Tom Daschle

Mr. DASCHLE

Mr. DASCHLE. I am happy to yield.

Mr. DASCHLE. I have come to the conclusion, that this may not even be half a loaf but it is a start. As a start, it affords an opportunity to come back in 2 months, 2 years, within the next two decades, and gives us a chance to build. It has the elements of a foundation upon which we can improve a system of prescription drug health care delivery to seniors for the first time in our lifetime, for the first time in the lifetime of Medicare. That to me is a valuable asset to put in the bank so that I am prepared to accept the many deficiencies in this bill in an effort to get something started. I don't expect I will enjoy unanimous support for that point of view within our caucus, perhaps within the Senate. But it seems to me we have to start somewhere. If we fall victim to making the perfect the enemy of the good, then I believe we will have lost yet another year and there will be no help for seniors under any circumstances. I don't find that acceptable.

Mr. DASCHLE. I yield the floor.

Mr. DASCHLE. In response to the Senator from Illinois, some of the bill's proponents would say that is what they hope to achieve through competition, but we have not seen that work. Medicare+Choice was supposed to be competition, and it has not worked. What we need to do is to have real competition with a Medicare benefit plan that will kick in, that will allow us to compare what could be done in the private sector with what could be done in the public sector. We have seen real cost containment in the Veterans' Administration. We have seen it in the Defense Department. To a certain extent, we have seen it in other governmental agencies, such as the Indian Health Service. We have not seen it yet with Medicare+Choice. That is No. 1. No. 2, we will be offering an amendment offered at least by Senators Gregg, Schumer, and others on access to generic drugs which will give people an option to buy the generic version of a given drug, and that will help. Senator Dorgan will offer an amendment for reimportation of drugs sold cheaper in other countries to allow greater cost containment. Those three things could go a long way to addressing the issue of costs more effectively, and that is what this amendment process is going to be all about.

Mr. DASCHLE. Well, there is not only one, there are four moving targets. The first moving target, as the Senator suggests, is the premium. It is suggested it be $35 a month, but there is no guarantee. It could be $100. It could be $20. No one knows. They will not know until they are able to determine just what it is going to take to bring a benefit to a given region. That is only the first. The suggested deductible is $275. There is no guarantee. Nobody knows whether it is going to be $500 or $100. There is no guarantee on the copay. It is supposed to be 50/50. It could be 70/30. There is no guarantee on the so-called initial cap on benefits, or the benefit loss at some point, whenever that kicks in. It could be $4,500. It could be different. That is the benefit cap beyond which one has to pay all of the costs of a prescription drug. So there are those four variables. As the Senator suggests, more clarity and certainty in this legislation would go a long way to eliminating a lot of the anxiety seniors have about this.

Mr. DASCHLE. Unfortunately, the Senator is correct. Some suggest it takes that long to set up the infrastructure, but as he also noted, Medicare took 11 months. When we established Medicare, 11 months later it was up and running. If an entire health care system can be developed with a payment regime for doctors as well as hospitals--and I might add there were two different payment regimes, Part A and Part B--in 11 months, I do not understand why it would have to take 3 years for us to do this. But that is what is incorporated in the bill.

Mr. DASCHLE. The Senator from Florida has put his finger on one of the big concerns many Members have, the volatility, as he called it, the revolving door. What private insurance companies have stated in the past, insuring drug coverage for seniors is almost like insuring for a hair cut. A hair cut is inevitable. So is the utilization of prescription drugs for seniors. Because we cannot make the actuarial analysis work, there is no choice; either not to go in or to be significantly subsidized to make a profit, to make this work. That is why for so long we have not seen Medicare+Choice work very well. It has not been adequately subsidized and ultimately people have just not found it in their interest to sign up. What we have seen is that the Medicare system has worked, has served this segment of our population very effectively, and we are simply trying to ensure that there is some stability. If seniors want to stay with Medicare, let them do so, rather than this revolving door, rather than being the guinea pigs in the private sector to find a way to devise a formula, where some private insurance companies could offer benefits that may or may not work over a period of years. This process of selection and deselection and analysis and ultimately implementation in a matter of 3 months every year could pose some serious problems for seniors in Florida or South Dakota.

Mr. DASCHLE. That is exactly what we would be suggesting with the first amendment the caucus will propose. The distinguished Senator has characterized it exactly right. Why not give seniors a little more choice? But with that choice, perhaps a little more certainty that regardless of what may happen in the private sector they will always have the Medicare plan available as a choice. That is all we are asking. If Medicare cannot compete effectively, no one will use it and everyone will go to the private sector. If it can compete, if it can provide a comparable benefit, why not have it, instead of going through this backup business every year. That will be a key priority amendment for us when we have the debate.

Mr. DASCHLE

Mr. DASCHLE. If the majority leader will yield, there is one other clarification I think is important, and that is we have had a lot to do with putting the list together. There is no relevancy requirement for first-degree amendments. If it is stated as an amendment to the Energy bill, it can be on any subject matter. If it says relevant, then we will use, as the distinguished majority leader has noted, the criteria he has laid out, subject generally to the energy issue. So the relevancy requirement is only a requirement in those areas where relevancy is listed as a factor in the amendment itself. There is no relevancy with regard to first-degree amendments.

Mr. DASCHLE

Mr. DASCHLE. Madam President, on March 31, 2003, a Mass of Christian Burial for Senator Daniel Patrick Moynihan was held at St. Patrick's Church here in Washington. At that service, a beautiful homily honoring our friend and revered former colleague Senator Moynihan was given by his pastor, Rev. Msgr. Peter Vaghi. For the benefit of all Senators and for history, I ask unanimous consent that Msgr. Vaghi's remarks be printed in the Record.

Mr. DASCHLE

Mr. DASCHLE. Madam President, on July 2, 2003, after many years of service, Dr. Judith A. Ryan of Sioux Falls, SD, will retire from her position as President and Chief Executive Officer of the Evangelical Lutheran Good Samaritan Society. Today I want to congratulate Dr. Ryan on her upcoming retirement and thank her for her many years of service. The Evangelical Lutheran Good Samaritan Society began partnering with church leaders in small, rural communities in the early 1920s, responding to the call to care for vulnerable populations--those who had no other options for care and no one to care for them. Today, the Good Samaritan Society, headquartered in Sioux Falls, owns or manages facilities in 25 States, employs 24,000 staff members, and serves more than 28,000 residents. I thank Dr. Ryan for her sterling management of this wonderful organization. Her long career as a health executive is distinguished by her commitment to excellence and her untiring efforts on behalf of America's senior population. South Dakota has been fortunate to have such an advocate and leader. Dr. Ryan's career is impressive. Prior to assuming her position as CEO of the Nation's largest not-for-profit long-term care and retirement system, she served as Chief Executive Officer of the American Nurses Association; Senior Vice President of Lutheran General Health System in Park Ridge, IL; Associate Director of the University of Iowa Hospitals and Clinics; and Associate Dean for the University of Iowa College of Nursing. Recognized for her work in the field of long-term health care, Dr. Ryan earned international recognition and was invited by the Danish Nurses Association to learn about emerging models of care in rural communities. Upon her return, she shared her insights at the National Rural Health Association's Annual Conference. Her presentation at that conference was entitled, ``A Call for Renaissance: The Small Town as Continuous Care Retirement Community.'' Dr. Ryan has served on numerous public policy and professional boards and recently participated as a member of the Health and Human Services Advisory Committee on Regulatory Reform. The committee made recommendations to the Secretary regarding potential regulatory changes that would reduce costs associated with departmental regulations and at the same time, maintain or enhance effectiveness, efficiency, impact, and accessibility. Dr. Ryan's past achievements and continuing interests provide evidence of her commitment to excellence and her advocacy on issues facing the elderly and their caregivers. I join her many friends and professional colleagues in extending thanks for her previous work and best wishes for her next endeavor.

Mr. DASCHLE

Mr. DASCHLE. Madam President, in recent weeks, thousands of students have received their diplomas and commenced a new phase of life. For the Class of 2003 at my alma mater, one of the enduring memories will be the national championship won by our women's basketball team, and I would like to take this opportunity to recognize that outstanding accomplishment. South Dakota is a sparsely populated State known for its vast open spaces and cold winter nights. Yet on most Fridays and Saturdays, thousands of people make the trip to Frost Arena--named not after the winter temperatures in Brookings, but after longtime coach and professor Reuben ``Jack'' Frost. Inside Frost Arena, they have come to expect some of the best basketball played in Division II of the National Collegiate Athletic Association. This championship team came to South Dakota State University from communities--large and small, urban and rural--that dot the Upper Midwest. They arrived on campus, like so many of us, holding the highest aspirations for themselves. In 2002, the SDSU Jackrabbits reached the Division II national semifinals. On March 29, 2003, Coach Aaron Johnston and his players won the Division II national championship with a 65-50 win over Northern Kentucky University, capping an incredible 32-3 season. For years to come, SDSU players, fans, and students will recall the excitement of that night. Whether you recall the moment as a player on the court, a follower in the stands--or a fan who watched the game on ESPN2--the excitement of that night will long be remembered as a highlight in SDSU's history of athletic successes. Our memories of that night will forever remind us why we are proud to call ourselves Jackrabbits. South Dakota State University, buoyed by its alumni's successes over its 122-year history, proudly boasts: ``You can go anywhere from here.'' On a basketball court in St. Joseph, MO, in front of a nationally televised audience, these individuals offered further proof that there are no limits and no boundaries to what a person can accomplish at South Dakota State. Madam President, I ask my colleagues to join me in saluting these young women and their coaches on this remarkable achievement. I am proud to request that the 2002-2003 South Dakota State University women's basketball team's roster be recorded in the Congressional Record.

Mr. DASCHLE

Mr. DASCHLE. Madam President, the National League of Cities, led by Mayor Brenda Barger of Watertown, SD, has designated, June 20, 2003, as the third annual National Small Cities Day to call attention to the role of small cities and towns in American life. The vast majority of cities throughout our Nation have populations of fewer than 50,000 people. These communities play an essential role in nurturing families, cultivating values, building a strong sense of commitment and connection, and ensuring safety and security. Millions of Americans live better lives because small cities and towns provide services and programs that meet the needs of their citizens. Particularly during these difficult times in our Nation's history, these Americans have looked to the leaders of their small communities to ensure their safety and security. Partnering with other levels of government, small cities work hard to provide helpful and reliable information about national issues affecting hometown America, and to maintain confidence in our American way of life. Often, they carry out their vital responsibilities with limited staff and tight budgets but with enormous good will and close connections to the citizens they serve every day. The leaders of the Nation's small cities and towns are indeed on the front lines in addressing many of our Nation's most pressing problems. Businesses, civic organizations, and citizens across the Nation are partners in strengthening hometown America, and must be encouraged to continue to support efforts that make these cities and towns such great places to live. The Federal Government, too, must continue to be a good partner by funding important Federal programs that support small cities and towns such as the Community Development Block Grant Program, the Community Oriented Policing Services Program, and local and regional homeland security planning and preparedness. We must continue to work together and look for ways to further strengthen our small cities and towns through creativity, innovation, and, above all, collaboration. I join the National League of Cities and the Small Cities Council in encouraging President Bush, my congressional colleagues, State governments, community organizations, businesses, and citizens to honor the efforts of ``small town America'' and renew our commitment to work together on this day and in the future to strengthen our small cities and towns, and to recognize their essential role in our intergovernmental partnership.

Mr. DASCHLE

Mr. DASCHLE. Mr. President, first let me thank the Senator from California for her efforts to improve upon this legislation. I have indicated to her privately that I support the amendment. I would support it if there were a rollcall vote. The fact that Dick Lugar, the initial cosponsor of this legislation when we introduced it several years ago, is a proud sponsor of this amendment is some indication of the degree to which the ethanol community and those of us who support this proposal would be supporting her amendment. As my colleagues from New Mexico, both the chairman and the ranking member, have noted, there is no reason, when we get into conference, this should not remain intact as part of the Energy bill. It is a good amendment. It provides even more opportunities to meet the targets set out in this legislation. So I would do all I could as Democratic leader to ensure that at the end of the day, when this legislation comes back in the form of a conference report, we will continue to see the Boxer amendment integrally a part of the bill itself and a part of this amendment. Again, let me congratulate her, thank her, and indicate I will be very supportive.

Mr. DASCHLE. Mr. President, first let me compliment the distinguished majority leader for the effort he has made to bring us to this point. Were it not for his effort, we would not have accomplished what we have with this unanimous consent agreement. I appreciate his efforts. Let me also single out in particular the distinguished Senator from Arkansas. Without her persistence and her effort, now weeks long, we would not be here. She has spoken out with courage and conviction and empathy on behalf of 12 million children, 8 million families who otherwise would be left out of tax relief. The argument that she has made from the beginning has been without this legislation those millions of children and those working families would get no tax relief on July 1. The passage of this legislation today will accommodate that concern, that need. This will give us an opportunity to send the recommendation to the House. It will send a clear message to working families that we are serious about providing the kind of tax relief that is so necessary for these families if we are going to provide it to others; that it will be available. The refundable child credit assistance can be made available in time for tax relief provided to others as well. I commend the Senator. I commend the majority leader. I thank my colleagues for this agreement. I yield the floor.

Mr. DASCHLE. Mr. President, I assume it has been cleared by the distinguished leader. I have no objection.

Mr. DASCHLE

Mr. DASCHLE. Mr. President, last Thursday marked an important--and extraordinary--milestone in the lives of two very special members of our Senate family. On May 29, 1937--66 years and one week ago today--Robert Carlyle Byrd and Erma Ora James were married. The Senate was not in session on their actual anniversary, so I come to the floor today--one week later--to congratulate Senator and Mrs. Byrd on their remarkable achievement. Robert and Erma Byrd both grew up in the hardscrabble coal country of West Virginia. They were high school sweethearts. Of all of Senator Byrd's tremendous achievements--and there are many--I suspect the two that mean the most to him are convincing Erma James to marry him in the first place--and staying married to her all these years. I have heard Senator Byrd say often that he could not do this job were it not for his wife's love and support. In his words: ``She is not only my wife, but also my best counselor. She has been a strong pillar of support in all my endeavors.'' The Byrds' marriage has brought them two wonderful daughters: Mona Byrd Fatemi and Marjorie Byrd Moore. They have also been blessed with six grandchildren and three great- granddaughters. After Mrs. Byrd and their family, the Senate and the Constitution, one of the things that Senator Byrd loves best--as we all know--is history--especially ancient history. So I think he may appreciate this thought from Homer: There is nothing more admirable than two people who see eye-to-eye keeping house as man and wife, confounding their enemies, and delighting their friends. For 66 years, Robert and Erma Byrd have done for more than delight their friends. Together, they have created a full and rich life. They have raised a family. And they have served the people of West Virginia, and America, well. We wish them many more years of happiness together.

Mr. DASCHLE

Mr. DASCHLE. Madam President, let me talk briefly about the important legislation addressed by the distinguished majority leader. He had spoken about the importance of our effort this month on prescription drugs. I applaud him for making this a priority. When I was majority leader almost a year ago, we made that same commitment. Of all my disappointments, the one that perhaps may be at the top of the list last year was our inability to pass the legislation. We got 52 votes. The majority of the Senate went on record in support of the plan that was taken up by the Senate. We did not have the 60 votes because there were opponents to the legislation that made points of order that kept the Senate from accomplishing our goal of getting to conference and moving through the bill. Let me simply list five concerns I have as we begin. Hopefully, all of the concerns can be addressed. It is critical we consider them very carefully. The first concern is procedural. The distinguished majority leader noted that we have had 29 hearings on Medicare since 1999 and, indeed, we have studied this issue a good deal. What I am concerned about now, however, is that we did not have a bill before the Senate. I know Senator Grassley is working tirelessly with others to provide a vehicle to allow us the opportunity to debate this issue. The administration, of course, has come out with their recommendations that Senator Durbin addressed a moment ago. However, we ought to have a hearing on the bill itself once it is written so we can walk through it and make sure we know exactly what we will be voting on and considering. Having that hearing on the bill seems to me to be an essential aspect of the procedural requirements we have to consider as we prepare for the debate on the Senate floor itself. The second issue has to do with the context. Some will use Medicare and prescription drugs as a Trojan horse to privatize the Medicare system. How tragic that would be if in the name of providing good prescription drug benefits to seniors, we end up with a system that most seniors will not recognize. Before Medicare was created in 1965, less than half of Americans over the age of 65 had health insurance. Now, 95 percent of seniors over the age 65 have health insurance. The reason they do is because of Medicare. If we privatize Medicare, seniors in rural areas, in particular, will suffer. Let us not privatize the system. Let us not destroy a system that works so well for so many. I find it interesting that those who laud the advantages of private- sector health care have difficulty explaining why Medicare can have such low administrative costs. Medicare's administrative costs are about 2 to 3 percent. The private sector administrative costs today are about 15 percent--5 times greater than the administrative costs of Medicare. We should think about that. I hope we are absolutely certain that in the name of prescription drugs we do not remove, we do not eliminate, we do not undermine a system that has worked so well for seniors, whether they are in urban or rural areas. The third concern is what kind of a package we will provide. The one thing seniors tell me they need is a clear understanding of what benefits they are going to get so they can compare whatever choices they may be offered. They need to know what the benefit plan is going to be. So let's make sure we define the benefits, describe them and put them in writing, so that no one has any question what it is we are going to do. Seniors also need to know what premium they will be asked to pay. We have to define that premium right in the bill itself. I hope our colleagues would all share that point of view, as well. Be as transparent when it comes to benefit and premiums as we can be so that seniors know what their benefits will be and can have confidence that those benefits will be there when they're needed. Fourth and finally, I hope, more than anything else, that we make the benefits consistent. For us to say seniors will be covered for a while, and then not covered even though they continue to pay premiums, and then covered again, would be a terrible mistake. Such coverage gaps, or sickness penalties, would lead to a deep-seated cynicism not only among seniors but among all Americans. I hope we recognize how important it is that we avoid any coverage gaps by including defined benefits and defined premiums. That is, in essence, what we are hoping we can achieve. As we draft the bill, let's simply do this: Let's make sure we have hearings so we know what is in it. Make sure that, in the name of prescription drugs, we don't privatize Medicare and dramatically change a system seniors depend on. Then let's tell seniors three things. They are going to get a defined benefit, a defined premium, and defined coverage all year with no sickness penalty. If we can agree on these principles, we can get broad bipartisan support for the bill at the end of this month. Again, I compliment the majority leader for his determination to continue the efforts we made in the last Congress on prescription drugs. We have a chance to do it right. We have a chance to do it in a bipartisan fashion. We have a chance to ensure that at long last we make a real contribution to health care in America, for seniors in particular. That is our opportunity that awaits us as we take up the drug bill later this month.

Mr. DASCHLE. I am happy to.

Mr. DASCHLE. The comment was made. I was not aware of it until just a few days ago. But I think it goes to the heart of what I was talking about. I appreciate the Senator from Nevada raising this question. Unfortunately, we have a much larger question at hand, if there are those on the other side who will see this as an opportunity to privatize--to eliminate the Medicare system, as the comments of the Senator from Pennsylvania suggest. If they want to eliminate Medicare, then I think all hope of accomplishing something regarding prescription drugs will be lost. If this is a Medicare debate, if we have to back up and first defend Medicare and make sure it is protected and kept intact, then we will never have an opportunity to get to prescription drugs. I hope the Senator from Pennsylvania would recognize the consequences of words of that magnitude. Obviously, we are prepared to have a debate about Medicare. But it will be at the expense of a debate about prescription drugs and whether we can add prescription drugs to Medicare sometime this year, hopefully this month.

Mr. DASCHLE. Yes.

Mr. DASCHLE. There are those on the other side--and I assume from that comment that Senator Bennett may be among them--who believe that eliminating or dramatically altering Medicare is the only option available to us. Frankly, I am troubled by that. I think Medicare has been one of the greatest health care success stories in our Nation's history. My mother is a beneficiary of Medicare. The remarkable consistency and the extraordinary access to health care that Medicare has provided to her and tens of millions of other seniors simply cannot be overestimated. As I said earlier, the administrative cost for Medicare is about 3 percent. The administrative cost for private health care plans is 15 percent, 5 times greater. Medicare provides every senior in South Dakota a chance to get health care. There are no private sector plans in large parts of South Dakota because HMO's and PPO's don't serve rural America. So from an access point of view, from an administrative point of view, from a benefit point of view, from an assurance and confidence point of view for seniors, I don't know how you could do much better than Medicare. Can it be improved? Absolutely. Could we provide more preventive and wellness care? Absolutely. Can we provide a prescription drug benefit? Absolutely. But when we draw down the Medicare trust fund to pay for tax cuts, we are, in essence, stealing from that very fund that will be needed in future years to provide the kind of health care that our parents, our grandparents, and our families depend upon. The quotes from our Republican colleagues are very disconcerting and troubling. As I say, if that becomes the debate, if the debate is about the future existence of Medicare itself, we will never be able to get to a drug benefit debate.

Mr. DASCHLE. I am happy to.

Mr. DASCHLE

Mr. DASCHLE. Mr. President, for 6 days, Aung San Suu Kyi--the courageous voice of democracy and freedom in Burma--has been in jail. Her crime? Support for reform and democracy in one of the world's most isolated and repressive countries. One of the world's great democrats is currently being held by a military junta disingenuously named State Peace and Development Council. Late last week, the Junta announced that it had Suu Kyi in ``protective custody.'' The truth, of course, is that she was beaten with a bamboo pole and detained in an ambush that killed four of her supporters. Several observers noted that her arrest is the latest in a vicious and coordinated attack which has claimed 70 of her supporters. This is evidence of the junta's deplorable disregard for international standards of decency and for the people it rules. It also tells us what we can expect from the junta. A year ago, after Suu Kyi was released from her 15 year long detention, there was a glimmer of hope for reform and democracy in Burma. Rather than re-engaging the world, however, the junta holds fast to its failed policies of the past. The Special Envoy from the United Nations is scheduled to travel to Burma this weekend as part of a larger effort to promote democracy. Yet with its actions this past week, the SPDC confirms what we had all feared--and what Suu Kyi warned: the military junta in power in Burma cannot and will not take the necessary steps to bring about democracy and freedom. I hope the UN Envoy will make clear his disappointment, indeed the world's disappointment, with these latest developments. Given the gravity of this situation in Burma, I am pleased to join with Senators Feinstein and McConnell, among others, in introducing legislation that underscores the depth of our concern and the strength of our resolve in ensuring democracy in Burma. The bill would ban imports from Burma, freeze SPDC assets in this country, tighten the visa ban on Burmese officials, and urge specific diplomatic steps to raise the importance of this issue with our friends in the international community. In the National Security Strategy, President Bush proclaimed that ``our first imperative is to clarify what we stand for: the United States must defend liberty and justice because these principles are right and true for all people everywhere. No nation owns these aspirations, and no nation is exempt from them . . . We will champion the cause of human dignity and oppose those who resist it.'' The SPDC is doing everything it can to rob the Burmese people of liberty, of justice, and of human dignity. It is time for the Senate to make clear just where the United States stands in the face of this injustice.

Mr. DASCHLE

Mr. DASCHLE. Madam President, I add my voice to those of Senator Lott and Senator Dodd and others in expressing my support and commendation to the Presiding Officer for his leadership, as well as to Senator Dodd and Senator Lott, Senator Santorum, Senator Stevens, and others who have taken the initiative to show such leadership on this very important project. If I could think of one word as I consider the prospect of the National Museum of African American History and Culture, it would be ``overdue.'' It is overdue. It is long past due. I hope on a bipartisan basis we continue to demonstrate our recognition of the remarkable contributions of African American culture and African American leadership to our country. One cannot understand the story of America without understanding the story of African Americans. I hope we continue to work to move this project along. Again, I commend those directly involved.