Tom Daschle

Mr. DASCHLE

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 President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. DASCHLE

Mr. DASCHLE. Mr. President, I thank the majority leader for his explanation and the discussion we have had this morning. I think it is fair to say there is no question we were misled about the situation we are in today. That is undeniable. I had the opportunity to discuss matters yesterday with regard to the legislative schedule with our majority leader, and this did not come up. We were misled with regard to what the intent of the procedure would be. So, clearly, there is a bitter taste in the mouths of the minority as we find ourselves in this situation this morning. The problem is not legislating on appropriations; the problem is legislating. We are not able to legislate in large measure because on virtually every bill cloture is filed prior to the time amendments are offered. Every bill. And so what has happened is the minority is relegated to a set of circumstances that requires us to use whatever vehicle becomes available. That isn't the way it used to be, but that is the way it has been for the last few years. So I am sympathetic, as I have noted to the majority leader, with this institutional concept of going back to the time when we respected appropriations as appropriations bills and also respected the authorization process. But the Senate virtually has eliminated the authorization process, in part, because we don't have the opportunity to offer amendments once authorization bills come to the floor. So we have been forced to use the appropriations bills as authorizing, appropriating, legislating, the whole gamut, the whole array, the universe of legislative actions that come with our responsibility. So I have indicated to the majority leader that I would like to find a way to overturn the mistake made by Republicans 4 years ago. I am glad they have acknowledged it was a mistake, but I must say, since that mistake was made, we have been driven into a new set of legislative circumstances that make it very difficult to do the people's business. Senator Byrd noted in our caucus that it isn't just this particular issue that is troubling. Frankly, there are a number of other issues. One I will mention is the scope of conferences. The majority overruled the Chair on the scope of conference issue. The majority now has the ability in a conference committee to put anything in a bill, whether or not it was added on the floor of the House or Senate. Anything. It is wide open. That, too, is something we ought to be looking at. There is a huge array of problems, procedurally, I think we ought to address. This is one of them. It seems to me in that context we ought to be looking at whether or not overturning the Chair now is what we need to do. I will say the majority leader has indicated a willingness to work with us in addressing these problems. I am personally concerned about the agriculture appropriations emergency supplemental we have to pass. Once a point of order is reestablished, we are completely locked out. There is no other way to do it. So from both a practical, as well as a procedural, and, frankly, a personal point of view, I am troubled by how we got here this afternoon. I will also note that one of our colleagues who uses the rules as successfully as anybody ever has in all 220 years of our history, the senior Senator from Massachusetts, is not here. How ironic it would be that while he is tending to family matters, we took away his rights. So I suggest to the majority leader that we schedule another time for a good debate about all the things we should do. I will work with my caucus to find the time, and we will need to have the votes. We know how the votes--I am quite sure I know--will turn out. I am prepared to work with the majority leader to schedule a day, but not this afternoon. This is not the moment, for all the reasons I have outlined. I think we deserve an opportunity to debate this and all of its ramifications, and why it is that we find ourselves here in the first place, and how we might work--as the majority leader has noted, cooperatively. Cooperation is a two-way street. I want to cooperate with him. And I will in every way that I can. But I hope the majority will cooperate with the minority in giving us an opportunity to offer amendments and not fill the tree and not play the parliamentary game out to the extreme so that we are forced to do things we would rather not do. I guess that would be my suggestion--that we find the time, perhaps early next week, to vote. We would agree to a timeframe within which this could be debated and a vote set. I would be happy to discuss either on or off the floor a refinement of that recommendation with the majority leader. I yield the floor.

Mr. DASCHLE. Mr. President, I would want to consult first with the senior Senator from Massachusetts to be sure he could be back that early. I assume he might be back by then. I would want to consult, as well, with my caucus. But that is in keeping with the recommendation that I made. I am not averse necessarily to doing it on Monday or Tuesday, and to setting, as I noted earlier, a timeframe within which we could debate it and vote. But, again, this is a matter which I think may require a little more consultation than the time we have this afternoon.

Mr. DASCHLE. Mr. President, the leader can get that commitment in spirit. Let met give the leader three qualifications, and I am sure the leader will accommodate me on all three qualifications. First, if Senator Kennedy has to be away for family business or personal family matters--the tragedy that he is facing--certainly the majority leader would understand that, and I hope he would accommodate Senator Kennedy's needs as we schedule. Second, he noted on more than one occasion, privately and publicly, that he is willing to work with us to ensure that, even if the Chair is overturned, we will find a way--and there are no misgivings about finding a way on either side, I hope--to pass an emergency agriculture appropriations measure. Clearly we will be denied that once this vote occurs. So I know--he told me privately and again alluded to it this morning--that he will work with us to do that. Third, it would seem to me we would have to have a period of time--no less, at least, than 5 or 6 hours, 3 hours equally divided--to discuss this matter and then have the vote. If he is willing to accommodate this Senator on those three matters, I would certainly, for the record right now, indicate my willingness to work with him to set a time certain for the vote.

Mr. DASCHLE. Mr. President, I have to respond to a couple of points made by my friend, the distinguished majority leader. First, with regard to the Social Security lockbox, if ever our point was made on a particular bill, it is this one. This is exactly why we are here. I am amused and completely appreciate what it is Senator Lott has just said once more: Why do we need so many amendments? This is a simple little idea--Social Security lockbox. Why do we need so many amendments? This is just a simple idea. Mr. President, a simple idea can have profound consequences. There may be one or there may be more than one way to enact a simple idea. Senator Lautenberg offered on the Senate floor an agreement that said we will limit ourselves--and here we are again, the minority--we will limit ourselves to 12 amendments. Our Republican colleagues objected. That wasn't good enough. Twelve amendments was too many. We find ourselves, time and time and time again, not filibustering a bill. I do not remember the last time the minority filibustered a bill because we didn't want it to pass. The only time I can recall we have filibustered--and fortunately we have never lost--is on our procedural right to offer amendments. That is the only time, that I am aware of, we have fought, because our rights need to be protected. I am compelled to set the record straight, and I am compelled again to respond. This is why we are in this box. Ideally, what will happen is, a bill could get laid down, Democrats and Republicans could offer amendments; if it got out of line, Senator Lott and I could say: People, we have to get this bill done. We have to get this bill done. Will you limit yourself? Let's develop a finite list of amendments. Often that works. I have some of the best lieutenants I could hope to have, and when I sic them on the caucus, it is amazing how responsive the caucus is. It works. I come back and report to the majority leader, we can do this in 15 amendments, and we can do this tonight, and it works. That is one model. The other model is, we are presented with a confrontation. A bill is filed, the tree is filled, a cloture vote is taken. That is the other model. That model doesn't work, and it will never work. I don't care whether it is an appropriations bill or an authorization bill, we will not allow that to work. We can continue to play that out until we die of old age. It is not going to work, not as long as we are here. If we are going to get cooperation, then I am willing to look at that Social Security lockbox again. Twelve amendments doesn't seem too many to me. Yes, there may be some irrelevant amendments--not irrelevant, but nongermane amendments. They are certainly relevant to us. I think the Republicans demonstrated last week, with the Patients' Bill of Rights, they can deal with it if we offer amendments. They can deal with it. They are in the majority. They have the votes to defeat our proposals. I am not sure I know what they are afraid of. In any case, I have spoken long enough. As the majority leader has noted, the time has come to move on. I am willing to work with him to make the most of the time remaining this week and certainly next week. I yield the floor.

Mr. DASCHLE

Mr. DASCHLE. Mr. President, I take a moment to thank the majority leader for his willingness to work with us and cooperate to the point that he has tonight to reach the agreement we have for Monday. I believe this is a fair compromise. We will have an opportunity to debate it, offer an amendment, and have the vote. We will also have the opportunity to have a good discussion about how we might proceed with agriculture disasters. I think this accommodates many of the concerns we have raised. I also must share his hope that we can finish this bill at a reasonable hour. It is 9 o'clock. There is no reason within the next hour we couldn't finish this bill. I appreciate especially the deputy minority leader for all of the work he has done to get us to this point. We are down to a couple of amendments on our side. I am hopeful we can finish. There is no reason we can't do it reasonably soon. I yield the floor.

Mr. DASCHLE

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

Mr. DASCHLE. I will use some leader time allocated to me today to talk about another matter.

Mr. DASCHLE

Mr. DASCHLE. Like so many of us, I listened all weekend long to the news reports, and held onto hope long past the point when it was reasonable to do so. I wanted so much for there to be a different ending--for John F. Kennedy Jr., his wife Carolyn, and her sister Lauren to somehow, miraculously, have survived. So like people all across our Nation, all across the world, I kept a vigil. Then, Sunday night, the Coast Guard announced that the rescue mission had become a recovery mission. Today, our thoughts and prayers are with the Kennedy and Bessette families. We pray that God will comfort them and help them bear this grief that must seem unbearable now. We offer our sympathies, as well, to the many friends of John Kennedy, Carolyn Bessette Kennedy and Lauren Bessette. They, too, have suffered a great loss. I want my friend, Senator Edward Kennedy, John's uncle, to know, as I have told him personally, we are praying for him. Just last week, Senator Kennedy stood on this floor and spoke about people who had died too young, and the heartbroken families they had left behind. He urged us to pass real patient protections so other families would not have to experience that same pain. Today, once again, it is Senator Kennedy's family, along with the Bessette family, who are experiencing the pain of death that comes far too soon. More than a century ago, the great New England poet, Emily Dickinson, sent a letter to a friend who had lost someone very dear. ``When not inconvenient to your heart,'' she wrote, ``please remember us, and let us help you carry [your grief], if you grow tired.'' I know I speak for many of us when I say to Senator Kennedy: Please-- if there is any way--let us help you carry your grief, if you grow tired. You and your family have given our Nation so much. Let us--if we can--give something back to you. All weekend, I watched the news. Over and over again, I saw that heartbreaking image of the little boy saluting his father's coffin. Then came the announcement that the little boy was gone, too. And just when I thought I finally understood the magnitude of the loss, I listened to the news again this morning, and I heard friends of John F. Kennedy, Jr. say they felt certain he would have run for public office one day--probably for a seat in the United States Senate. I don't know if that is true. I do know that John F. Kennedy, Jr. believed deeply in public service. He believed what his father had said: ``to those whom much is given, much is required.'' If he had chosen to run for the Senate, I have no doubt he would have succeeded, and he would have been a great Senator. I suspect we will regret for a long, long time what John Kennedy did not have time to give us. I hope we will also remember, and treasure, what he did have time to give us. Those moments of joy when he was a little boy playing in the Oval Office with his sister and father; his stunning example of courage when he said good-bye to his father. I hope we will remember: His kindness and surprising humility; his inventiveness, and his professional success; the good humor and amazing grace with which he accepted celebrity; the dignity with which he bore his sorrows; and the happiness he found in his life, particularly in his marriage. Some years ago, another young man died too young. Alex Coffin, the son of Reverend William Sloane Coffin, was driving in a terrible storm when his car plunged into Boston Harbor and he drowned. He was 24 years old. Ten days later, William Sloane Coffin spoke about Alex's death to his parishioners at Riverside Church in New York City. I want to read a short section of his sermon, because I think it bears repeating today. The one thing no one should ever say about Alex's death--or the death of any young person--is that it is God's will. ``No one,'' Reverend Coffin said, ``knows enough to say that . . . . God doesn't go around this world with his finger on triggers, his fist around knives, his hands on steering wheels. God is dead set against all unnatural deaths . . . . My own consolation lies in knowing that . . . when the waves closed over the sinking car, God's heart was the first of all our hearts to break.'' None of us knows why John Kennedy Jr., Carolyn Bessette Kennedy and Lauren Bessette were taken from us in the prime of their lives. We don't know why the Kennedy family has had to endure so much sorrow over so many years. Nor do we know why the Bessette family has to suffer such an incomprehensibly huge loss all at once. What we do know is that the hearts of the Kennedys and the Bessettes were not the only hearts that broke when the waves closed over that sinking plane last Friday night. We are all heartbroken by the deaths of three such remarkable young people. Not long ago, I came across a book of poems by another man who also lost a young son. The man's name is David Ray. His son's name was Sam. Sam also died, at 19, also in a car accident. After Sam's death, his father wrote a whole series of poems to him, and about him. I'd like to read a very short one; it's called ``Another Trick of the Mind.'' Out of a book, a little trick-- Instead of the picture and much longing for that lost face, place yourself within the frame. You are back together again, if only in the past, or in the dream, or this gilded picture in mind. But it is no longer a dream, or a picture of loss. And then you go on, down the road you have to go, together. In our memories, we all have a scrapbook full of images of John Kennedy, Jr. Perhaps in the days ahead, when the sadness creeps up on us, we can imagine--just for a moment--that John and Carolyn and Lauren are still with us. And we can go down the road we have to go, together. And maybe when we play that trick on ourselves, and our sadness lifts for that moment, we can remember how fortunate we were to have had them with us as long as we did. I yield the floor. Mr. MACK addressed the Chair.

Mr. DASCHLE

Mr. DASCHLE. Mr. President, I appreciate this opportunity to participate in today's discussion of the Land and Water Conservation Fund (LWCF). Senator Landrieu and Senator Murkowski deserve great credit for their efforts to restore the LWCF's important conservation goals, as does Senator Lott for his commitment to addressing this issue on a bipartisan basis. Congress originally intended that revenues from off-shore oil and gas drilling be deposited into a Land and Water Conservation Fund to allow the federal and state governments to protect green space, improve wildlife habitat, and purchase lands for conservation purposes. I have come to appreciate this program, as the Land and Water Conservation Fund has been used by local and state governments in South Dakota to purchase park lands and develop many of the facilities that exist in municipal and state parks throughout the state. For the past five years, however, the state side of the LWCF has not been funded, the revenues from off-shore oil and gas drilling have been used to fund other federal programs. As a result, much-needed local and state park improvement projects have been held back, and there has been growing pressure in recent years to divert these funds back to their original purpose. Americans depend increasingly on parks and open spaces for recreation because they allow all of us to deal better with the stress of modern life. Therefore, it is important that states are given the resources they need to improve parks and public lands, and I am prepared to work in a bipartisan fashion to enact legislation this year to ensure greater annual funding of conservation efforts from off-shore oil and gas drilling revenues. A number of proposals, many of which are bipartisan, have been proposed by the administration and members of Congress to ensure that future off-shore oil and gas drilling revenues are dedicated to conservation purposes. A consensus appears to be developing that considerably more resources should be invested to protect and maintain rural and urban parks, preserve farmland and forests, provide incentives for the protection of endangered species on private lands, fully fund payments-in-lieu-of-taxes, and protect coastal resources. I believe that this legislation could have a tremendous positive impact on local, state, and national parks, and greatly enhance outdoor recreation and environmental education projects throughout South Dakota and the nation. It is my strong hope that Congress will produce compromise legislation reflecting many of the basic objectives contained in these proposals and ensure a strong future for our nation's natural resources. I am dedicated to working with Senators Landrieu, Murkowski, and Lott to achieve this goal.

Mr. DASCHLE

Mr. DASCHLE. I yield 3 minutes to the distinguished Senator from Rhode Island.

Mr. DASCHLE. Mr. President, for the last 2 years, Democrats have worked tirelessly for this moment. We have been guided by a very simple goal. That goal is to protect the rights of 160 million Americans who have private health insurance. Democrats have tried to answer the question: What should motivate that system, money or medicine? What should be the crux of our health care system? Do we put a money screen on decisions, or do we put a medical screen on decisions? We concluded that when it comes to someone's life, someone's health, the answer to that question is very simple. Democrats have outlined six basic principles. The first is that all 160 million Americans ought to be covered by patient protections. We offered an amendment to ensure that all 160 million Americans would be covered, and our Republican colleagues defeated it. The second principle is to ensure we provide access to needed care regardless of circumstances: access to qualified specialists, real access to emergency rooms, access to lifesaving treatments and drugs, access to quality care that is unique to America in some cases. We offered amendments to provide these protections, and our Republican colleagues defeated them. The third principle is simply this: That doctors ought to make medical decisions. Not accountants, not bureaucrats, not people with green eyeshades who make monetary decisions instead of medical ones. Let doctors make those decisions. We offered an amendment, and our Republican colleagues defeated it. The fourth principle is quite simple to understand, but extremely important to millions of Americans. Let us, above everything else, protect the doctor-patient relationship. Let us ensure that all doctors can talk about all medical options with their patients when they are facing critical medical decisions. Let us ensure that we protect doctors from retaliation by managed care companies. And let us ensure that chronically ill patients get to keep their doctors. Mr. President, that is not too much to ask. When we talk about rights, basic rights in this country, what could be more basic than that? We offered an amendment, and our Republican colleagues defeated it. The fifth principle is one we also feel strongly about, and that is accountability. I have heard many of our Republican colleagues say: You should not have to go to court to get your health care; the important thing is getting the care you need. We agree with that, and we provide a strong, independent appeals process. But all too often, HMOs make decisions that are wrong. And all too often, patients are left with absolutely no recourse. We simply believe that when this happens, when an HMO or an insurance company makes the wrong decision, you ought to have some recourse. You ought to be able to hold them accountable. You can with a doctor. You can with a hospital. Why not with an insurance company? Finally, I have never been more proud of our women Senators, and I have never been more convinced that we need more women in the Senate than I am tonight, because they have enlightened us, Mr. President, in our caucus and on the floor. They have sensitized us to women's issues unlike anything I have ever heard before. There isn't a man in the Senate who can tell us what they told us, with the eloquence, with the passion, with the feeling. They told us there are special needs of women that just are not being addressed. If we are going to make this system work better for millions of Americans, we ought to understand that. So we offered an amendment to ensure that women's needs are protected, and our Republican colleagues defeated it. Tonight, I agree with those who have said we missed a golden opportunity to pass a real Patients' Bill of Rights. We have offered clear choices. The majority has opposed us every step of the way. The majority leader said, let's work together, work with us. We have made every effort to work with our colleagues, but the only thing we have gotten back is what I believe the Republican bill truly stands for when it calls itself HMO reform. In my view, HMO stands for ``half measures only.'' That is all we have gotten--half measures. To those who say, isn't this just a little bit better? my answer is no. In all sincerity, I believe we will actually lower the standard when we pass this bill tonight. We have not made progress; we have moved backward. I am always amused, frankly, that our Republican colleagues turn to taxes anytime they want to fix a problem. I am surprised there is not a tax break for observing the speed limit. Tonight, there is another $13 billion bill that we will be voting on, most of which is a tax break. I support meaningful tax reform, targeted especially to working families. But when we talk about a Patients' Bill of Rights, are we really talking about the need for a tax break, or a break from the kind of oppression that many people feel with their insurance and managed care companies? I also regret the fact that we did not have an opportunity to debate the bipartisan bill. I wish we could have had a good debate on the Graham-Chafee bill. I wish we could have at least moved forward with that piece of legislation. I believe there would have been 45 Democratic votes for that bill tonight. The problem is, as I understand it, there are only three on the Republican side. Even if we offered a bipartisan bill, cosponsored by two very prominent Members of our Senate tonight, we would only have the same 48 votes we had on almost every single amendment we offered. The President will veto this bill because he and we know we can do better than this, that we should not lower the standard. We should do far more to ensure that we cover all patients, all 160 million. Ultimately, I believe, as Senator Kennedy noted, we will pass a comprehensive Patients' Bill of Rights. This afternoon I was reminded again of how critical this is to real people. Throughout this debate, what meant most to me is the experience I have had in talking to real people whose lives have been affected by managed care companies, whose lives have been directly, and in some cases, negatively affected by their decisions. Justin Dart, a full-fledged lifelong Republican was out on the lawn this afternoon. He was there in his wheelchair, surrounded by medical equipment needed to function and maintain his health. He has experienced medical care. He has benefited from it, and, unfortunately, as he related again today, he has been disappointed by it. In the most passionate and most eloquent way he could say it, with his lips quivering, speaking to all of us, as he urged the Senate to do the right thing tonight, he said: ``I'll give my life for my country, but I won't give it to an insurance company.'' Too many people have given their good health, and in some cases their lives, because decisions have been made by insurance companies for the wrong reasons. We are going to fix that. I am hopeful, as others have expressed, we can do better, we can find a way to ensure that all Americans are going to be protected, as we know they should be. We should not give up until we know we have done the job right. Mr. President, over the past three-and-a-half days, we have finally had the opportunity to have a good debate on several critical issues affecting patients' rights. Senate Democrats--and the patients of America--have waited a long time for it. Because of limited time, other critical issues remain to be debated. Still, we are glad the Senate has spent most of this week debating two dramatically different approaches to patients' rights. The American people deserve to understand the differences. They are important. Mr. President, the Senate has indeed missed a golden opportunity to pass a real Patients' Bill of Rights. Instead, the Republican majority is handing the insurance industry its version of HMO reform: Half Measures Only. On critical issues, we gave our colleagues a choice: guaranteed patient access to the closest emergency room versus ambiguous assurances of limited emergency care; access to clinical trials for all life-threatening and disabling diseases versus limited clinical trials only for cancer; medical determinations made by doctors and other health professionals versus decisions made by HMO accountants; the right to hold HMOs accountable for their decisions that harm or kill patients versus the right to live with whatever bad decisions an HMO might make; and, of course, the extension of basic rights to all privately insured Americans versus the exclusion of over 100 million Americans. The list goes on. All that was necessary on the Senate's part was to listen to the doctors and nurses and other health professionals. To listen to the American people. Unfortunately, a majority of the Senate chose to ignore those voices and listen instead to the industry that stands to continue to profit from our failure to provide meaningful patient protections. The industry that opposes even minimal protections and any means of enforcing them. Frankly, we are astounded. Yes, we were told repeatedly by Senator Nickles and Senator Gramm and Senator Frist that this would happen. That their plan was simply to block this legislation from ever coming to the Senate floor, since they did not want to be in a position of having to defend an indefensible position. When that plan failed, they made it clear their strategy was focused on political cover instead of meaningful reforms. (That cynical strategy will ultimately fail, too.) Still, we held out hope--that reason would win out in the end. That the overwhelming public support for our modest reforms --support that knows no partisan boundaries outside of Washington, DC--would influence at least a handful of Senate Republicans. We are astounded that it did not--that there are not five Republican senators willing to challenge their leadership in order to please over 80% of the American people. Maybe some of them just didn't read the two bills. The other day, Senator Gramm again invoked the name of his ``mama'' and said he wants her to be able to call her doctor instead of a bureaucrat when she gets sick. Well, we agree. But, given his concern, Senator Gramm and the vast majority of his Republican colleagues are supporting the wrong legislation. It is the Democratic bill that protects patients' rights to communicate directly with their doctor and make medical decisions with their doctor--without inappropriate interference from a nameless, faceless HMO accountant. Senator Gramm and other opponents argue: ``The Democratic bill is a step toward government-run health care.'' That charge is simply untrue--under our bill, health care professionals, not the government, would make decisions. Ours is not a step toward government-run health care; it's a step away from HMO accountant-run health care. The insurance industry's TV ads opposing the Democratic bill warn that people get hurt ``when politicians play doctor.'' Again, that is the height of irony. Senate Democrats are not playing doctor. Under the current system, and under the Republican bill, it is HMO accountants who are playing doctor, denying the real doctors the ability to implement medically sound decisions. And real people are getting hurt every day. Let's be clear--we're not opposed to managed care. The theory of managed care--that a primary care physician and health network will understand the whole patient and manage his or her care to improve patient health--is a good one. But all too often that theory has been corrupted in practice. Too often, instead of managed care, we have managed costs. The Hippocratic Oath is not about saving money; it's about saving lives. And while we should take reasonable actions to curb health care costs, we cannot do it at the expense of Americans' health. Furthermore, any costs associated with the Democratic bill would be minimal--and nonexistent for HMOs that already provide the medical services they should. The United States has the best health care in the world--the best doctors, nurses, facilities, and equipment. But what good is the best health care in the world if insurance company accountants block your access to it? Over the course of the last several days, my Republican colleagues have rejected every Democratic proposal to improve Americans' access to better health care. In one twist, they rejected our proposal to protect women from being discharged from the hospital too soon after breast cancer surgery, only to turn around the next day and take credit for that proposal at the same time they denied those same breast cancer victims--and other women and men--access to clinical trials for new, life-saving treatments. It has been a pattern all week: reject the real patient protections, and, in the specific cases where there's enough of a public outcry, offer up a half-measure that pretends to solve one problem at the expense of another. We saw the same tactic on the juvenile crime bill, when Republicans bent over backwards to avoid any meaningful gun legislation. Their operating principle: block the real solution and take credit for a false one. Perhaps the most egregious and disheartening example of hypocrisy is the majority's approach to determining which Americans will benefit from the half-measures they are willing to support. Democrats believe all 161 million privately insured Americans should be guaranteed a national floor of patients' rights. We are talking about the basic rights of American patients. Two people living on the same street-- possibly insured by the very same company--should not have two different sets of ``basic rights'' simply because they work for different employers. Under the Republican bill, only 48 million Americans--those in self- funded plans--are covered by the vast majority of their protections. They exclude over 100 million Americans from their so-called protections. The majority has argued that this exclusion is necessary to satisfy one of their core principles: that the states should be left to regulate HMOs. In the Nickles amendment striking the Kennedy amendment to cover all privately insured Americans, the majority stated, ``It would be inappropriate to set federal health insurance standards. . . . One size does not fit all, and what may be appropriate for one State may not be necessary in another.'' That amendment passed Tuesday, by a largely party-line vote. So the majority established that as its core principle, one that overrides the need to provide all Americans basic health care rights. Yet listen to the core principle laid out in the Snowe amendment I mentioned earlier. (Curiously, the Snowe amendment, which every Republican senator supported, extended its protections to all privately insured women.) In the Snowe amendment, the majority stated a ``core principle'' diametrically opposed to the core principle of the Nickles amendment: ``In order to provide for uniform treatment of health care providers and patients among the States, it is necessary to cover health plans operating in 1 State as well as health plans operating among the several States.'' That amendment passed Wednesday at 1:23 pm. Two-and-a-half hours later, the Republican majority reversed itself once again. They voted against a Democratic amendment to expand coverage to all privately insured Americans, regardless of their condition or disease--not just women with breast cancer. The whole idea behind a comprehensive Patients' Bill of Rights is that it will cover all people and all diseases, not simply those that get the most media coverage. Some of my colleagues seem to have two contradictory sets of core principles on the same issue on the same day. And, at the end of the day, the result is that, for all but one disease, the majority has chosen to deny more than 100 million Americans any protections at all. It's a cynical, and destructive, philosophy. The American people are sure to reject it, for they understand this issue far better than some politicians seem to think. How could they not understand? Every American knows someone who has been denied timely, necessary treatment by an HMO that put costs above patient care. Our bill is a modest one. It would guarantee American patients a minimum level of protection to ensure timely access to quality health care. That's what Americans expect when they buy health insurance, and that's the least they deserve. I am disappointed that, this week, America's patients were denied that minimal protection. But I can assure them that the fight for their rights is far from over. Senate Democrats--and maybe even a few brave Republicans--are committed to a real Patients' Bill of Rights, and it will pass, whether it's next week, next year, or next Congress. I guarantee it. Mr. President, I also want to take a moment to thank some of the multitudes of people who have fought so hard for a real Patients' Bill of Rights and who are committed to that fight until we succeed. I thank Senator Kennedy. I must say, I do not know if we have a more passionate, more articulate, more aggressive defender for working people in this country than we have in Ted Kennedy. He is an inspiration. We all are deeply indebted once more for the leadership he has provided not only in our caucus but in the Senate on this extraordinarily important issue. I am proud to have worked with him to develop S. 6. Also, he, like many others, has been tireless on the floor this week, and I commend him for doing such a good job for our entire caucus. I thank my assistant Democratic leader whose presence on the floor has just been phenomenal. I do not know how I could do what I do were it not for the fact that he is always there--always there. I thank my caucus. I do not know that I have ever been more proud of the caucus than I am tonight for their participation, for their leadership, for their willingness to roll up their sleeves to do their homework, to come to the floor and debate, as they did so aggressively all week. In one way or another, every member of our caucus has contributed to this debate and to the two-year effort to make it possible. More of them than I could name right now have contributed enormously, often selflessly. Our caucus has never been more unified. We believe in patients' rights, and we are committed to fight for them. So, I thank every Democratic senator. I say to each of you, it truly would not have been possible without you. I thank, as well, the majority leader for allowing this debate, and the assistant Republican leader. This debate happened because they agreed to schedule it. It would not have happened were it not for that agreement, and I am grateful for that. I thank Senator Frist for his involvement because of his unique experience in life. A special thanks goes to the more than 200 organizations representing doctors, nurses, and other health care providers as well as consumer groups, that have supported our bill. They pulled out all the stops they could, with whatever limited resources they had, to ensure that they were part of this American Democratic system. Again, I cannot name them all. But their shared commitment to a comprehensive, meaningful Patients' Bill of Rights has been critical to this process. And I say to each of them, don't be disheartened by today's loss. As I said before, we will ultimately prevail, and patients will ultimately be protected. I should send that same message to Justin Dart and all the men, women, and children who have shared their stories--often painful stories--with us. This debate could not have been held were it not for the fact that they put meaning to this debate in ways that only they can. Their stories remind us that this is not a theoretical debate. It is a real choice affecting real people who have suffered and will continue to suffer in the absence of meaningful reforms. We thank you, and we will continue the fight. Last, I want to thank the people who are too often thanked last, the staff--the staff in every office who have worked in various ways to ensure our long struggle led to a real floor debate. Senator Kennedy's staff deserves special recognition. I'm sure there were many others, but I want to recognize four of them in particular: Michael Myers, David Nexon, Cybele Bjorklund, and Jim Manley. As always, they are as amazing as their boss. They have been absolutely essential to the effort. Finally, I want to thank my own staff--both those in my own office and those throughout the Leadership Committees. At the risk of leaving someone out, I'm going to try to name most of them. Few people know how hard they work, and their commitment to service and to this cause of patients' rights is unsurpassed. From my staff, I want to thank especially: Jane Loewenson, Elizabeth Hargrave, Shelly Ten Napel, Pete Rouse, Laura Petrou, Bill Corr, Mark Patterson, Ranit Schmelzer, Molly Rowley, Marc Kimball, Chris Bois, and Elizabeth Lietz. From the Floor Staff, I thank Marty Paone, Lula Davis, Gary Myrick, and Paul Brown. We are very lucky, as Republicans and Democrats, to have the floor staff that we do. We owe them a big debt of gratitude, because without them we could not do what we do. From the Leadership Committees, my special thanks to: Bonnie Hogue, Caroline Chambers, Chuck Cooper, Maryam Moezzi, Tim Mitchell, Jodi Grant, Nicole Bennett, Maria Meier, Alexis King, Jamie Houton, Andy Davis, Mary Helen Fuller, Marguerite Beck-Rex, Brian Barrie, Kobye Noel, Katherine Moore, Nate Ackerman, Rick Singer, Clare Flood, Adriana Surfas, Kevin Kelleher, Brian Jones, Russell Gordon, Robyn Altman, Jeremy Dorin, Paige Smith, Chris Casey, Jeff Hecker, and Toby Hayman. So tonight, Mr. President, the fight goes on. I am optimistic that in the end we will have the opportunity to debate, once more, how we can resolve this issue, how we can stick to those six principles, how we can ensure that this American health system, which is so good in so many ways, can be made better. I yield the floor. Mr. NICKLES addressed the Chair.

Mr. DASCHLE. I yield 8 minutes to the distinguished Senator from Massachusetts.

Mr. DASCHLE. Mr. President, I yield 8 minutes to the distinguished Senator from Florida.

Mr. DASCHLE

Mr. DASCHLE. Mr. President, I will take a minute off the bill. I do not know how you top that. I was simply going to say that if you believe anything the Senator from Texas just said, you are going to buy a turnip truck from him, too. But I hope everybody can remember what this is all about. This is simply about whether or not patients have the right to a specialist, whether or not the HMO under any circumstances can tell a patient and his or her doctor that, no, you cannot go to a specialist, because in millions of cases around the country today, tomorrow, and for the past several years, that is exactly what has happened. Do we have access to specialists or not? The Democrats are saying yes, we need access to the specialist. That is the essence of health care in America today. But people are being denied that access. We want to change that. This amendment will do it. It deserves our support. I yield the floor.

Mr. DASCHLE. Mr. President, I ask unanimous consent that reading of the amendment be dispensed with.

Mr. DASCHLE. Mr. President, I have an amendment at the desk.

Mr. DASCHLE

Mr. DASCHLE. I ask unanimous consent that at least the deductibility amendment be allowed as part of the Kennedy amendment as well.

Mr. DASCHLE. That makes it very clear. This vote is about denying millions of Americans the right to patient protections, not about health and deductibility for self-employed businessmen. I yield the floor.

Mr. DASCHLE. Mr. President, I think the distinguished Senator from Pennsylvania had it right. We all support 100-percent deductibility for the self-employed. We just voted for it an hour or so ago. There is no question all of the Senate supports it. We are on record in support of it. The question is whether we should accelerate it. We just voted to accelerate it on this side on the Robb amendment. That isn't the question on this amendment. This amendment is about whether or not we offer 100 million additional Americans the patient protections under the Patients' Bill of Rights. In order to clarify that, I ask unanimous consent that the deductibility language be added to both the Republican bill, S. 1344, and the Daschle substitute.

Mr. DASCHLE. I yield 1 minute to the distinguished Senator from Massachusetts.

Mr. DASCHLE

Mr. DASCHLE. Mr. President, today I would like to take a moment to acknowledge a remarkable young woman from Rapid City, South Dakota, Jeanmarie Hicks, who was recently selected as the National Winner in the 1999 National Peace Essay Contest sponsored by the United States Institute of Peace. This year more than 2,500 high school students from all 50 states were asked to express their thoughts on the topic of preventing international violent conflict. Winners from each state were awarded a $1,000 college scholarship and invited to participate in a week of special activities here in Washington. The National Winner receives an additional $10,000 college scholarship. Jeanmarie Hicks, who recently graduated as valedictorian from St. Thomas More High School in Rapid City, wrote an eloquent essay entitled ``Preventive Diplomacy in the Iraq-Kuwait Dispute and in the Venezuela Border Dispute.'' In addition to her writing skills, Jeanmarie recently took first place in South Dakota in both the National French Contest and the National Spanish Contest, and will attend the College of St. Benedict in Minnesota this fall. I know my colleagues join me in congratulating Jeanmarie on all of her accomplishments, and I ask unanimous consent that her essay be printed in the Record.

Mr. DASCHLE

Mr. DASCHLE. Madam President, I yield the remainder of the time to the distinguished Senator from Massachusetts for him to manage.

Mr. DASCHLE. Madam President, I yield the floor.

Mr. DASCHLE. Madam President, I ask unanimous consent that the reading of the amendment be dispensed with.