headed. This chart shows over the last 30 years the budget history of the United States at the Federal Government level. We can see the last time we had a surplus was back in 1969, a little bitty surplus of $3 billion. We bumped along. Then we got into the seventies and the deficits started rising. Then we got into the Reagan years and the deficits exploded. We then had the Bush years and the deficits got even worse, so that on a unified basis--unified basis simply means all spending, all revenue put in one pot; that is a so-called unified budget--and on a unified basis in 1992, the last year of the Bush administration, we had a $290 billion deficit. In 1993, President Clinton put before the Congress a 5-year plan to reduce the deficit. We passed that plan. It was done with all votes on this side of the aisle. Not a single Republican voted for that plan. Not one. That plan has reduced the deficit each and every year of the 5 years of the plan. In fact, now we are seeing a slight surplus. What did that plan contain? It cut spending. It cut spending and it raised income taxes on the wealthiest 1 percent in this country. The Senator from Texas who was talking earlier opposed that plan. He said, as did many on that side of the aisle, that it would not work. In fact, they said it would increase the deficit. They said it would increase unemployment. They said it would increase inflation. They said it would be an economic disaster. They were wrong. They were not just a little bit wrong, they were completely wrong. The fact is that plan worked and worked extremely well, and the proof is in the pudding. We can see what happened to the deficit after that plan passed in 1993. Each and every year the deficit came down. In this last year, we ran on a unified basis a $70 billion surplus, and we are headed for much larger surpluses if the projections come true. On a unified basis, we ran a surplus last year. But remember, that counts all revenues and all expenditures. If we take out Social Security, because that is a separate trust fund, we will see we still ran a deficit last year of $29 billion--if we take out Social Security--because it was in surplus by about $100 billion. The good news is, we are very close to balancing without counting Social Security this year, and in 2001, we anticipate we will balance without counting Social Security. That is an enormous, enormous development and enormous progress. You can see back in 1992, if we were not counting Social Security, we had a $340 billion deficit. That is the kind of progress that has been made, and it has been made because, as I indicated, we had a 1993 5- year plan that cut spending, raised taxes on the wealthiest 1 percent, raised income taxes on the wealthiest 1 percent, and in 1997, we had a bipartisan deal. In that case, we came together and agreed on a budget plan to finish the job of balancing the budget. This chart shows what the 1993 plan did and what the 1997 plan did. You can see most of the savings are the result of the 1993 package. Again, our friends on the other side of the aisle--all of them, to a person--voted against it. The bipartisan agreement was 1997, but most of the work has been done by the 1993 5-year plan and that, in combination with the 1997 plan, has put us in this very favorable circumstance we face now. I thought just for the record we should look back on what the deficits were under each of the last three Presidents. With President Reagan, from 1981 through 1988, we saw the deficits explode. They went from $80 billion a year--that is the deficit he inherited-- and very quickly he shot it up to $200 billion. Then we, at the end of his term, saw some improvement--back down to about $150 billion. When President Bush came in, the deficits exploded again, and went from $150 billion, as I indicated, up to $290 billion a year by 1992. Under President Clinton, as I indicated, in 1993 we passed a 5-year plan; and we can just look at the results. In 1993, the deficit was $255 billion. And you can see each and every year thereafter the deficit went down under that 5-year plan. We almost achieved unified balance under that 5-year plan. So the proof is in the pudding. Our friends on the other side of the aisle talk about ``sham'' and ``hoaxes,'' and all the rest of it. The proof is in the pudding. My friends, Democrats passed a plan in 1993, without a single Republican vote. Democrats did the heavy lifting to get this country back on a fiscally responsible course. Facts are stubborn things. And the facts show, without question, that the Democrats passed a plan that, in fact, restored fiscal health to this country. It is true in 1997 we did get together on a bipartisan basis to finish the job. I wish it could have been bipartisan in 1993. But our friends on the other side of the aisle said then that if you pass this plan, you are going to make the deficit worse. They said if you raise taxes, even if it is on just the wealthiest 1 percent, that is going to collapse the economy. They were wrong. Their economic prescription for this country was wrong. And the facts clearly show that they were wrong. Thank goodness there were people who were willing to stand up and cast very tough votes to cut spending and, yes, to raise taxes on the wealthiest 1 percent so we could get this country back on course. It worked; and it worked splendidly. The results are dramatic. Not only have we reduced the red ink and eliminated it--no more running of deficits--but we also got remarkable economic results. We now have an unemployment rate that is the lowest in 41 years. The other side said, when we passed the 5-year plan in 1993, if you pass it, unemployment is going to go up. Unemployment went down. Unemployment went way down, the lowest it has been in 41 years. The other side said, the inflation rate, if you pass this plan, will go up. They were wrong. The inflation rate has gone down. We have the lowest rate of inflation in 33 years. But the good news does not end there. In addition, we passed welfare reform. In fairness and in truth, that was done on a bipartisan basis. We came together on welfare reform. And the result, coupled with the good economy that came from the 1993 budget plan, that coupled with welfare reform, has led us to the lowest percentage of our people on welfare in 29 years. Look at this dramatic improvement in terms of the percentage on welfare in this country. As well, Federal spending has come down because, as I indicated, in 1993, part of that package was to cut the growth of spending in this country. And we did even more in the 1997 bipartisan plan. So the two together, the 1993 plan and the 1997 plan, have brought down Federal spending as a percentage of our national income to its lowest level since 1974. So now we are spending, as a percentage of our national income, the lowest level in 25 years of the Federal Government. Because we have reduced deficits and gotten our fiscal house back in order, debt held by the public has also declined. We reached a debt, in relationship to our gross domestic product, of 50 percent in 1993. We saw, through the Reagan and Bush years, that the debt was climbing in relationship to the size of our gross domestic product. In 1993, when we passed that plan, we stopped the growth of the debt in relationship to the size of our income and reversed it. So now we have seen the debt come down to a level of 44 percent of our gross domestic product. And we anticipate, if we stay the course that we are currently on, we will get the debt down to only 9 percent of our gross domestic product in 2009. The budget before us threatens that course. Because the colleagues on the other side of the aisle are so fixated on a massive tax-cut scheme, they would rather do that than to make this progress in reducing our national debt. I think that is precisely wrong. I think what we did in 1993 demonstrates that taking debt burden down gives a greater lift to this economy than any tax-cut scheme that anybody can come up with. That is not to say we should not have tax reduction, because we should. The question is one of priorities and proportion. Our friends on the other side of the aisle say--we have $2.6 trillion of surpluses projected over the next 10 years--there are only two priorities. Their two priorities are to safeguard $1.8 trillion of that for so-called ``retirement security''--I don't know exactly what that means. That entire $1.8 trillion is generated by Social Security. It should be set aside for Social Security. That is the plan we Democrats offered in the Budget Committee. We offered to safeguard every penny of Social Security surplus for Social Security. That is $1.8 trillion. In addition, we said we also ought to put about $400 billion aside for Medicare. The budget that is before us does not provide one penny of these projected surpluses for Medicare --not one penny. These are not the priorities of the American people. Instead, our Republican colleagues say all the non-Social Security surplus, or virtually all of it--because you have about $800 billion of non-Social Security surplus over the next 10 years--they say, use virtually all of it for a tax-cut scheme. And the best description we have of what they do with it is a 10-percent, across-the-board tax cut. That is what the chairman of the Finance Committee has said he thinks should be done. That is what their leadership in the House have said they think should be done. We have a different view of what the priorities for the American people are. For that $2.6 trillion, we say every penny that comes from the Social Security surplus ought to be reserved for Social Security. Interestingly enough, that is what was passed here in the Senate. But it went to the conference committee, and somewhere in the dead of night they backed away from that commitment; they backed away from that commitment and they came up with this very clever, very complicated little scheme. And this very complicated and very clever scheme says, on one page, yes, we are going to devote the Social Security surpluses to Social Security, but in the very next line they undermine it all-- they undermine it all--they create a big loophole so that on a simple majority vote here the Social Security fund can be raided, can be looted, just like it has been done for the last 15 years. That is wrong. That is not the priority of the American people. The American people want to preserve every penny of Social Security surplus for Social Security. That is what the Democrats offered in the Senate Budget Committee. In addition to that, we said the next $400 billion of surplus ought to be reserved to strengthen and protect Medicare. Our friends on the other side have not provided one penny of the projected surpluses to strengthen Medicare. Instead, they say, let's have this massive tax cut scheme to benefit primarily the richest and wealthiest among us. Now, the Senator from Texas says, you cannot love investment and not love the investor. That is true. I think we all respect those who invest. We respect those who save. We respect those who are successful. The question is, how do we use Government policy? Who do we benefit when we make decisions? Do we use governmental power to benefit the wealthiest among us? Is that what we do? That is not what I favor. As I said, I believe the first priority ought to be every penny of Social Security surplus for Social Security; that is, $1.8 trillion of the $2.6 trillion we now estimate will be in surplus over the next 10 years. But the next $400 billion we say ought to be used to strengthen and protect Medicare. That leaves another $400 billion that would be available for high-priority domestic needs under our plan, like education, like health care, and, yes, defense and tax relief for the American people. Our friends on the other side of the aisle have a different view. They say, yes, reserve the $1.8 trillion, but not just for Social Security, no, not just for Social Security. They call it ``retirement security.'' If they want to reserve every penny for Social Security, why don't they say Social Security? Why have they come up with this new term ``retirement security''? I think most of us know why they have done that--because the Senator from Texas has a scheme to privatize part of Social Security, and he wants the money reserved for his plan. He doesn't want to say reserve every penny of Social Security surplus for Social Security. Instead, he wants to make people believe he is going to do that, but then he provides a big loophole so that later on this year he can come along and raid the Social Security trust fund for his plan to create private accounts. That is what is really going on here. None of us is fooled. They do not provide anything, not a penny of these projected surpluses, to strengthen and protect Medicare, when we know Medicare is in the most imminent danger of being insolvent. We say the priority ought to be Social Security and ought to be Medicare and, after that, we also ought to have some money for high-priority domestic needs like education and health care, and, yes, tax relief. But it is a matter of priority, and our friends on the other side of the aisle say the priority ought to be a massive tax cut. This is the comparison for what happens. Let me focus on the 10 years. The blue column represents what the Republicans would do to pay down debt, and the red column shows what we offered as Democrats in the Budget Committee to pay down debt. A lot of people might be as surprised by this, because the Democratic plan paid down more debt than the Republican plan. We paid down more debt over the next 10 years, by nearly $400 billion over and above what is in the Republican plan, because we believe that is a key priority for the country. Again, our Republican friends think there is a different priority. They want to have this massive tax cut scheme. That is really what is most on their mind. Unfortunately, because of this, they do not have, as I have indicated before, one penny of the surpluses set aside to strengthen Medicare, not a dime. They have what I call ``the Republican broken safe.'' Here it is. You look in it and what do you find? There is nothing there. Now, with what they have done in the conference committee, we ought to have this up for Social Security, too, because, goodness knows, we could find, after the clever game they have played here in this budget document, that we may go into the Social Security trust fund in the future and open the vault door and find there is nothing there, either. Because they have this set up so that they can raid every penny of the Social Security trust fund surplus and put it over into private accounts. They could do that. They could use it for a tax cut and call it retirement security. Who knows what that means, ``retirement security''? If they wanted to reserve the money for Social Security, why didn't they say it? Well, I guess if we wanted to be fair to them, they do say it, don't they? On one line they say they are going to reserve the money for Social Security, but they say, by a simple majority vote, you can overturn that. Before it was a supermajority vote. Now in the dead of night they changed it, simple majority vote, and now you can loot Social Security. You can raid it, because in the very next line, section 202, they created another reserve fund. It is clever. I don't think it is going to work for them, because the American people are too smart. They know the kind of games that get played here in Washington. This is one of the most cynical games I have seen yet. In the Budget Committee, when we vote and the people are there watching and the reporters are there watching, we vote to protect every penny of Social Security surplus for Social Security. That is the vote when everybody raised their hands in the Budget Committee. Maybe that is the reason, when we held the conference committee meeting between the House and the Senate, the Members were there, but there was no budget there. How can you have a meeting about a budget and not have the budget there? It was very interesting. There were no TV cameras there. We were there, the Members representing the House and the Senate, but there was no budget document there. I think I now know why there was no budget document there--because they did not want this little trick revealed. They did not want this little loophole found out. They were hoping they had buried this so deep in the document that nobody would find it in time for this discussion and this debate and this vote. But we are going to vote, and we are going to see who is ready to protect Social Security and who has a mind to raid it later this year. We are going to see, by Members' votes, who is committed to protecting Social Security and who is committed to protecting Medicare and who isn't. We are going to see whose priority is a massive tax cut scheme for the wealthiest among us, because that is really what is afoot here. That is really what is afoot. What happens if you give a 10-percent across-the-board tax cut? For those in this country who earn less than $38,000 a year, they are going to get $99. That is going to be their tax cut. But for folks who are earning over $300,000, they are going to get $20,000 of a tax cut. The Senator from Texas thinks this is a fair deal. I don't think this is a fair deal. I don't think this represents the priorities of the American people. The other side is saying the priorities of the American people are to have a massive tax cut that would give a $20,000 check to those earning over $300,000 a year in this country, send $99 to those who have an income of less than $38,000, and not have one penny of the surplus available to strengthen Medicare, and to leave vulnerable the Social Security trust fund that everybody says ought to be inviolable, ought not be touched, that every penny ought to be set aside to redeem the promise made by Social Security. That is what I thought we were going to do. That is what the Democrats offered in the Senate Budget Committee. We offered a plan that said of the $2.6 trillion of surpluses, take the $1.8 trillion that comes from Social Security and dedicate every penny to Social Security. Take the next $400 billion and use it to strengthen Medicare. Take the final $400 billion and use it, yes, for tax relief, but also for high-priority domestic needs such as education and health care and, yes, defense. Those are America's priorities. But that is not what is in this budget resolution. These are not America's priorities. These are the priorities of, frankly, those who are getting ready to get a $20,000 tax break, and they are salivating. Of course, for the very wealthy, it is much more than this. For those who have had good fortune in this country--and we are grateful for that; it is one of the great things about America, that people have had enormous advantages. The priority of this country isn't to make those who have had great success even more comfortable; the priority of the American people is to strengthen Social Security, strengthen and protect Medicare, provide for high-priority domestic needs such as education and health care and, yes, defense, and also to provide tax relief. My Republican friends have just focused on a tax cut scheme. That is what is wrong with this budget at the most fundamental level. I see that my colleague from the State of Washington is here. How much time would she like?

Mr. CONRAD. I wish it were not the case but, unfortunately, it is. We had, I think, hoped--certainly the Senator from South Carolina and I-- that we would be at a point where we really would reserve every penny of Social Security surplus for Social Security. We thought that is where we were headed. Unfortunately, what our friends across the aisle have done is indicate that that is what they are doing, but that is not what the budget document says. No, no, no, they have changed it all, and they have made it possible to continue the raid on the Social Security trust fund on a simple majority vote which, of course, their lockbox was intended to protect against. Unfortunately, what they say they have done and what they have done are two very, very different things.

Mr. CONRAD. Unfortunately, that is not what the budget document provides. It is very interesting; the Senator from South Carolina probably knows better than anybody how one can play games with these documents. It is fascinating what they have done here, because on one line, they suggest that they have provided a lockbox for Social Security. That is on one line on page 16 and it runs on to page 17. But then on the bottom of page 17, in the next section, they gut what they did earlier on the page. This is the oldest budget game in the book: ``Now you see it, now you don't.''

Mr. CONRAD. They had one, but they did not have a budget there. It is most amazing. As my colleague knows, a conference is the representatives of the Senate and the representatives of the House coming together to work out the differences between the two. We were there, the Members were there. I think you would have been quite amazed, I say to the Senator from South Carolina, because there was no budget there, there was no document there. There was no discussion about the differences between the House and Senate. What we had was an immaculate conception. What we had was a document that appeared out of nowhere after we had met.

Mr. CONRAD. Yes. I was on the conference committee. It went to the conference.

Mr. CONRAD

Mr. CONRAD. Mr. President, I thank my colleague, Senator Dorgan, for offering this motion, and for bringing to the attention of our colleagues in the Senate the disastrous circumstances we face in American agriculture. I represent North Dakota. I can tell you that in agriculture in our State we are on the brink of a depression. We are the victims of a triple whammy of bad prices, bad weather, and bad policy. Bad prices are the lowest prices for farm commodities in 52 years. The bad policy is the last farm bill that was passed, and some of our trade policy that has left America vulnerable to a very intense effort by our competitors. Mr. President, our chief competitors--the Europeans--are spending 10 times as much to support their farmers as we are spending to support ours. We are, in essence, saying to our farmers, you go out and compete against the French farmer and the German farmer, and, while you are at it, take on the French Government and the German Government as well. That is not a fair fight. In addition to the bad prices and the bad policy, we are also stuck with bad weather. We have had 5 years of overly wet conditions in North Dakota. The result has been the development of a disease called scab. That is a fungus. It has dramatically reduced production. There are parts of North Dakota that saw their production reduced 40 percent. So you put all of this together, what do you have? You have an economic calamity, a disaster of its own, with the lowest prices in 52 years and production reduced because of bad weather, and because of an outbreak of disease that is unprecedented in this century, and couple that with the bad policy of a bad farm bill that has been put in place that makes no note of what happens to farm prices but that cuts each and every year the support that is given to American agricultural producers at the exact time our competitors are dramatically increasing what they are doing for their producers. Mr. President, Members of the Senate, this is an emergency. It is a disaster. It is stunning in its proportion. I just completed a series of meetings across the State of North Dakota. Everywhere I went, producers took me aside and said unless something is done and done quickly, we are faced with a calamity of losing tens of thousands of family farmers across the heartland of America. I hope very much that our colleagues will support this motion that instructs the conferees to provide additional funding for agricultural policy reform. It is critically needed. It must be done. The consequences could not be more serious. A failure to act will lead to the unraveling of the farm safety net in this country and will mean we will lose literally tens of thousands of farm families this year. We are not talking about sometime in the distant future. We are talking about right now. We are talking about an economic calamity. Again, I hope my colleagues will support this motion. I yield the floor.

Mr. CONRAD

Mr. CONRAD. Mr. President, today, I am pleased to be joined by Senator Daschle, Senator Wellstone, Senator Inouye, Senator Harkin, and Senator Murkowski to introduce legislation to help improve health care delivery in rural and underserved communities throughout America through the use of telecommunications and telehealth technology. Telehealth encompasses a wide variety of technologies, ranging from the telephone to high-tech equipment that enables a surgeon to perform surgery from thousands of miles away. It includes interactive video equipment, fax machines and computers along with satellites and fiber optics. These technologies can be used to diagnose patients, deliver care, transfer health data, read X-rays, provide consultation and educate health professionals. Telehealth also includes the electronic storage and transmission of personally identifiable health information, such as medical records, test results, and insurance claims. The promise of telehealth is becoming increasingly apparent. Throughout the country, providers are experimenting with a variety of telehealth approaches in an effort to improve access to quality medical and other health-related services. Those programs are demonstrating that telecommunications technology can alleviate the constraints of time and distance, as well as the cost and inconvenience of transporting patients to medical providers. Many approaches show promising results in reducing health care costs and bringing adequate care to all Americans. For the first time, technological advances and the development of a national information infrastructure give telehealth the potential to overcome barriers to health care services for rural Americans and afford them the access that most Americans take for granted. But it is clear that our nation must do more to integrate telehealth into our overall health care delivery infrastructure. Because so many rural and underserved communities lack the ability to attract and support a wide variety of health care professionals and services, it is important to find a way to bring the most important medical services into those communities. Telehealth provides an important part of the answer. It helps bring services to remote areas in a quick, cost-effective manner, and can enable patients to avoid traveling long distances in order to receive health care treatment. We have made progress. The Balanced Budget Act of 1997 includes a provision that provides for some Medicare reimbursement of telehealth services. Unfortunately, however, the Health Care Financing Administration interpreted the legislative language too narrowly and severely limited the services that are covered. This bill clarifies the intent of Congress regarding Medicare reimbursement and thereby increases access to these services in underserved areas. The first element of my proposal clarifies and expands Medicare reimbursement for telehealth. Medicare reimbursement policy is an essential component of helping to integrate telehealth into the health care infrastructure and is particularly important in rural areas, where many hospitals do as much as 80% of their business with Medicare patients. Because the Secretary defined reimbursable services so narrowly in the BBA, this legislation clarifies that all services that are covered under Medicare Part B if you drive to a doctor's office, are covered via telehealth. In particular, it clarifies that the technology called ``store and forward'', which is a cost-effective method of transferring information, is included in this reimbursement policy. Finally, this bill expands coverage from health professional shortage areas, as enacted in 1997, to cover all rural areas. The second element of this proposal asks the Secretary of Health and Human Services to submit a report to the Congress on the status of efforts to ease licensing burdens on practitioners who cross state lines in the course of supplying telehealth services. Currently, consultation by almost any licensed health professional in this situation requires that the practitioner be licensed in both states. In talking with telehealth providers in my state, and with experts on the Ad Hoc Committee, I have been told repeatedly that this is one of the most significant barriers to developing broad, integrated telehealth systems. More importantly, they tell me states have actively been using licensure to close their borders to innovative telehealth practice. Many states have taken legislative action to ensure that out- of-state practitioners must be fully licensed in their state in order to provide telehealth services, even if they are fully licensed in their own state. During a discussion with a telehealth practitioner from my home state of North Dakota, I was told about a group of telehealth specialists who, among their small group practice, were licensed in more than thirty different states. That means they pay thirty different fees, are responsible for thirty different continuing education requirements, and are overseen by thirty different regulatory bodies. This is a costly and burdensome procedure for many practitioners, but the burden falls particularly heavily on rural practitioners, who face long travel times to acquire continuing education, and who frequently run on lower profit margins than urban practitioners. While I am not prepared at this time to propose that the federal government get involved with professional licensure, I have asked the Secretary to study the issue and report to Congress yearly on the status of efforts by states and other interested organizations to address this issue. This will allow us to reach out to the states and work together to find solutions to cross-state licensure concerns. As part of this report, I have asked to the Secretary to make recommendations to Congress, if appropriate, about possible federal action to lower the licensure barrier. A third element of my proposal involves coordination of the Federal telehealth effort. The Department of Health and Human Services has created an informal interagency task force that is examining our federal agency telehealth efforts. This group reported on Federal activities related to telehealth and provided a thorough examination of many of the important issues in telehealth. My bill attempts to use that task force to inventory Federal activity on telehealth and related technology, determine what applications have been found successful, and recommend an overall Federal policy approach to telehealth. Many departments and agencies of the Federal government are engaged in telehealth activity, including the Veterans Administration, Department of Defense, Department of Agriculture, Office for the Advancement of Telehealth, and many others. The more these agencies work together to coordinate the Federal effort and consolidate Federal resources, the more effective the Federal government will be in contributing to telehealth in a positive way. I believe this is especially important in light of the GAO report calling for an expanded role for this group and more coordination of telehealth issues across the Federal agencies. The efforts of this group, along with the ongoing activities of the Congressional Ad Hoc Steering Committee, will provide a renewed focus for telehealth across the Federal government. Such coordination will also help protect the American taxpayer from unnecessary duplication of effort. The fourth part of my proposal helps communities build home-grown telehealth networks. It attempts both to build a telehealth infrastructure and foster rural economic development and incorporates many of the most important lessons learned from other grant projects and studies on telehealth from across the Federal government. Clearly, the scarcity of resources in many rural communities requires that the coordination and use of those resources be maximized. My bill encourages cooperation by various local entities in an effort to help build sustainable telehealth programs in rural communities. It plants seed money to encourage health care providers to join with other segments of the community to jointly use telecommunications resources. Using a unique loan forgiveness program, it rewards telehealth systems that supply appropriate, high-quality care while reducing overall health care costs. Most importantly, it does not create a system where various technological approaches are imposed upon communities. Rather it enables potential grantees to determine user-friendly approaches that work best for them. This home-grown approach to developing user- friendly telehealth systems, as well as the preference for coordinating resources within communities, will help ensure the long-term viability of such programs after the grant expires. Mr. President, my proposal continues our national efforts to integrate telecommunications technology into the rapidly evolving health care delivery system. I am very encouraged by the positive feedback I have received from telehealth networks across the country. I have continued to work with telehealth networks and representatives to strengthen this proposal. As a result, I have made several changes in the bill that I believe will make this a stronger proposal. But, as with any complex issue, I understand that some may prefer different approaches. I would like to continue to encourage all interested parties to come forward with creative solutions to these important issues. It is my hope that telehealth legislation can be included in the comprehensive rural health care legislation in this Congress so we can continue to improve access to needed health care services for rural and underserved populations.

Mr. CONRAD

Mr. CONRAD. Mr. President, today, I am pleased to be joined by Senator Daschle, Senator Wellstone, Senator Inouye, Senator Harkin, and Senator Murkowski to introduce legislation to help improve health care delivery in rural and underserved communities throughout America through the use of telecommunications and telehealth technology. Telehealth encompasses a wide variety of technologies, ranging from the telephone to high-tech equipment that enables a surgeon to perform surgery from thousands of miles away. It includes interactive video equipment, fax machines and computers along with satellites and fiber optics. These technologies can be used to diagnose patients, deliver care, transfer health data, read X-rays, provide consultation and educate health professionals. Telehealth also includes the electronic storage and transmission of personally identifiable health information, such as medical records, test results, and insurance claims. The promise of telehealth is becoming increasingly apparent. Throughout the country, providers are experimenting with a variety of telehealth approaches in an effort to improve access to quality medical and other health-related services. Those programs are demonstrating that telecommunications technology can alleviate the constraints of time and distance, as well as the cost and inconvenience of transporting patients to medical providers. Many approaches show promising results in reducing health care costs and bringing adequate care to all Americans. For the first time, technological advances and the development of a national information infrastructure give telehealth the potential to overcome barriers to health care services for rural Americans and afford them the access that most Americans take for granted. But it is clear that our nation must do more to integrate telehealth into our overall health care delivery infrastructure. Because so many rural and underserved communities lack the ability to attract and support a wide variety of health care professionals and services, it is important to find a way to bring the most important medical services into those communities. Telehealth provides an important part of the answer. It helps bring services to remote areas in a quick, cost-effective manner, and can enable patients to avoid traveling long distances in order to receive health care treatment. We have made progress. The Balanced Budget Act of 1997 includes a provision that provides for some Medicare reimbursement of telehealth services. Unfortunately, however, the Health Care Financing Administration interpreted the legislative language too narrowly and severely limited the services that are covered. This bill clarifies the intent of Congress regarding Medicare reimbursement and thereby increases access to these services in underserved areas. The first element of my proposal clarifies and expands Medicare reimbursement for telehealth. Medicare reimbursement policy is an essential component of helping to integrate telehealth into the health care infrastructure and is particularly important in rural areas, where many hospitals do as much as 80% of their business with Medicare patients. Because the Secretary defined reimbursable services so narrowly in the BBA, this legislation clarifies that all services that are covered under Medicare Part B if you drive to a doctor's office, are covered via telehealth. In particular, it clarifies that the technology called ``store and forward'', which is a cost-effective method of transferring information, is included in this reimbursement policy. Finally, this bill expands coverage from health professional shortage areas, as enacted in 1997, to cover all rural areas. The second element of this proposal asks the Secretary of Health and Human Services to submit a report to the Congress on the status of efforts to ease licensing burdens on practitioners who cross state lines in the course of supplying telehealth services. Currently, consultation by almost any licensed health professional in this situation requires that the practitioner be licensed in both states. In talking with telehealth providers in my state, and with experts on the Ad Hoc Committee, I have been told repeatedly that this is one of the most significant barriers to developing broad, integrated telehealth systems. More importantly, they tell me states have actively been using licensure to close their borders to innovative telehealth practice. Many states have taken legislative action to ensure that out- of-state practitioners must be fully licensed in their state in order to provide telehealth services, even if they are fully licensed in their own state. During a discussion with a telehealth practitioner from my home state of North Dakota, I was told about a group of telehealth specialists who, among their small group practice, were licensed in more than thirty different states. That means they pay thirty different fees, are responsible for thirty different continuing education requirements, and are overseen by thirty different regulatory bodies. This is a costly and burdensome procedure for many practitioners, but the burden falls particularly heavily on rural practitioners, who face long travel times to acquire continuing education, and who frequently run on lower profit margins than urban practitioners. While I am not prepared at this time to propose that the federal government get involved with professional licensure, I have asked the Secretary to study the issue and report to Congress yearly on the status of efforts by states and other interested organizations to address this issue. This will allow us to reach out to the states and work together to find solutions to cross-state licensure concerns. As part of this report, I have asked to the Secretary to make recommendations to Congress, if appropriate, about possible federal action to lower the licensure barrier. A third element of my proposal involves coordination of the Federal telehealth effort. The Department of Health and Human Services has created an informal interagency task force that is examining our federal agency telehealth efforts. This group reported on Federal activities related to telehealth and provided a thorough examination of many of the important issues in telehealth. My bill attempts to use that task force to inventory Federal activity on telehealth and related technology, determine what applications have been found successful, and recommend an overall Federal policy approach to telehealth. Many departments and agencies of the Federal government are engaged in telehealth activity, including the Veterans Administration, Department of Defense, Department of Agriculture, Office for the Advancement of Telehealth, and many others. The more these agencies work together to coordinate the Federal effort and consolidate Federal resources, the more effective the Federal government will be in contributing to telehealth in a positive way. I believe this is especially important in light of the GAO report calling for an expanded role for this group and more coordination of telehealth issues across the Federal agencies. The efforts of this group, along with the ongoing activities of the Congressional Ad Hoc Steering Committee, will provide a renewed focus for telehealth across the Federal government. Such coordination will also help protect the American taxpayer from unnecessary duplication of effort. The fourth part of my proposal helps communities build home-grown telehealth networks. It attempts both to build a telehealth infrastructure and foster rural economic development and incorporates many of the most important lessons learned from other grant projects and studies on telehealth from across the Federal government. Clearly, the scarcity of resources in many rural communities requires that the coordination and use of those resources be maximized. My bill encourages cooperation by various local entities in an effort to help build sustainable telehealth programs in rural communities. It plants seed money to encourage health care providers to join with other segments of the community to jointly use telecommunications resources. Using a unique loan forgiveness program, it rewards telehealth systems that supply appropriate, high-quality care while reducing overall health care costs. Most importantly, it does not create a system where various technological approaches are imposed upon communities. Rather it enables potential grantees to determine user-friendly approaches that work best for them. This home-grown approach to developing user- friendly telehealth systems, as well as the preference for coordinating resources within communities, will help ensure the long-term viability of such programs after the grant expires. Mr. President, my proposal continues our national efforts to integrate telecommunications technology into the rapidly evolving health care delivery system. I am very encouraged by the positive feedback I have received from telehealth networks across the country. I have continued to work with telehealth networks and representatives to strengthen this proposal. As a result, I have made several changes in the bill that I believe will make this a stronger proposal. But, as with any complex issue, I understand that some may prefer different approaches. I would like to continue to encourage all interested parties to come forward with creative solutions to these important issues. It is my hope that telehealth legislation can be included in the comprehensive rural health care legislation in this Congress so we can continue to improve access to needed health care services for rural and underserved populations.

Mr. CONRAD. Mr. President, I rise today to introduce the Dickinson Dam Bascule Gates Settlement Act of 1999 and I am pleased that my colleague from North Dakota, Senator Dorgan, is an original cosponsor of the bill. This legislation would permit the Secretary of the Interior to accept a one-time, lump-sum payment for the city of Dickinson, ND, in lieu of the annual payments required under the city's existing repayment contract for construction of the ``bascule gates'' on the Dickinson Dam on the Heart River. This bill would resolve a long-standing issue for the city of Dickinson and the Bureau of Reclamation. The Dickinson Dam Bascule Gates Settlement Act is nearly identical to a bill I introduced last June, and it is my hope that the Senate will quickly consider and pass this important piece of legislation. Mr. President, the history of the bascule gates is long and complex. The Bureau of Reclamation constructed the Dickinson Dam on the Heart River in 1949 and 1950 to supply water to the city of Dickinson, and for flood control, recreation, and other purposes. The reservoir created by this dam was named Patterson Lake in about 1960. The need for additional water supply for the city was identified in the early 1970's, and the bascule gates were constructed in the early 1980's, to provide additional water storage capacity in Lake Patterson. At the time, the city expressed reservations over the cost of the bascule gates and the viability of the gates, since the city was not aware of any other location in a northern climate in which the gates had been tested or proven. In 1982, shortly after the gates were operational, a large ice block caused excessive pressure on the hydraulic system, causing it to fail. Construction modifications were made to the gate hydraulic system and a de-icing system were added in 1982, adding further costs to the project. In 1991, the city began to receive its municipal water supply from the Southwest Pipeline Project, a project constructed in part with funds provided for North Dakota's statewide water project, the Garrison Diversion project, which is another Bureau of Reclamation project. The Southwest Pipeline brings high-quality water from Lake Sakakawea on the Missouri River to the city of Dickinson and other communities in southwest North Dakota. The water is of much higher quality that the water from the city's previous supply from Lake Patterson, and has helped spur economic development in the region. While the citizens of the area now benefit from a higher quality water supply, the city no longer benefits from the additional water supply provided by the bascule gates. The result is the city is paying for two Bureau of Reclamation projects, while it is using water from only one of those projects for its municipal water supply. The city has repaid more than $1.2 million to the United States for the bascule gates, despite the fact that the gates now provide almost no direct benefit to the city. The city has previously investigated alternatives to the current situation. The city has discussed the option of assuming title to the dam and bascule gates, as well as attempting to negotiate a new agreement with the Bureau of Reclamation administratively. However, because the terms of the existing contract are outlined statutorily, new legislation is required to make any changes to the current repayment contract. The legislation I am introducing today would do three primary things. First, it would permit the Interior Secretary to accept a lump-sum payment of $300,000 from the city and terminate the remaining annual payments required under the existing repayment contract. This is an increase from last year's legislation, which called for a $150,000 final settlement. Enacting this legislation would end the issue of paying for the construction of these gates for both the city and the Federal government. Second, my bill would require the Secretary to reallocate the costs of operation and maintenance for the bascule gates and the Dickinson Dam. The bill does not prescribe any particular reallocation formula, but does require the Secretary to consider the fact that the current benefits of the dam and bascule gates are primarily for flood control, recreation, and fish and wildlife purposes. In my view, operation and maintenance costs should be borne by those who benefit from a particular project. Finally, my bill would permit the Secretary to enter any appropriate water service contracts in the future if the city or any other entity uses water from Patterson Lake for municipal water supply or for other purposes. It is only fair that if the city benefits in the future from the water stored behind the bascule gates that we preserve an option for recovering additional costs from those beneficiaries. Mr. President, this legislation represents a win-win situation for the residents of the Dickinson area and for the Federal Government. I hope this Congress will carefully study this issue and quickly pass this important legislation. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. CONRAD

Mr. CONRAD. Mr. President, I rise today to introduce the Dickinson Dam Bascule Gates Settlement Act of 1999 and I am pleased that my colleague from North Dakota, Senator Dorgan, is an original cosponsor of the bill. This legislation would permit the Secretary of the Interior to accept a one-time, lump-sum payment for the city of Dickinson, ND, in lieu of the annual payments required under the city's existing repayment contract for construction of the ``bascule gates'' on the Dickinson Dam on the Heart River. This bill would resolve a long-standing issue for the city of Dickinson and the Bureau of Reclamation. The Dickinson Dam Bascule Gates Settlement Act is nearly identical to a bill I introduced last June, and it is my hope that the Senate will quickly consider and pass this important piece of legislation. Mr. President, the history of the bascule gates is long and complex. The Bureau of Reclamation constructed the Dickinson Dam on the Heart River in 1949 and 1950 to supply water to the city of Dickinson, and for flood control, recreation, and other purposes. The reservoir created by this dam was named Patterson Lake in about 1960. The need for additional water supply for the city was identified in the early 1970's, and the bascule gates were constructed in the early 1980's, to provide additional water storage capacity in Lake Patterson. At the time, the city expressed reservations over the cost of the bascule gates and the viability of the gates, since the city was not aware of any other location in a northern climate in which the gates had been tested or proven. In 1982, shortly after the gates were operational, a large ice block caused excessive pressure on the hydraulic system, causing it to fail. Construction modifications were made to the gate hydraulic system and a de-icing system were added in 1982, adding further costs to the project. In 1991, the city began to receive its municipal water supply from the Southwest Pipeline Project, a project constructed in part with funds provided for North Dakota's statewide water project, the Garrison Diversion project, which is another Bureau of Reclamation project. The Southwest Pipeline brings high-quality water from Lake Sakakawea on the Missouri River to the city of Dickinson and other communities in southwest North Dakota. The water is of much higher quality that the water from the city's previous supply from Lake Patterson, and has helped spur economic development in the region. While the citizens of the area now benefit from a higher quality water supply, the city no longer benefits from the additional water supply provided by the bascule gates. The result is the city is paying for two Bureau of Reclamation projects, while it is using water from only one of those projects for its municipal water supply. The city has repaid more than $1.2 million to the United States for the bascule gates, despite the fact that the gates now provide almost no direct benefit to the city. The city has previously investigated alternatives to the current situation. The city has discussed the option of assuming title to the dam and bascule gates, as well as attempting to negotiate a new agreement with the Bureau of Reclamation administratively. However, because the terms of the existing contract are outlined statutorily, new legislation is required to make any changes to the current repayment contract. The legislation I am introducing today would do three primary things. First, it would permit the Interior Secretary to accept a lump-sum payment of $300,000 from the city and terminate the remaining annual payments required under the existing repayment contract. This is an increase from last year's legislation, which called for a $150,000 final settlement. Enacting this legislation would end the issue of paying for the construction of these gates for both the city and the Federal government. Second, my bill would require the Secretary to reallocate the costs of operation and maintenance for the bascule gates and the Dickinson Dam. The bill does not prescribe any particular reallocation formula, but does require the Secretary to consider the fact that the current benefits of the dam and bascule gates are primarily for flood control, recreation, and fish and wildlife purposes. In my view, operation and maintenance costs should be borne by those who benefit from a particular project. Finally, my bill would permit the Secretary to enter any appropriate water service contracts in the future if the city or any other entity uses water from Patterson Lake for municipal water supply or for other purposes. It is only fair that if the city benefits in the future from the water stored behind the bascule gates that we preserve an option for recovering additional costs from those beneficiaries. Mr. President, this legislation represents a win-win situation for the residents of the Dickinson area and for the Federal Government. I hope this Congress will carefully study this issue and quickly pass this important legislation. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. CONRAD

Mr. CONRAD. Mr. President, we would be pleased to go to the next amendment and lay this one aside. If someone wants to return to it later, we can provide time to them. But we are ready to move on.

Mr. CONRAD. I will be happy to yield.

Mr. CONRAD. As a member of the Budget Committee and a member of the Finance Committee and somebody who was worked and voted for Medicare reform in the Finance Committee as part of a group cochaired by Senator Breaux along with Senator Chafee, I believe we must have reform of the Medicare program. There is no question about that. I applaud the efforts of Senator Breaux. Nobody has worked harder over a longer period of time to try to get the job done. As a part of the centrist coalition, I voted in the Finance Committee for a series of difficult steps to begin the process of reforming the Medicare program. I think my record on the question of being willing to cast tough votes to reform Medicare is beyond question. But I must say, as I look at this amendment that has been offered by the distinguished chairman of the Finance Committee, I have real doubts about this. It looks to me to be a political statement as much as it is an interest in reforming Medicare. When I see in the resolution the suggestion that the President's budget framework does not devote 15 percent of the budget surplus to the Medicare program, I do not think that is a true statement. I have read the President's framework, and it says very clearly that of the surpluses over the next 15 years, 15 percent is dedicated to Medicare. He does it by making a transfer to the trust fund. People get up and quote the Comptroller General all of the time around here, only they leave out something very important that he said. The Comptroller said in his statement before the Finance Committee that the President's proposal ``provides a grant of a new set of Treasury securities for the Medicare Hospital Insurance Program which would extend the life of the trust fund from 2008 to 2020.'' That is the testimony of the Comptroller General before the Senate Finance Committee. Others have stood in the Chamber and said that he denigrated the proposal. Well, he certainly did raise questions about it in certain ways, but he also made the very clear statement that the President's proposal does extend the solvency of the Medicare trust fund from 2008 to 2020. Those who stand in this Chamber and tell our colleagues and the American people that the President's proposal does not do anything are not telling the truth. To just be selective in their quotations of the Comptroller General does a disservice to this body and a disservice to anybody else who is listening. Let's be direct and honest. The President's proposal is to reserve 15 percent of the surpluses over the next 15 years for Medicare. That is a break in policy, without question. It is a change. We should debate the wisdom of that change. But to stand up here and say it makes no difference, that is not factual and it is not honest as far as I am concerned.

Mr. CONRAD. I would like to complete the thought and then I will be happy to yield. As I read this resolution, it is suggesting that it makes no sense to make any transfer from the general fund to the HI trust fund. I do not agree with that. I think that is flat wrong. You can question the policy. You can say, gee, we should not be doing that, but to suggest that in this resolution, to adopt in this resolution that we are just going to be opposed to a transfer I think is a mistake. That has the cart before the horse. As I go through this resolution, there are other things that trouble me. I, for one, value the work of the Medicare Commission. I value the work of Senator Breaux, Mr. Thomas, and the others who served there, but as I read this resolution it is suggesting that what they came up with in terms of a proposal is what we ought to adopt. I am not prepared to say that because they also proposed a dramatic change in policy. They proposed, instead of what we know now as the Medicare program, a system of vouchers. People would be able to go out in the marketplace and buy insurance, and they would get from the Federal Government, instead of the coverage provided by Medicare, a voucher for a certain amount of money to go out and purchase insurance. That may be an excellent idea. I do not know. I think we are a long way from making a determination that that is the right course. We have not completed a hearing process in the Finance Committee on that question. As I read this resolution, it is fundamentally endorsing that approach. Also included in the recommendation of the Commission is an increase in the age of eligibility. That may be necessary, but I do not think we ought to conclude that in the Chamber here today. So, Madam President, I respect those who bring the amendment before us but I, for one, would not vote for it. I do not think saying, in effect, that we should not make a transfer from the general fund to strengthen Medicare is something we ought to be saying. In fact, I offered an amendment last night that said just the opposite, that we ought to, as part of a reform proposal, put more resources into the Medicare plan. I think it needs more resources. I also believe it has to be reformed. I think we need both. I am certainly not going to vote for an amendment that suggests that what the President has proposed is wrong. I also think, as I indicated, that some of the statements here are just factually incorrect. I yield the floor.

Mr. CONRAD. Mr. President, I yield such time as the Senator from Massachusetts consumes.

Mr. CONRAD

Mr. CONRAD. Mr. President, very briefly, let me just say I hope our colleagues will support the amendment which my colleague from Wyoming has offered, along with a number of others of us who are very concerned about what has happened in the livestock industry. In American agriculture now, we face the lowest prices in 52 years. We have been through an absolute price collapse in many sectors of the livestock industry. In the hog industry alone, prices have dropped to 8.5 cents a pound. Mr. President, it takes 40 cents a pound to break even in the livestock industry. And 8.5 cents a pound is absolutely ridiculous. We anticipate losing as many as three-quarters of the hog producers in our State if something is not done. This amendment, offered by Senator Enzi, cosponsored by others of us, we think is one way to help livestock producers manage risk through a program of risk management. I hope very much our colleagues will support it.

Mr. CONRAD. Mr. President, I thank Senator Dorgan and I thank our colleagues. This is a matter of sheer survival. I want to say to my colleagues, we are on the brink of a depression in farm country in this Nation. If you come to North Dakota today and go with me to community farms, what you find people want to talk about is the collapse of farm income because it is threatening the survival of literally tens of thousands of family farmers just in our State of North Dakota. In fact, this year, unless something happens and happens quickly, we anticipate we will lose one-third of all the farmers in the State. The reason that is occurring is really very simple. This chart shows what happened from 1996 to 1997, as farm income was washed away: In 1 year, a 98 percent reduction in farm income in our State. The reason we have seen this collapsing income is really three factors: Bad prices, bad weather, and bad policy. The bad prices are stunning. This shows what has happened to farm prices over a 52-year period. We now have the lowest prices for our major commodities in 52 years. We have wheat selling for $2.60 a bushel. Mr. President, $2.60 a bushel. That is 5 cents a pound. There is no way anybody can make it at those prices. The cost of production is about double that. So what we have is a hemorrhaging, a loss of income, and farmers' livelihoods being threatened. That is what we are faced with. When I talk about bad policy, when we passed the last farm bill-- which is, frankly, a disaster itself--the support for farmers was cut in half. Under the previous legislation we averaged $10 billion a year. Under the new legislation, $5 billion a year. This makes it virtually impossible to write any kind of decent farm legislation. The current farm legislation cuts support for farmers each and every year and cuts it sharply, without regard to what happens to prices. In previous legislation we used to make an adjustment. When prices fell there was more assistance. But look what our major competitors are doing. It is very interesting, because if we look at what they are doing we see that they are spending almost 10 times as much as we are to support their producers. In Europe, they are spending nearly $50 billion a year to support their farmers. We are spending $5 billion. This is not a fair fight. This is unilateral disarmament in a trade confrontation. We would never do it in a military confrontation. Why ever are we doing it in a trade confrontation? This says to our farmers: You go out there and compete against the French farmer and the German farmer. And, oh, while you are at it, you take on the French Government and the German Government as well. That is not a fair fight. You have to say to our farmers it is pretty amazing you are able to survive in a circumstance like this one, when our major competitors are spending 10 times as much to support them. When we look at what they are doing for support of exports, it is even more dramatic. Instead of a factor of 10 to 1, they are outspending us by a factor of more than 100 to 1. In fact, it is about 130-to-1 to support their farm exports versus what we are doing. Then some say just leave it to the market. That is not what our competitors are doing. If that is what we do, we are going to consign our farmers to a life of economic hardship and economic collapse. That is what is happening in farm country today. That is why it is absolutely critical that an amendment like this one pass to help farmers through this period of collapsed commodity values. If we do not do it, we will see literally thousands of farm families forced off the land. The stakes are high. I urge my colleagues to support this amendment.

Mr. CONRAD

Mr. CONRAD. Mr. President, I thank the Senator from Massachusetts for this amendment, because I think it puts into stark relief what the choices are. Fundamentally, this debate is about what we do with the projected surpluses over the next 15 years. On our side, we believe that the best use of the surpluses is, first and foremost, to protect every dollar of Social Security surplus for Social Security. Then we turn our attention to Medicare, because we believe Medicare is also critically important to this country's future, and we recognize that it is endangered. We recognize that in 2008 it will be insolvent unless we take action. So we say take, of the surplus over the next 15 years, 15 percent of that surplus --15 percent of that total unified surplus--over the next 15 years. Dedicate that to Medicare. That is some $700 billion. That still leaves resources for high-priority domestic needs like education and health care, defense, and, yes, tax relief. It is much less in the way of resources available for a tax cut plan than in the Republican priority list, because they really only have two priorities. Their priorities are safeguarding Social Security, which we commend them for; but their other priority is a massive tax cut. They don't provide an additional dollar out of the surpluses that we now project over the next 15 years to strengthen Medicare. We think that is a mistake. We have heard the other side repeatedly saying that putting this transfer of resources to Medicare will require raising taxes, benefit cuts, or increasing gross debt to pay for Medicare in the future. We have heard that said repeatedly on that side of the aisle. I would like to give an alternative view, because I don't think that is right. It sounds right. If one were expecting budget deficits in the future, it would be right. But that is not what we are anticipating. The fact is, we now project that there will be a surplus for more than a decade even after we dedicate part of the surplus to Medicare and Social Security. That is because by paying down the publicly held debt, the President's plan reduces net interest costs to the Federal Government and increases economic growth. Therefore, even after we start using the surplus to pay for Medicare and for Social Security, there will still be a budget surplus, hence no need for benefit cuts or for premium increases. Mr. President, that is central to what we are proposing and what we are advocating. We believe it is critically important to put Social Security first, but also to put Medicare first, because it has made a profound difference in the life of this Nation. We now know that without Medicare and Social Security, a significant chunk of our senior population would be below the poverty level. Two programs in the life of this country have lifted senior citizens out of poverty: Social Security and Medicare. So we believe that is where the priority ought to be: Social Security, and Medicare. After they are taken care of--after they are taken care of; after they are taken care of--then we can deal with other domestic priorities, certainly education and health care. And, yes, defense. And, yes, there would still be resources available for tax relief--not as much as the tax cut plan in the Republican budget resolution, because they don't provide one thin dime out of these projected surpluses to strengthen Medicare. They provide resources for Social Security surpluses to support Social Security. That is in our plan as well. Where we diverge is on the question of whether or not we are going to use some of these surpluses we now project to strengthen Medicare. That is really at the heart of this debate and this discussion.

Mr. CONRAD. I yield 10 minutes off the bill. Mr. DOMENICI addressed the Chair.

Mr. CONRAD. How much time would the Senator from West Virginia like?

Mr. CONRAD

Mr. CONRAD. Mr. President, I want to commend the Senator from New York on his maiden speech here in the Senate Chamber. The first speech by any member is one of the most important, and I think the Senator from New York chose well when he chose this subject. Obviously, it is a matter of urgent concern in New York, and the Senator has spoken movingly and persuasively about what must be done to respond to the crisis there. I want to thank the Senator from New York for bringing this to the attention of his colleagues and for doing a masterful job of informing us of what is facing the people of New York. I again thank and commend the Senator on his initial speech here in the Chamber. In my 12 years in the Senate, I believe the Senator from New York is one of the most impressive new members and we are very happy to have him here.