Hillary Clinton

Mrs. CLINTON

Mrs. CLINTON. Further to that point, I believe it is the fact, is it not, that in the course of examining the many needs which our country has, in order to deal with the vulnerabilities we currently experience, the Senator has come up with a number of items that the Appropriations Committee has determined would further our security, fulfilling the responsibility that the Congress is given under our Constitution?

Mrs. CLINTON. Is it further the case that in taking testimony and receiving evidence, the Senator has helped to create a better understanding of what the needs are that we should be meeting as we attempt to prepare our country for the unfortunate but realistic possibilities of terrorism?

Mrs. CLINTON. Is it not the case that in the Senator's capacity as the chairman of the Senate Appropriations Committee that the committee, under the Senator's leadership, has held a number of hearings about the various needs that our country faces with respect to both military and homeland security?

Mrs. CLINTON. Mr. President, I thank the Senator from West Virginia. I thank him for the courtesy of yielding to me for a question, but I thank him even more for his stalwart defense of our Constitution and his constant reminder of our founding document and the principles that it contains. I ask the Senator from West Virginia, is it not also the case that under the Constitution, this issue about congressional power was very well debated, thought through, written about by our Founders, and that among the powers that were granted to the Congress was the power of the purse, the power to make the decisions about how the people's money would be used? Is that a correct reading of the Constitution that we cherish so greatly?

Mrs. CLINTON

Mrs. CLINTON. Mr. President, I join my colleague from Vermont in supporting this bill that he is introducing today, the Daniel Patrick Moynihan Lake Champlain Basin Program Act of 2002. I thank Chairman Jeffords, with whom I have the honor and pleasure of serving on the Senate Environment and Public Works Committee, for working on this legislation, for being devoted to Lake Champlain, and for giving my distinguished predecessor, Senator Moynihan, the honor of naming it after him. Senator Moynihan was in my office on Tuesday. I told him of Senator Jefford's plans, and he was surprised and delighted. But he certainly deserves this great honor because, along with Senator Jeffords, he has been a champion of this natural and cultural resource that our States share: the Lake Champlain Basin and Champlain Valley. We are joining with our colleagues--Senator Leahy and Senator Schumer--in introducing this legislation because we know how significant this lake is. It is the sixth largest natural freshwater lake in the United States. Some of us consider it a ``Great Lake.'' It is home to an array of fish, birds, and other wildlife. It also has significant historic, social, and economic consequences for our entire country. What we aim to do with this legislation is to give the Champlain Valley Basin the kind of support it needs to continue its recovery. This is an area that Senator Jeffords and Senator Moynihan paid particular attention to. They have worked very closely together over the last many years. And it builds on legislation that Senator Moynihan played a key role in during the 101st Congress, as well as a plan that came out of the 1990 legislation entitled ``Opportunities for Action'' that enabled the Lake Champlain Steering Committee to create the new guiding document on which our legislation, in great measure, draws. This will provide new and important resources for counties in Vermont and also counties in New York, including Clinton, Essex, Franklin, Hamilton, Warren, and Washington Counties. This is very important environmental legislation, but it is equally important economic, social, and historic legislation. That is why I am very proud to sponsor this legislation with my chairman, Senator Jeffords, and to join him in naming this legislation after our illustrious and esteemed colleague, Senator Patrick Moynihan. There is no more fitting tribute to Senator Moynihan than to give him the recognition that he is due for the leadership role he played in bringing to national attention places of great national importance, such as Lake Champlain. I thank Senator Jeffords.

Mrs. CLINTON

Mrs. CLINTON. Mr. President, I join my colleague from Vermont in supporting this bill that he is introducing today, the Daniel Patrick Moynihan Lake Champlain Basin Program Act of 2002. I thank Chairman Jeffords, with whom I have the honor and pleasure of serving on the Senate Environment and Public Works Committee, for working on this legislation, for being devoted to Lake Champlain, and for giving my distinguished predecessor, Senator Moynihan, the honor of naming it after him. Senator Moynihan was in my office on Tuesday. I told him of Senator Jefford's plans, and he was surprised and delighted. But he certainly deserves this great honor because, along with Senator Jeffords, he has been a champion of this natural and cultural resource that our States share: the Lake Champlain Basin and Champlain Valley. We are joining with our colleagues--Senator Leahy and Senator Schumer--in introducing this legislation because we know how significant this lake is. It is the sixth largest natural freshwater lake in the United States. Some of us consider it a ``Great Lake.'' It is home to an array of fish, birds, and other wildlife. It also has significant historic, social, and economic consequences for our entire country. What we aim to do with this legislation is to give the Champlain Valley Basin the kind of support it needs to continue its recovery. This is an area that Senator Jeffords and Senator Moynihan paid particular attention to. They have worked very closely together over the last many years. And it builds on legislation that Senator Moynihan played a key role in during the 101st Congress, as well as a plan that came out of the 1990 legislation entitled ``Opportunities for Action'' that enabled the Lake Champlain Steering Committee to create the new guiding document on which our legislation, in great measure, draws. This will provide new and important resources for counties in Vermont and also counties in New York, including Clinton, Essex, Franklin, Hamilton, Warren, and Washington Counties. This is very important environmental legislation, but it is equally important economic, social, and historic legislation. That is why I am very proud to sponsor this legislation with my chairman, Senator Jeffords, and to join him in naming this legislation after our illustrious and esteemed colleague, Senator Patrick Moynihan. There is no more fitting tribute to Senator Moynihan than to give him the recognition that he is due for the leadership role he played in bringing to national attention places of great national importance, such as Lake Champlain. I thank Senator Jeffords.

Mrs. CLINTON

Mrs. CLINTON. Mr. President, I would like to recognize Mr. Daschle for his efforts and concern for the farmers, growers, and ranchers of this nation. His leadership on providing financial assistance to these farmers who have been stricken by the wrath of Mother Nature is to be commended. Mr. President, my colleague from New York, Senator Schumer, and I would like to engage Senator Daschle in a colloquy.

Mrs. CLINTON. Mr. President, this year has been the worst year in memory for many specialty crop farmers. In New York's Hudson Valley region, losses on specialty fruit crops total $65 million for 2002 alone. For the communities and the fruit growers in the region, crop disaster relief is much needed to sustain our farms through this difficult time.

Mrs. CLINTON. Mr. President, these weather conditions have wreaked havoc on an industry vital to New York State. As their trees now stand, green leaves and no fruit, it is feared that a large percentage of these fruit farmers will be forced out of business. It is crucial that these farmers receive assistance along with the farmers and ranchers of the rest of the country who have suffered the devastating effects of drought.

Mrs. CLINTON

Mrs. CLINTON. Mr. President: I ask unanimous consent that the text of the bill, to designate the facility of the United States Postal Service located at 380 Main Street in Farmingdale, New York, as the ``Peter J. Ganci, Jr. Post Office Building,'' be printed in the Record.

Mrs. CLINTON

Mrs. CLINTON. Mr. President: I ask unanimous consent that the text of the bill, to designate the facility of the United States Postal Service located at 380 Main Street in Farmingdale, New York, as the ``Peter J. Ganci, Jr. Post Office Building,'' be printed in the Record.

Mrs. CLINTON

Mrs. CLINTON. Madam President, as we approached the 1-year anniversary of 9/11, I rise today to again honor all of the public safety officers whose courageous and heroic acts saved thousands of lives at the World Trade Center. In particular, I want to highlight a group of public safety officers who deserve to be honored for their heroism. The New York City court officers risked their lives and contributed immensely to the rescue and recovery operations at Ground Zero. I especially would like to honor three court officers who gave the ultimate sacrifice--their lives. Their heroic deeds have earned them the nomination for the Public Safety Officer Medal of Valor--a testament to true American heroes. I would like to say a little bit on each officer. Captain William ``Harry'' Thompson, of the Bronx, was widely respected and beloved by all 1,600 court officers in New York City as senior instructor at the New York State Court Officers Academy. A 27- year veteran, he was the father of two adult sons and was the sole supporter for his widowed mother. All who knew Captain Thompson considered him a ``spit and polish'' type of officer. Captain Thompson was proud of his profession and New York is so very lucky that he devoted his life to public service. Senior Court Officer Thomas Jurgens was part of a family who believed in giving back to one's city and country. Senior Court Officer Jurgens was the son of a firefighter, and was a volunteer fireman from Lawrence, Long Island. He made all of us proud by serving his country in the Persian Gulf war as an Army combat paramedic. Senior Court Officer Jurgens was a 4-year veteran at the Manhattan Supreme Court, and he was married in June 2001. Senior Court Officer Mitchel Wallace, of Mineloa, Long Island, worked at the Manhattan Supreme Court for 2 years. Before September 11, the New York State Court of Appeals Chief Judge Judith Kaye honored him for resuscitating a man who had collapsed from cardiac arrest aboard a Long Island railroad train. Senior Court Officer Wallace planned to marry Noreen McDonough in October, and he called her ``Cinderella.'' In addition to these brave heroes who were lost, 22 other court officers risked their lives to save others at the World Trade Center. These men and women have been honored for their bravery on September 11. They are: Deputy Chief Joseph Baccellieri, Jr., Officer Tyree Bacon, Sgt. Frances Barry, Captain John Civelia, Sgt. Gerard Davis, Officer William Faulkner, Officer Gerard Grant, Officer Edwin Kennedy, Officer Elayne Kittel, Officer William Kuhrt, Officer Theodore Leoutsakos, Officer Craig Lovich, Sgt. Patricia Maiorino, Major Reginald V. Mebane, Sgt. Al Moscola, Sgt. Kathryn Negron, Officer Joseph Ranauro, Sgt. Albert Romanelli, Sgt. Richard Rosenfeld, Officer Andrew Scagnelli, Officer Mahindra Seobarrat, and Sgt. Andrew Wender. Hundreds of court officers volunteered to work on recovery efforts at Ground Zero. After working full shifts at the courthouse, these officers would then work a full shift at Ground Zero. They would return home, clean the dust and debris from their hands, and return to their jobs at the courthouse. Through valor, duty, and commitment, they did all that they could to assist in the rescue and recovery operations. On behalf of the American people, I express my thanks and appreciation for these public safety officers whose dedication and patriotism strengthen the resolve of our Nation. These officers went above and beyond the call of duty, sacrificing their lives in order to save others, not because it was their job, but because it was their sense of duty of pride. These officers represent the very best in America.

Mrs. CLINTON

Mrs. CLINTON. This is compounded because the administration's budget calls for eliminating money that would go to our police, firefighters, and local law enforcement; eliminating more than $500 million from the COPS program; eliminating entirely Federal funding for hiring new so- called COPS officers; eliminating and cutting other essential programs such as the local law enforcement block grant. This makes no sense to me. It is fine to have this abstract, theoretical, philosophical, even constitutional debate, as important as it is--and I believe with all my heart it is a critical debate--but let us not kid ourselves: If we do not get resources where it counts, we are not going to be better prepared, we are not going to be better defended. I hope as we debate homeland defense, we also recognize the obligation we owe to those men and women who would answer the call today when it is sent out. I yield back the remainder of my time.

Mrs. CLINTON. Mr. President, I thank the Senator. I rise to join Senator Byrd in speaking about our homeland security needs. Our colleague from South Carolina always teaches me something whenever I have the pleasure and privilege of hearing him speak in this Chamber. New Yorkers particularly owe Senator Byrd a great debt of gratitude because he and his very worthy staff have done a tremendous amount of work to help New York recover and rebuild from the tragedy of September 11. As we appear today in this Chamber, I cannot help but remark that Senator Byrd has been focused on homeland security from the moment I first spoke with him on September 12 around 7 a.m. after we knew the full extent of the damage, and I was going up to see what had happened in New York for myself. He has been extremely understanding and also very knowledgeable about what it was going to take to make us more secure. I also thank Senator Lieberman for his tremendous efforts in trying to craft legislation that will make us safer. We are not just doing this for a political exercise or just to reorganize for the sake of reorganizing, but we know there are serious issues to be addressed, some of which Senator Hollings spoke about. I do support the idea of a Homeland Security Department, but I come today to recognize the seriousness of the issues that should be addressed while we are trying to determine what it is we need to do to make our Government more prepared. There are a number of issues, and my colleagues have raised quite a few of them, but I want to focus on one particular aspect of our homeland security, and that is the resources that our frontline firefighters, police officers, and emergency responders need to be the soldiers to defend our homeland security. Just as we support our men and women in uniform who are doing a very important job extremely well, from Afghanistan to the Middle East to the Far East, we have to do the same for our local homeland defenders. I have been disappointed in the disconnect between rhetoric and resources from the administration. We certainly have had many heartfelt and moving moments where words have captured our feelings. When it comes to providing the resources that our police, our firefighters, and our emergency responders need, I think the administration has fallen short. That was certainly clear over the August recess when the President chose not to sign the emergency designation for the $5.1 billion supplemental appropriations bill, which included $2.5 billion for improving our homeland security. That number did not come out of thin air. It was the result of hearings, testimony, and evidence presented by people on the front lines. A number of people from New York who were in our police department and our fire department, who had been there on September 11, who understood what we needed to be well prepared, came down to set forth a very clear agenda that they hoped the Federal Government would help them meet. The supplemental appropriations bill, for example, would have given our first responders $100 million so that police and firefighters would have communications systems that could talk to each other. We found out, tragically, on September 11 that we did not have that, and New York is not alone in not having what is called interoperability between the police and firefighter radio systems. There would have been $150 million in additional FIRE Act grant funding to help fire departments improve their emergency preparedness, and there would have been $90 million to track the long-term health care of those who responded at Ground Zero, not just so we fulfill our obligation to take care of these brave men and women but also so we can be better prepared to take care of all of our first responders. I am not alone in thinking the President's refusal to sign the emergency designation was a terrible mistake. The International Association of Firefighters has voiced its concern in very clear, unmistakable language. I know they are particularly passionate about this issue because they lost so many of their colleagues. In his August 20 letter to President Bush, the International Association of Firefighters general president, Harold Schaitberger, had this to say: I would be dishonest if I did not convey our anger, concern and growing doubt about your commitment to us . . . No one, not even the President, has the right to pontificate about his or her commitment and respect for firefighters while ignoring our legitimate needs. With all due respect, support entails more than kind words. The President said he was exercising fiscal discipline by not making the emergency designation and said that this was, in his view, wasteful congressional spending; that $5 billion was not an emergency even if it went to the kind of emergency needs and services that we know we are lacking. I have to respectfully disagree. I think we do face an emergency. We are rushing through this legislation because clearly we think we face an emergency. But the real emergency is not in Washington to reorganize a huge Government department. The real emergency is in the police stations and the firehouses and the emergency rooms of America. That is why I am concerned that when the Congress goes through the kind of process it did to arrive at a need for $5.1 billion and it is totally disregarded, then why on Earth would we want to give up congressional oversight and authority in setting the agenda to protect our country? I believe it is imperative we do everything we can in setting up this Department to get the money to where it needs to go. We have to get the dollars where the responsibility rests. When a disaster occurs, whether it is man-made or accidental, we do not call the White House. We do not even call the Senate or the Congress or the Governor's office. In most instances, we call 911. It is clear the kind of support we need for direct Federal homeland security funding needs to be a part of any homeland security defense program. We have a heavy responsibility in Washington, not just to talk the talk but to walk the walk with our first responders. We have to give them the equipment and the resources and the training they need. According to the U.S. Conference of Mayors, since September 11 cities have invested almost $3 billion in added security costs for equipment, overtime, and training. As of this date, with the exceptions of New York and Washington, DC, which suffered so grievously on September 11, not one city has received a single dime to cover these additional costs. Some bioterrorism funding--about $1.1 billion--has been dispersed to the States, and that helps, but that does not answer the need that our firefighters, police officers, and emergency responders have. I think it is clear, if we are going to be debating this Department, let us talk about the real needs that are out there. We have to be sure we follow the clear example that has been set by communities in trying to shift funds to meet their emergency needs. We have to help them shoulder these additional burdens. Clearly, the Federal, State, and local governments are at partnership in preparing, in being responsible, and then finally in responding. But if they do not have the resources, they cannot do the job. So as we debate this Department, let us join with the people on our front lines who understand what they really need--groups such as the U.S. Conference of Mayors, the National League of Cities, and the National Association of Counties. Let us support direct Federal funding to local communities. Let us do it in the form of a community development block grant. Let us follow the money where it needs to go. From my perspective, it is imperative we debate resources, not just reorganization. It would be a cruel deception to pass something called Homeland Security Department reorganization, which we all know is going to take years to untangle to try to get focused and to be effective, and not provide the dollars that our frontline defenders need. I ask unanimous consent for 2 additional minutes.

Mrs. CLINTON. Ten minutes.

Mrs. CLINTON

Mrs. CLINTON. I am very pleased that today the Senate HELP Committee voted unanimously to report S. 2394, the Preserve the Pediatric Rule Act of 2002, out of Committee, as amended by consensus language to assure that, for already-marketed drug, companies have an opportunity to conduct studies voluntarily before the rule is invoked, which is consistent with current Food and Drug Administration practices.

Mrs. CLINTON. I would agree.

Mrs. CLINTON. That is correct.

Mrs. CLINTON. I agree.

Mrs. CLINTON

Mrs. CLINTON. Madam President, I ask unanimous consent the order for the quorum call be rescinded.

Mrs. CLINTON

Mrs. CLINTON. Madam President, I rise today to recognize the 12-year anniversary of an incredibly important step in America's continuing effort to expand the circle of opportunity and to realize a more perfect union. Twelve years ago today, the Americans with Disabilities Act became law. When we think about that remarkable day in history, we remember the relentless efforts of some of our colleagues who took such leadership in this important expansion of civil rights protections. Senators Harkin and Kennedy used their positions of power to fight for those with little or no power. Their work opened the doors to people with disabilities in much the same way as the Civil Rights Act had done three decades earlier for other Americans. We also remember the people who fought behind the scenes, those who tenaciously and selflessly advocated for equal access because they knew that people with disabilities were being excluded from schools, from jobs, from the most fundamental participation in our American way of life. One such person--someone whom I was very proud to call my friend--was truly the heart and soul of the disabilities civil rights movement. That person was Justin Dart. We lost a great American and a great leader with Justin's death on June 22. But because of his lifelong commitment to ensuring the rights and dignity of every single American, we will never forget him. He was not only a great and tireless leader, he was an extraordinary human being. Anyone who ever saw him, with his cowboy hat and his infectious grin, would never forget him. Justin Dart's passionate advocacy led many to refer to him as the Martin Luther King of the disabilities movement. So on Martin Luther King's birthday, January 15, 1998, my husband, President Bill Clinton, awarded Justin the Medal of Freedom, our Nation's highest civilian award. We also invited Justin back to the White House when we honored the 10th anniversary of the Americans with Disabilities Act. And throughout my tenure as First Lady, and since becoming a Senator from New York, I often sought his guidance on health and disabilities issues. Justin Dart's leadership changed the way we, as a society, think about people with disabilities. We all know--those of us who have lived long enough--that at one time we presumed a disability meant a lifetime of dependence. Now we know better. We know that we have countless Americans, of all ages, with disabilities who not only want to but can lead independent lives to contribute to the quality of our lives and our Nation's prosperity. That is why, in 1998, the Clinton-Gore administration formed the Presidential Task Force on Employment of Adults with Disabilities, and then in the year 2000 expanded its mission to include young people. This task force has been instrumental in helping us understand the challenges that still confront Americans with disabilities and in understanding, despite the extraordinary progress we have made since the ADA was passed, we still have a very long way to go. According to a recent survey of Americans with disabilities conducted in 2000, 56 percent of 18- to 64-year-olds with disabilities who were able to go to work were employed in 2000. That is up from 47 percent in 1994. That is progress, but we also have to recognize that 44 percent of Americans with disabilities are still not working. Justin himself eloquently expressed the status of Americans with disabilities on the 7th anniversary of the ADA when he said: The job of democracy is far from finished. Millions and millions of people with disabilities, in America and other lands, are still outcast from the good life. In Justin's honor, we simply have to do better. One of the ways I will keep honoring Justin Dart's legacy is to continue the fight for equal access and full funding under the extraordinarily important legislation passed 25 years ago to provide education for children with disabilities. The Individuals with Disabilities in Education Act, known as IDEA, has literally transformed the lives of countless American children. I have a particular connection with that law because, as a young lawyer just out of law school in 1973, I went to work for the Children's Defense Fund. We could not understand why, if you looked at census tracks and saw how many children were living in a particular area between the ages of 5 and 18 and compared that with the number of children enrolled in school, there was a discrepancy. There were children we knew living in an area but they were not in school. Where were they? We could not understand it by just looking at the statistics so we literally went door to door to door. I was knocking on doors in New Bedford, MA, asking people did they have a child who was not currently enrolled in school. I found blind children, deaf children, children in wheelchairs, children who were kept out of school because there were no accommodations for their education. I remember going into a small apartment that opened out on to a tiny terrace where the family had constructed a grape arbor, and it was a beautiful apartment with a small garden. A little girl was sitting in a wheelchair out on this little terrace on a summer afternoon. She had never been to school. We then, working with many other advocates for children and people with disabilities, wrote a report and engaged in the debate which led to the passage of the Individuals with Disabilities in Education Act in 1975. This year the HELP Committee, on which I serve, is beginning the hard work of reauthorizing this important legislation. When it was passed in the Congress in 1975, we made a promise that the Federal Government would pay 40 percent of the cost of educating children with disabilities. I thought that was a fair bargain because, clearly, educating a child who is blind or deaf or in a wheelchair and needs more help, therefore, requires more resources which is going to raise the costs for local communities. But it was another example of America doing the right thing. It has made such a difference. Anyone who goes into schools today and sees bright young children raising their hand from their wheelchair or walking down the hallway on braces with their friends or having someone help with the reading because they are blind knows what a difference it has made, not only for the children with disabilities but for all children and for the kind of society we are. Unfortunately, the Federal Government has never paid its fair share. That is something that has to change. That is something about which I often talked to my friend Justin Dart. He would have wanted us to keep going with the fight to ensure that all Americans are treated with dignity. He had a very astute way of looking at life and actions in Washington. He once said: The legitimate purpose of society and its government is not to govern people and to promote the good life for them, but to empower them to govern themselves and to provide the good life for themselves and their fellow humans. As usual, Justin Dart summed it up. The Americans with Disabilities Act provided a firm foundation on which to build that empowerment, to ensure that every boy and girl, no matter what their physical or mental status might be, is viewed with the same respect and caring that every other human being deserves as well. Justin Dart lived it. He advocated. He harassed. He reminded. He prodded and promoted all of us to do better. He himself was confined to a wheelchair. He lived with a great deal of pain, but that smile never left his face. With his beloved wife and family, he showed up whenever the call was sounded for his championship on behalf of people who he never forgot and for whom he never stopped fighting. We will miss Justin Dart, but it is up to us to continue his legacy and to ensure that the work to which he gave his life continues in his honor and on behalf of the countless young Americans who might never know his name but who are given a chance to chart their own destinies because he came before. I thank my friend Justin Dart and wish him and his wonderful family Godspeed. I suggest the absence of a quorum.

Mrs. CLINTON

Mrs. CLINTON. Mr. President, I am proud that the House and the Senate have worked out the differences between the two versions of the Nurse Reinvestment Act that we passed last year. I am also proud that today, the Senate will pass this agreed-upon legislation with unanimous support, and I look forward to subsequent action by the House so that this bill can be swiftly signed into law. I thank Senators Mikulski, Hutchinson, Kerry, Jeffords, and Kennedy for their leadership. Many on the House side have also worked hard on this legislation, including Representatives Bilirakis, Capps, and others. We have all heard a great deal about the workforce shortage from nurses in New York and across the Nation. Around the country, nurses are facing an emergency of their own. The number of undergraduate nursing program graduates in New York State has dropped each academic year since 1996, and this pattern is evident everywhere. The Nurse Reinvestment Act we are passing today contains scholarships, public service announcements, and other provisions to encourage people to enter the profession, as well as nurse faculty provisions too, so that colleges of nursing have the personnel equipped to help train new nurses entering the pipeline. But the current nursing shortage problem exists not only because fewer individuals are entering the nursing profession, but also because the healthcare industry is having trouble retaining the nurses already on staff. Fifty percent of nurses say that they have recently considered leaving their jobs for reasons other than retirement, and approximately half a million licenses nurses are not currently practicing nursing. Many of the nurses who have considered leaving the profession cite their low level of overall job satisfaction. But there are some health care facilities that are taking action and having an effect on retention and nurse satisfaction. During the last nursing shortage, researchers found some hospitals experienced low turnover and low vacancies. They found these hospitals shared certain characteristics. They were structured along participatory, collaborative, and patient-centered lines and, as a result, act as ``magnets'' that attract and retain nurses. The American Nurse Credentialing Center developed a credentialing program to designate facilities as magnet facilities if they met certain criteria. And over the years, these magnet facilities have continued to demonstrate results. The average length of employment for registered nurses in magnet hospitals is 8.35 years, which is twice the length of employment in hospitals generally, and magnet hospital nurses consistently report greater job satisfaction, fewer needlestick injuries, and lower burnout rates than other nurses. But the beneficiaries of this legislation are not just hospitals and nurses, but patients as well. Magnet hospitals report lower mortality rates, higher patient satisfaction, and greater cost-efficiency, with patients experiencing shorter stays in hospitals and intensive care units. That is why last year I introduced the bipartisan Nurse Retention and Quality Care Act with my colleague, Senator Gordon Smith of Oregon, to provides grants to health care organizations to implement these magnet hospital principles that improve nurse retention. The Nurse Reinvestment Act, which we are passing today, adds for the first time some recognition of the importance of retention in addressing nursing issues, as well, and specifically mentions the magnet principles of collaboration, nurse involvement in decisionmaking, and orientation toward patient outcomes. I look forward to action by the House and the President to assure that this bill becomes law. On September 11, and since, our nurses have been on the front lines of the battle against terrorism and bioterrorism. Today, they continue to defend America. I am pleased to be celebrating our work together to help hospitals, nurses, and patients, through this bill, which we will work together to fund.

Mrs. CLINTON

Mrs. CLINTON. Madam President, I ask unanimous consent that Suzanne Johnson, a legislative fellow in my office, be permitted on the Senate floor throughout the debate on S. 812, and other prescription drug issues.

Mrs. CLINTON

Mrs. CLINTON. Thank you, Madam President. Madam President, I wish to pick up on a comment that you made at the end of your remarks before assuming the Chair. I, as all of our colleagues, deeply respect the leadership you have provided on this issue. You are down here on the floor day after day making the case on behalf of the need for prescription drug coverage and reform that would provide the lifesaving quality-of-life drugs to our seniors and open the doors to others who are not yet of Medicare eligibility but who have very high prescription drug costs. At the end of your remarks you said this was connected to the debate that we finished last week concerning the serious issues about accounting and corporate governance to which we have to pay special attention. I agree with that. We may be debating prescription drug coverage, but it is in the larger context of what kind of country we want to be. What kind of values do we espouse? How are we going to ensure that people not only have the perception but the reality that our system works for everybody, not just for the rich and the powerful, not just for the big companies but for the small businesses and for the average citizen? There is a connection. I think that connection deserves to be drawn. I thank you for doing so. The legislation we are discussing this week addresses not just a top health priority but a fundamental value of who we are as Americans. Will we or will we not provide access to affordable prescription drugs for our seniors? Will we or will we not make equivalent generic drugs available for all Americans? Simple question; complicated answer. That is what we are attempting to work out today. The prescription drug issue is well known to any of us who have had to fill a prescription in the last several years. Prescription drug costs have been rising at an annual rate of 20 percent, far outpacing inflation and more than doubling in the last 5 years. We set a goal a couple of years ago to double NIH funding within 5 years, but instead we have seen the doubling of drug industry costs. Costs have increased for a number of reasons. People have begun to use more of these so-called lifestyle drugs in addition to the lifesaving drugs. Costs are also increasing because of drug company marketing efforts to shift patients away from older, less expensive drugs to newer, costlier, so-called ``me too'' drugs which have had an impact. ``Me too'' drugs are copycat drugs that actually do little or nothing more than the existing drugs we already have, but they are more expensive because they are new. It is like when you go to the supermarket and they say new and improved, new and different. These are new but not necessarily improved drugs. They are copycat drugs. We have recently heard examples of Vioxx and Celebrex, expensive, new, heavily advertised drugs that doctors now tell us may be no better than the kinds of drugs you get across the counter for which you don't need a prescription. Drug companies are also spending up to $13,000 per doctor annually trying to influence research results and prescribing patterns. Think about it. Every doctor in America has a $13,000 allocation from drug companies that flood his or her offices with salespeople with all kinds of inducements--with trips and dinners and the like in order to convince the doctor to use this different drug than the doctor has been using or to try the new and improved copycat drug. This is going on despite the ethics and gift guidelines that the American Medical Association has developed and that the pharmaceutical association-- known as PhRMA--has agreed to follow. Many of my physician constituents continue to complain to me that, despite these ethical guidelines, drug company representatives have attempted to circumvent and flout them. With the multibillion-dollars that drug companies spend annually on drug promotion and on physicians, this shocks me, I have to tell you. I said to my staff: You have to go and triplecheck this. I couldn't believe it. But with the money they spend on drug promotion mostly directly to physicians, their spending exceeds the amount of money that we spend as a nation educating all medical students and medical residents in our Nation. That just isn't right. We have a voluntary set of guidelines that are supposed to control it, but, unfortunately, as with a lot of human nature, those voluntary guidelines don't have enough teeth in them to make it happen. I am also concerned about the erosion of privacy. Drug companies are doing everything they can to convince patients--that is you and me--to try the drug. In addition to convincing physicians with all of their money, they are spending a heck of a lot of money trying to convince us to try something. A friend of mine said she didn't even know she had a problem until she saw an advertisement. And all of a sudden, she now thinks she has a problem. She talked to her doctor. Her doctor said she really didn't need it. She said: I am not sure. She said: Should I listen to the doctor or should I listen to the advertising? I said: For Heaven's sake, you wouldn't do that on anything else. Why would you do it on this? Advertising really works. It gets into our psyche. It kind of convinces us of things and makes us feel that we are not doing what we should unless we go out and buy a new product. That is the same with new drugs. The privacy aspect is different than going out and being convinced that you need a different car or that you should try a different detergent. Under the Bush administration, privacy regulations previously issued by the Secretary of Health and Human Services have been changed. These changes make it easier for drug companies to acquire patient information about us and then to use that patient information they get from doctors, pharmacists, or health provider organizations without our full knowledge, and certainly without our prior consent. Several weeks ago, we heard about a woman in Florida who received an unsolicited prescription drug, Prozac, in the mail. She believes her privacy was violated. I think she is right. It was violated. Can you imagine, all of a sudden, into your mailbox come drugs that you never asked for, that were never prescribed for you? I do not think any drug company should have access to a patient's records or be able to use that kind of intimate information without a patient's full agreement and consent. So I worry about the combination of the Bush administration weakening privacy regulations and the drug companies using that information, which is extremely personal, to try to sell us something. I do not have any argument with the lifesaving benefits that are provided to all of us because of the work done by pharmaceutical manufacturers. Their role in the American health system is not only vital but should be rewarded through exclusive patents on their discovery for the full patent term of up to 20 years, as set forth by one of our colleagues and a colleague from the House in the Hatch- Waxman bill passed years ago. However, Hatch-Waxman represented a carefully crafted balance designed to make the American consumer--the American patient--the ultimate beneficiary. On the one hand, Hatch-Waxman established full restoration of the monopoly patent time for a brand name drug as an incentive for real innovation. On the other hand, Hatch-Waxman ensured that after the monopoly term ended, the consumer would get the benefit of competition because there would no longer be an exclusive right to manufacture and market that drug. We know the consumer will get benefits with lower drug prices and generic versions which are just as good as the brand name patented versions. Generic drugs share the same active ingredients as the brand name drugs but, as this chart shows, the generics are usually considerably less expensive. Generic drugs have also increased in price but at a much slower rate than brand name drugs have. Generic drugs help keep prices down, particularly for our seniors. If you look at this next chart, it is a chart showing the costs that are involved in manufacturing and advertising drugs. It is very clear that the amount of money that is spent to market these drugs goes right into the cost of them. That $13,000 per doctor, that has to be paid by somebody, and we are the ones who end up paying for it. It is important to protect innovation. Nobody wants to undermine innovation. But in recent years, drug companies have clearly taken advantage of these loopholes to keep generics off the market. What we have found is that the brand name manufacturers are frivolously listing patents not because the generics will infringe on the patents but simply to force generics to certify that those patents are invalid in order to get the lower priced generic drugs to market. The reason is that forcing this certification gives the brand name drug an automatic 2\1/2\-year extension, called a 30-month stay, on their monopoly, regardless of the merits of the patent. Let me give you a few quick examples. There is a medication called Pulmicort, which is an asthma medication. In addition to all the patents on the compound--in other words, the active ingredients that are in the drug that makes it work for asthma--in addition to all the patents on the compound, on its use, and on its formulation, they have a patent on the container, which is in what is called the Orange Book. The container may be a really nice container, it may look great inside your medicine chest, but when a generic company is seeking to make a pill for asthma, it is not trying to make the bottle, it is trying to make the pill. So a patent on the bottle should not prevent the generic version of the drug from coming to market. In addition, we know that some drug companies make sweetheart deals with generic companies, literally paying them--I would say bribing them--to stay off the market, which under one of the loopholes in the current law means that other generics also have to stay out of the market. So generic X comes and says, we are going to the market with this drug, and the big drug company says, we will pay you not to; and they say, OK, we will not. That means nobody can come with a competitive drug that will do the same thing at a lower price. I support adequate patent terms for pharmaceutical manufacturers to conduct research and development, which all of us know is high risk and high stakes, but the best way to encourage that research and development is a prospective approach rather than a patent extension after the fact. Companies, as we know, have been maneuvering at the 11th hour just as their patents are about to expire. This legislation, the underlying Schumer-McCain legislation, is intended to prevent that. So let's do the right thing. Let's get our generic manufacturers a level playing field. Let's get a prescription drug benefit for our seniors. And let's send a message to America that we want to treat people fairly in this great country of ours. Thank you, Madam President.

Mrs. CLINTON. Madam President, I commend my colleague from New Jersey for his statement, which I think all of us recognize was arrived at after considerable study and thought since he does represent a State which has a concentration of our finest pharmaceutical companies. His statement today, which shows a balance and a very thoughtful approach to policies that affect us, is a great addition to this debate. Madam President, I ask unanimous consent to speak for up to 12 minutes as in morning business.