Byron Dorgan

Mr. DORGAN

Mr. DORGAN. Mr. President, how much time remains on each side?

Mr. DORGAN. I would like to close debate on my amendment, if the Senator would like to proceed.

Mr. DORGAN. Mr. President, let me answer the question of the Senator from Massachusetts. The Senator from Oklahoma took a long while to say no. Their proposal does not cover the 161 million Americans. It is essentially the same proposal we have seen previously. It falls far short of covering the majority of the American people who our proposal would cover. Mr. President, I yield 10 minutes to the Senator from Florida, Mr. Graham.

Mr. DORGAN. Mr. President, let me begin by describing this amendment and why I have offered it to this bill. Let me also say that the amendment is not subject to a point of order. This amendment deals with the Patients' Bill of Rights. Quite simply, it says that when this Congress enacts patient protection legislation, we should protect all 161 million Americans enrolled in private health insurance plans. Many of us have been attempting to get this Congress to pass a meaningful Patients' Bill of Rights, and so far, we have not been successful in doing so. As most Americans know at this point, more and more of the American people are being herded into HMOs and managed care organizations which has jeopardized the quality of health care they receive. Too often these days, decisions about their health care are being made not by doctors but by some accountant in an HMO or in a managed care organization 1,000 miles away. We have all heard stories on the floor of this Senate about the problems patients experience when their health care is viewed as a function of someone's profit and loss, not of his or her health care needs. We proposed a Patients' Bill of Rights to address these problems. It is rather simple legislation. It says that: Patients should have the right to know all of their medical options-- not just the cheapest medical options. That ought to be a fundamental right. Patients ought to have the right to choose the doctor they want for the care they need, including specialty care when they need it. That ought to be a right of patients who believe they are covered with a health care policy. Patients ought to have the right to emergency room treatment and emergency room care wherever and whenever they need it. Patients ought to have a right to a fair and speedy process to resolve disputes with their health care plan. And they ought to be able to hold their health care plan accountable if its decision results in injury or death. The Senate passed a piece of legislation last year that was called the Patients' Bill of Rights. Some of us called it a patients' bill of goods because it was a relatively empty shell. The House passed a Patients' Bill of Rights that is a good bill. It is a bipartisan bill sponsored by Republican Congressman Norwood and Democratic Congressman Dingell. It passed by a 275-151 vote. Since that time, the Senate appointed a set of conferees on October 15, and the House appointed its conferees on November 3. It wasn't until the end of February that there was a meeting of the conference committee. As I said previously, the conference committee isn't making much progress. In this amendment, we deal with only one aspect of the Patients' Bill of Rights and that is the question of the number of Americans that a bill of rights should cover. If a Patients' Bill of Rights is enacted by this Congress, we propose with this amendment that Congress will cover all of the American people with private health insurance, rather than just the 48 million Americans proposed to be covered in the Republican Patients' Bill of Rights. We believe the Patients' Bill of Rights should cover all 161 million Americans in private health insurance plans, including the 75 million people whose employers provide coverage through an HMO or private insurance. Unfortunately, these folks are not covered in the Republican plan. The 15 million people with individual policies are not covered in the majority party's plan. The 23 million State and local government employees are not covered in the majority party's plan. We propose that when and if Congress passes a Patients' Bill of Rights, that all 161 million Americans are covered by those provisions. Very simple. We understand from the previous vote held a couple of weeks ago that the majority in the Senate do not want to pass our Patients' Bill of Rights. We understand that. They voted against it. But how about at least passing a part of our Patients' Bill of Rights, the part that says everybody ought to be covered? That is what I offer today as an amendment. Senator Reid and I held a hearing in his home state of Nevada on the issue of the Patients' Bill of Rights. At the hearing we had a mother come, the mother of Christopher Thomas Roe. She stood up and told us about her son. He died October 12 of last year. It was his 16th birthday. The official cause of Christopher's death was leukemia, but the real reason he died is because he was denied the kind of opportunity for patient care that he needed to give him a chance to live. He was diagnosed with leukemia, but he had to fight cancer and his HMO at the same time. It is one thing to tell a kid you have to fight a dreaded disease, you have to battle cancer. It is quite another thing to tell that young child and his family: Take on cancer and, by the way, take on your insurance company as well. That is not a fair fight. That is never a fair fight. The Roe family was told that the kind of treatment he needed to send his cancer into remission was experimental. The family immediately appealed the health plan's decision. The review, which was supposed to take 48 hours during a very critical period of this young boy's life, took 10 days. As the appeal dragged on, Christopher's condition worsened. And as Chris's doctor had known, the traditional chemotherapy did not work. At the hearing, Chris's mother, Susan, held up a very large picture of Christopher, about the size of this chart. It was a picture of a strapping, bright-eyed, 16-year-old boy. Susan told Senator Reid and I, with tears in her eyes, how Chris turned to her one day not long before he died and said: Mom, I just don't understand how they could do this to a kid. This is a 16-year-old boy who died who wanted that extra chance to be cured but whose insurance company said no, no, no. And he died. We all know the stories. There is the woman who fell off a 40-foot cliff in the Shenandoah Mountains. She was hauled into an emergency room unconscious with broken bones and all kinds of physical problems. She survived and was later told by her insurance plan: We will not cover your treatment because you didn't have prior approval to get emergency room care. Or how about this young child, born with a horrible cleft lip? It is hard to look at. Dr. Greg Ganske, a Member of the House of Representatives in the Republican Party who supports this legislation, says in his practice that it is often not considered a ``medical necessity'' to fix this kind of problem. Let me show you how a child with this condition looks when he receives proper medical intervention by a skilled surgeon. Is there a difference? How can anyone look at these two pictures and say fixing this condition is not a ``medical necessity''? The point we are making with this amendment is very simple. Managed care organizations hold the future of too many patients in the palm of their hands. Decisions are not being made by doctors in doctor's offices. Too often, they are made in accountants' offices 500 or 1,000 miles away. We are saying that it is wrong to make medical decisions a function of profit and loss. This country can do better than that. This ought to be a slam dunk. The legislation that provides real protection, a meaningful Patients' Bill of Rights, ought to get 100 votes in the Senate. But we can't get any movement on this at all from the conference committee charged with working out the differences between the House and Senate bills. I know a few of the conferees and the chairman of the conference committee were saying we have made great progress. I describe that progress in glacial terms. At least glaciers move an inch or two a year. It is hard to see that this conference moves at all. We are only asking today to say with this amendment that if we are going to pass a Patients' Bill of Rights, let's not create a hollow vessel. Let's create a Patients' Bill of Rights that provides real protection for 161 million Americans, not inadequate protection for 48 million Americans. If we are going to do this, let's do it right. That is the amendment. We will have a chance to vote on it. We understand that the majority of the Senate decided they didn't want a real Patients' Bill of Rights. They wouldn't vote for the entire package, the one that provides protection for young kids such as Christopher, who are fighting leukemia, or for young people born with this severe cleft lip deformity. So all we ask is that whatever we are going to do with respect to patients' rights that we apply it to all Americans. Everyone ought to have the right and the opportunity to expect decent health care coverage if they have an insurance policy. What about a Patients' Bill of Rights for all Americans? I yield to the Senator from Massachusetts.

Mr. DORGAN. Are we finished? Will I close at this point? I have 5 minutes.

Mr. DORGAN. Mr. President, has the Senator from Oklahoma completed his debate? It is my intention to close debate on my amendment.

Mr. DORGAN. Mr. President, I yield 7 minutes to the Senator from Massachusetts.

Mr. DORGAN

Mr. DORGAN. If I might ask another question, the point here is this bill deals with the effort the Federal Government makes to respond to the education needs in this country. Most of education funding, of course, comes from State and local governments. We provide some funding in a range of areas. We provide assistance in VA, health care, and a range of other issues. This is a very important piece of legislation that invests prominently in the lives of the people of this country. The technique that is being objected to is not a new technique; it has been employed before. That is the point I was making. Is it a good technique? I don't know. You could find other ways to adequately fund these needed programs. Some in this Chamber may not want to fund these programs. They may think they are not a priority perhaps. This is not a new technique. But apparently when it comes to funding for VA, health care, and education, we have people come to the floor to make a point of order.

Mr. DORGAN. If the Senator will yield for a question, I wonder if the Senator recalls last year a technique similar to this used on the Department of Defense bill. I am just curious whether our colleague, the Senator from Texas, came to the floor to make a point of order when it had to do with defense. I don't know the answer to that. I am curious. It seems to me if there is a consistent point of order against the deployment of this technique, one wouldn't just make it on education issues, which, of course, to you, me, and others is very important. It is some of the most important spending we do. It is some of the most important investments we make in the country. I ask the question, Does the Senator know whether a similar point of order was made by our colleague when it had to do with the Defense Department last year?

Mr. DORGAN. Mr. President, will the Senator yield?

Mr. DORGAN. Mr. President, reserving the right to object, this is a critically important piece of legislation. It is a funding bill for education and labor issues and a range of things that are very important. If the consequence of the motion offered by the Senator from Texas would be to require a substantial across-the-board cut to this piece of legislation, it is of significant interest to virtually every Member of this body. I don't believe we ought to go on. If the Senator from Nevada chooses not to object, I shall object. But I will leave it to the Senator from Nevada to comment as well.

Mr. DORGAN. Mr. President, continuing to reserve the right to object, the Senator from Pennsylvania talked about if this prevails, the requirement of an adjustment to the bill would be ``catastrophic.'' That was the word he used. I am trying to understand the consequences of that. What kind of adjustment would we be talking about with respect to this bill on Education and Labor?

Mr. DORGAN. Mr. President, I support the legislation dealing with the issue of suicide. It is very important. Many, many years ago, early one morning I came to an office and found a coworker had taken his life. It was, of course, a morning I will remember the rest of my life, finding a coworker and a friend who had, over the nighttime hours, taken his life. I suppose only those who have been acquainted with that circumstance can barely imagine the kind of horrors that persuade someone to take their own life. I think anything we can do as a country in public policy to reach out and say to those who are visited by those emotional difficulties, those pressures and internal problems that persuade them to consider taking their life, anything we can do to reach out to them to say, here is some help, we ought to be able to do that. This amendment is very small. Incrementally, it will be helpful. I appreciate the work of Senator Wellstone and Senator Reid. I think someday--we may never know the name--adding these resources will help someone who is ravaged by these emotional difficulties and can be prevented from taking their own life, and we will be rewarded for having paid attention to this issue.

Mr. DORGAN. Will the Senator yield?

Mr. DORGAN. Mr. President, reserving the right to object, I will propound a question under the reservation. I am trying to understand the consequences of the amendment. Let me reserve the right to object while I ask the Senator from Texas and the Senator from Pennsylvania this: If the point of order is sustained, can we get some notion of what consequences it will have on the spending in this bill for education, labor, and other issues?

Mr. DORGAN

Mr. DORGAN. Madam President, here in Washington, DC, administrations come and go, Members of Congress and their staff pass through at an increasing pace. It often seems that many of the people that we know are on their way to someplace else. With all this change, we cherish the points of stability in our lives, and among these are the professional staff members who have been with us for the long haul. These are the people who could have gone elsewhere and earned more money, but they chose to stay and work in public service. They are the silent heroes here in Congress. They keep the process moving; their invisible stamp is upon all our work in public policy. We depend upon them more than we like to say. Lucy Calautti is one of those key staff members who makes things happen here in the United States Senate. Lucy has worked with me for over 25 years, first in my role as an elected State official in our State Capitol in North Dakota, then in the U.S. House of Representatives and now the U.S. Senate. During much of that time she has been my Chief of Staff. Lucy goes about her work with an energy, focus, and high-spirited competence that people who deal with her have come to know well. For me, Lucy has been a treasure. I have had the great luxury of knowing that when I leave the office to travel to North Dakota, the work here will continue to be directed by a real leader. Lucy is a true original. She is practical and idealistic, a patriot and an ardent advocate of women's rights. When she graduated from high school in Queens, New York in the 1960s, she went right into the Navy to serve her country. That was not exactly the most popular thing to do back then. When she left the service she came to North Dakota and enrolled in North Dakota State University to get her Masters degree. I hired Lucy in 1974, and during all of those years she has brought passion and conviction to her work. No problem has been too small or too big. If it concerned the people of North Dakota and our country, then Lucy would tackle it until it got resolved. One of Lucy's passions has been Major League Baseball. For years she and her husband, Kent, have taken a weekend or two in February to catch a part of Spring training in Florida. It's true she has suffered over the years as an ardent New York Mets fan. But for years I have watched the autographed baseballs on her desk form a rising pyramid in their plastic cases. I had a sense where this stack was heading. And now, not surprisingly, Lucy is going to leave my office this week to become the head of Government Relations for Major League Baseball. I am sad, but I am happy, too. America's national pastime is gaining a tireless advocate here in Washington. No one deserves this opportunity more than Lucy, and no one could do a better job. Such passages are common here in Washington, but that does not make them any easier. I just wanted to take a few moments to express my appreciation to Lucy Calautti, on behalf of all the people of my state, for a job well done. We wish her well.

Mr. DORGAN

Mr. DORGAN. I ask unanimous consent to speak in morning business.

Mr. DORGAN

Mr. DORGAN. Madam President, I want to talk about the issue of energy supplies and the debate over energy. I noticed today a number of Senators came to the floor of the Senate, and they waved their arms and raised their voices a bit and railed about energy: Lord, we should know what is going on here, they say. We have the OPEC cartel, yes, but we also have an administration that does not have an energy policy, and woe is us. This is not brain surgery. This is not complicated at all. We have a cartel called OPEC that controls a substantial amount of the oil that is exported to this country, and they decided to decrease production. When they did, prices began to go up. More than that, we also have the largest oil companies in this country and around the world merging. Exxon, Amoco, BP, are all merging. We have larger oil companies and a circumstance of a cartel supplier, and now people who go to the gas pumps are paying higher and higher energy prices. I do not hear any discussion about whether the energy companies may have played a role in this. Does anybody understand how, when you get larger, you also have the opportunity to manipulate prices? I think you do. Is a major part of this problem the OPEC cartel? You bet your life it is. But I think another part of this problem is we do not understand pricing policies of energy companies that have become larger and larger. We need to know that. That is why I fully support the Federal Trade Commission's investigation, and why I believe the Justice Department ought to be part of the same investigation. I find it interesting, as the oil companies become larger and continue to oppose ethanol production, Congress has still not done nearly enough to promote the kind of energy supplies that are renewable--wind energy and others. We ought to get, in my judgment, a wake-up call from these oil prices that we are held hostage by the OPEC cartel. We are a growing economy and produce and use a substantial amount of energy, but we are far too dependent on OPEC countries. If one looks at production of energy, it does not matter who is in the White House--a Republican or Democratic administration--we see that same line, and the line is not going up, it is marginally going down. We need an energy policy that is a Republican and Democratic energy policy, not one about which one side continues to wave and rail about the other side. We need a bipartisan energy strategy that recognizes this country should not be beholden to an OPEC cartel for its energy supplies. Not to do so means we put ourselves at risk, we put our economies at risk, and put the American people at risk when, in some cases, they cannot purchase the energy they need.

Mr. DORGAN

Mr. DORGAN. Madam President, today Governor Schafer, from my State of North Dakota, has made a request of President Clinton in the form of a disaster declaration request as a result of substantial damage that has occurred in North Dakota from some huge storms that have rumbled across our State in recent weeks. About a week ago, late in the afternoon, in the Fargo-Moorhead region of North Dakota-Minnesota, huge thunderstorms rolled across the northern plains and dumped 7 to 8 inches of rain on that flat land in the Red River Valley in a matter of 8 hours--7 to 8 inches of rain in 8 hours. This occurred only a week after some regions just 80 to 90 miles North of there received 17 to 18 inches of rain in a very short period of time: 24 to 36 hours. There was an enormous quantity of rain. These two storm events occurred in the Red River Valley, which is as flat as a table top. There is not a hill in sight. The result was dramatic sheet flooding in every direction. I recently took a tour of some affected regions in northeastern North Dakota--Grand Forks County and Walsh County and other areas, and small communities like Langdon, Mekinock, and a range of other communities. Communities in the region were hit with more moisture than anyone had ever seen in their lifetime in such a short period of time. As a result, flat fields were totally inundated with water. Roads and railroad lines were washed away. There was one area I traversed in which they had a box culvert that weighed about 2 to 3 tons. The force of the water--which, incidentally, totally inundated these fields-- washed out a 2-ton box culvert, and nobody could find it. It was gone. How does one lose a 2-ton box culvert? Yet it was gone. It is hard to imagine these flooding events unless one sees them personally. We have had two of them in two weeks in the eastern part of North Dakota, and they have been devastating. As a result, the Governor has made a disaster declaration request of the President, a request which I fully support and upon which I hope the President will act with dispatch this week. FEMA is continuing in both of these areas-- northeastern North Dakota and also the Fargo region--to do their damage assessments. Sufficient work has been done on the damage assessments for us to know we are going to require some Federal assistance. Some people say: Why is there Federal help available in the form of disaster assistance? Precisely because there are some events which occur--floods, tornadoes, earthquakes, fires, and so on--that are so large and so significant and cause so much damage that State and local governments cannot possibly deal with the resulting damage. That is why the rest of the country says: You have had some trouble, let us give you a helping hand. That is what happened during the 1997 floods from the Red River in the Red River Valley which most everyone will remember. That is what happened with the Los Angeles earthquake. That is what happened when the Southern United States experienced substantial tornado and hurricane damage. We regret we have to come again with a request for disaster assistance, but we do. It is not of our making. It is an act of nature that is quite unusual. I have not, in all of my life, seen a circumstance where, in a period of 24 to 36 hours, we had 17 to 18 inches of rainfall in a very small area. We are a semiarid State. We get 17 inches of rain in a year in North Dakota on average. Yet a week ago today, Fargo and Moorhead received 7 to 8 inches of rain in a matter of 8 hours and, as I said, 90 miles north of there, they received 17 to 18 inches in some parts in a matter of 24 to 36 hours. One can imagine the devastation that causes. We are trying to wrap up a supplemental appropriations bill probably by tomorrow evening. The hope is that it gets filed tomorrow evening. Both sides want to get it to the President for his signature by the end of this week. It will be attached to the military construction bill. I am working with my colleagues on the Appropriations Committee to make certain these flood events are mentioned in the context of that supplemental bill. I expect FEMA already has the resources with which to deal with this, if and when the President declares a disaster. I wanted to bring to my colleagues' attention the request the Governor of North Dakota has made. My expectation is the President will move quickly to respond to it, and my concern is that we do everything we can not only to deal with the issue of infrastructure damage to public buildings, and there is substantial damage in those areas-- roads, buildings, water and sewage systems--but also that we are able to be helpful to family farmers, many of whom have lost virtually all of their crops, crops they dutifully planted this spring with such great hope and now have been completely decimated by these sheet floods. My colleagues and I who come from this region of the country will continue to work on all of these issues. We are joined by our colleagues from the State of Minnesota because all this occurs on the North Dakota-Minnesota border.

Mr. DORGAN

Mr. DORGAN. Madam President, I want to talk about the subject that is going to be front and center in the Congress this week, the issue of a prescription drug benefit and Medicare. There are stories in today's papers--the Washington Post, the New York Times, and others--in which the chairman of the National Republican Congressional Committee is quoted as saying that there is a belief that his party, meaning Congressional Republicans, need to do something on the issue of prescription drugs. He says, ``It's a great issue--no question it polls well.'' Another member from the other side of the aisle said: ``We're going to use the marketplace pressure to solve the problem, which is much better than the government program.'' In other words, the majority party feels they have to bring a bill to the floor addressing the need for prescription drug coverage because the issue polls well. So they are going to bring an illusory bill to the floor of the House this week that requires private insurance companies to offer an insurance policy that helps people pay for their prescription drugs. The catch is that the insurance companies say they cannot offer such a policy. Officials from two companies have come to my office and told me that, to offer a policy with $1,000 in benefits, it would cost $1,200. I come from a rural State. In rural States, a recent study shows that rural Medicare beneficiaries pay 25 percent more out-of-their own pockets for prescription drugs than do urban beneficiaries. Of course, rural areas are shrinking. Many have seen the movie ``Four Weddings and a Funeral.'' In rural areas of my State, ministers tell me they have four funerals for every wedding because the population is getting older and the younger people are moving out. And those senior citizens living in rural areas are the ones who are paying the highest prices for prescription drugs. And many of them cannot afford the drugs they need. They have heart trouble, diabetes, and a range of other problems. Their doctors say: You need to take this miracle medicine, this life-saving drug, to help you live a better life. And they say to their doctors: I can't afford it. We need to do two things. First, we need to add a prescription drug benefit to the Medicare program, and second, we need to put downward pressure on drug prices. I thought I might, with my colleagues' consent, show on the floor of the Senate a couple of pill bottles that illustrate part of the problem. Here are two bottles for a prescription drug called Zocor used to lower cholesterol. This is the same tablet, in the same strength, made by the same company, probably made in the same manufacturing plant. If you buy Zocor in Canada, it costs $1.82 per pill. But if you buy the same drug--the same pill, made by the same company--in the United States, it costs $3.82 per pill. Let me say that again. If you are a Canadian, you pay $1.82 for Zocor; if you are an American, you pay $3.82, more than twice as much. Why? Because the big drug manufacturers have decided they want to charge the American consumer more than twice as much. One other example, if I might. Here are bottles of Zoloft. Zoloft is a common prescription drug used to fight depression. If you buy this medication in Canada--the same pill, in the same strength, by the same drug company--it costs $1.28 per pill. But if you buy it in North Dakota, it costs $2.34 per pill. The Canadian pays $1.28; the American pays $2.34, 83 percent more. I have other examples, but I think you get the point: American consumers pay the highest prices in the world for their prescription drugs. These are the prices that our current marketplace have achieved. Why should an American citizen have to go to Canada to buy a drug that was produced in the United States in order to pay half the price that is charged in the United States? The answer is that they should not have to do that. I think these examples illustrate why, when those on the other side of the aisle say ``we're going to use the marketplace pressure to solve the problem,'' this marketplace approach just is not going to work. We need a real prescription drug benefit added to the Medicare program. What we do not need is an illusion of a benefit where we tell private insurance companies to sell a policy they say they can't underwrite and won't sell. That is not good public policy. Maybe the polls show that Medicare prescription drug coverage is a popular issue, but you do not solve a problem, no matter how popular an issue, by coming up with a solution that does not work. We need to add a prescription drug benefit to the Medicare program in a way that is sensible and thoughtful and workable. And, second, as we do that, we need to put some downward pressure on prescription drug prices. It is not fair, right, or reasonable that the American consumer ought to pay double the price for the same drug, put in the same bottle, manufactured by the same company. That is not fair. The common medications that senior citizens so often need--to treat their heart problems, diabetes, arthritis, and so many other difficulties--have been increasing in cost at a dramatic rate. I am not talking about creating price controls, but we need to do something to put some downward pressure on prices. One thing we should do is pass legislation that I have introduced, along with Senator Snowe, Senator Wellstone and others, that will allow American consumers to have access to these drugs from anywhere in the world, as long as they are FDA-approved with safe manufacturing standards. This legislation, the International Prescription Drug Parity Act, will allow Americans to access these drugs from anywhere in the world at a lower price. If we eliminate the legal obstacles that currently exist and allow pharmacists to purchase these medications from other countries on behalf of their American customers, the pharmaceutical industry will be forced to re-price their drugs in this country. In short, I wanted to come to the floor to make the point that we must put a prescription drug benefit in the Medicare program, but we must do it in a way that works. We should not do this just so some will be able to go home to their states and say: We passed prescription drug coverage, didn't we? That might provide some self-satisfaction but it does nothing for the millions of Medicare beneficiaries who need prescription drug coverage. And finally, as we develop this legislation, we need to acknowledge that drug pricing is unfair in this country and do something to put some downward pressure on prescription drug prices.

Mr. DORGAN

Mr. DORGAN. Madam President, it has been more than a year since the Columbine tragedy, but still this Republican Congress refuses to act on sensible gun legislation. Since Columbine, thousands of Americans have been killed by gunfire. Until we act, Democrats in the Senate will read some of the names of those who lost their lives to gun violence in the past year, and we will continue to do so every day that the Senate is session. In the name of those who died, we will continue this fight. Following are the names of some of the people who were killed by gunfire one year ago today. June 26, 1999: Kevin S. Bonner, 28, Chicago, IL; Danny R. Davis, 35, Chicago, IL; Sharon Duberry, 35, Gary, IN; Weldon Ellingson, 79, Cedar Rapids, IA; William Ernest, 34, Philadelphia, PA; Marilyn Freestone, 57, Cedar Rapids, IA; Estella Martinez, 40, San Antonio, TX; Willie Palmer, 29, Baltimore, MD; Ruben Ruvalcaba, 22, San Antonio, TX; Anthony Scott, 22, Bridgeport, CT; Carlos Sermiento, 22, Dallas, TX; Chau Tran, 17, Lansing, MI; Julio A. Vincencio, 18, Chicago, IL; Mose Penn Warner, 82, Louisville, KY. In addition, Mr. President, since the Senate was not in session on June 24 and June 25, I ask unanimous consent that the names be printed in the Record of some of those who were killed by gunfire last year on June 24th and June 25. June 24: James Bailey, 21, Kansas City, MO; Kurt Chappell, 38, Cincinnati, OH; Philemon Epepa, 48, Houston, TX; Dana Fowlkes, 28, Baltimore, MD; Deslond Glenn, 17, Forth Worth, TX; Antonio Hernandez, 32, Houston, TX, John Kerr, 28, Memphis, TN; Max James Langley, 74, Mesquite, TX; Angelo Lard, 32, Detroit, MI; Mary Jane Noonan, 37, New Orleans, LA; Tull Rea, Sr., 89, Dallas, TX; Edwin A. Vazquez, 23, Chicago, IL; Unidentified male, 20, Newark, NJ. June 25: Mona Lisa Castro, 28, Fort Worth, TX; Joe T. Harp, Pine Bluff, AR; Lavar R. Knight, 19, Chicago, IL; Millard Courtney Sauls, 25, Washington, DC; Latrice Spencer, 22, Louisville, KY; Fred Warren, 18, Miami-Dade County, FL; Quintrale Williams, 38, New Orleans, LA; Unidentified male, 16, Chicago, IL.

Mr. DORGAN

Mr. DORGAN. Mr. President, earlier this morning a Member of the Senate described the circumstances on the floor of the Senate yesterday with respect to a vote on the issue of a prescription drug benefit for Medicare. Yes, there was a vote on that issue. I want to describe why that motion was offered and the importance of it. I also want to say that, while I certainly have the greatest respect for my colleague, this was not a circumstance where the minority leader or anyone else intended to surprise anybody. When the minority leader or any other Senator is pursuing an agenda he believes is important for our country, he does not go desk to desk in the Chamber asking permission from anyone else to offer an amendment. That is not the way the Senate works, of course. The minority leader believes very strongly, as does almost every single member of this caucus, and perhaps some others in the Senate, that we need to add a prescription drug benefit to the Medicare program. Life-saving miracle drugs can only perform miracles for those who can afford them. Senior citizens all too often are choosing between groceries and the prescription drugs they need. If we were to create the Medicare program today, unquestionably we would have a prescription drug benefit in that plan. We have been very relentless in saying we believe we must add a prescription drug benefit to the Medicare program and we should do it in this Congress. We cannot and will not apologize for being relentless in that pursuit. We have had very few opportunities on the floor of this Senate to pursue our agenda. Yesterday was one of them. If, at the end of the day, we get a bipartisan agreement to add a prescription drug benefit to the Medicare program, then we will be rewarded for our success by the senior citizens in this country who will be able to have access to the prescription drugs they need. If, at the end of the day, we do that, I guarantee that it will only be because, for the last couple of years, we have been relentless on the floor of the Senate and in the House, saying this Congress must do this. We have had others who say, yes, we agree about the need for a prescription drug benefit, but we want to have the private insurance companies write a plan, and so on and so forth. The fact is that the private insurance companies have said publicly, and they have come to my office and said repeatedly, ``We will not write a plan; we cannot write a plan.'' It is not within the range of financial possibilities for us to do what the majority party is proposing. In fact, one company official said, ``We will write a plan that has $1,000 in benefits, and we would have to charge $1,200 in premiums for the plan to cover the administrative and other costs of the benefit.'' That is the same as having no plan, the same as doing nothing in terms of adding prescription drug coverage to Medicare. Our goal is to find a way to solve this problem in this Congress. This Congress, with all due respect, on some of the big issues, has been a Congress of underachievers. We can do a lot better than this. We can add a prescription drug benefit to Medicare. We can pass a campaign finance reform bill. We can pass a Patients' Bill of Rights. We can pass an education bill that reduces class size and helps rebuild and renovate some of our nation's dilapidated schools. We can do these things if we put our minds to it. But somehow there is this notion by at least those who control the agenda that what we need to do is tuck in our wings and get out of town and do as little as possible. I don't want to belong to a Congress of underachievers. I want our Congress to do the things we ought to be doing together. Yes, a prescription drugs benefit in Medicare is one of those items. We cannot apologize for what we did yesterday. We must, at every opportunity, continue to push and coax and pull those in the Chamber who don't really want to do this to join us and fix what is wrong with respect to this Medicare program. What is wrong, in part, is that it doesn't have coverage for prescription drugs, and there are a lot of senior citizens who are prescribed medications that will allow them to live longer and healthier lives, and they discover they can't afford them. A woman in Dickinson, ND, who had breast cancer was told by her doctor that in order to reduce the chances of a recurrence of her breast cancer, she must take this prescription medicine. This woman, who was on Medicare and had a small fixed income, said, ``Doctor, there isn't any way I can afford that medicine. There is no way. I am just going to have to take my chances.'' This situation faces too many senior citizens who need prescription medicine and find that they cannot afford it. That is why we must put a prescription drug benefit in the Medicare program. Let's do something at the same time that puts some downward pressure on drug prices. Prices have risen too fast and too far on prescription drugs. I just want to say that no one crossed any lines by not going to every desk in the Chamber about that motion yesterday. We are going to keep trying until we get enough votes in the Senate to add a prescription drug benefit in the Medicare plan. It is for a good reason. This country needs that sort of policy in place right now. Mr. President, I yield the floor.

Mr. DORGAN

Mr. DORGAN. Mr. President, I am going to be offering an amendment to the pending appropriations bill that I want to talk about this morning. I commend the chairman, Senator Specter, and the ranking member, Senator Harkin, for their work to increase funding for the National Institutes of Health. As all of us know, Congress is on track toward doubling the funding for important health research and investigation through the NIH. That is critically important to this country. I am one of those who has been supportive of doubling the funding for the National Institutes of Health. The NIH is trying to unlock the mystery of many of the diseases that ravage the bodies of people who are suffering from Parkinson's disease, cancer, heart disease, and so many other diseases that afflict the American people and people around the globe. The type of research that is taking place at the National Institutes of Health is exciting and vibrant and paying big dividends. I thought I would mention, as I start, something I saw one day at the NIH called the healing garden. This was an exhibit out at the NIH campus where they had a series of plants growing in this aquarium-like device called the healing garden. I asked the folks at NIH for an explanation, and they told me about it. They said a lot of people think modern medicines, especially the medicines that are developed through research at NIH to respond to the challenges of treating diseases, come from chemicals. But they told me that a lot of medicines come from natural substances we find all over the Earth. They were displaying some of those substances in this healing garden. I want to describe a couple of the things they were displaying because it is interesting. NIH is gathering from around the world 50,000 to 60,000 different species of plants, shrubs, and trees and testing and evaluating what kind of properties they have to heal and treat diseases. The common aspirin comes from the bark of a willow tree. The Chinese knew that a couple of thousand years ago. If they had a headache, they would chew the bark of a willow tree. In modern medicine, aspirin is a chemical modification of that active ingredient derived from willow tree bark. Now aspirin is produced chemically, but the bark of the willow tree was the derivative. The java devil pepper was in the healing garden. Drugs used to treat hypertension, or high blood pressure, which were used formerly as a tranquilizer, come from the java devil pepper. Who would have guessed this connection if not for the research by the scientists who discovered it? Agents that fight tumors, leukemias or lymphomas, come from the plant called the mayapple. The rose periwinkle produces drugs used as anticancer agents primarily in treating Hodgkin's disease and a variety of lymphomas and leukemias. Foxglove is used in the medications digitalis and digitoxin, which are used to treat congestive heart failure and other cardiac disorders. Of course, we all know about aloe, an active ingredient, of course, in skin care preparations. It is interesting that, as funding has increased for studying plants and animals, scientists at the NIH are finding quite remarkable things. Deep in the Amazon rain forest lives a frog that has a deadly toxin on its skin. They believe that from studying the toxin of that frog, they can create a painkiller that is 200 times more powerful than morphine and not addictive. Think of that: 200 times more powerful than morphine and not addictive. There is another frog which is very rare that has a toxin on its skin that is so deadly that a drop of it on the skin of a human being causes the heart to stop. The scientists asked the question: If there is something this powerful that it causes a human heart to stop, can we unleash the power of that toxin to do something positive? That is the kind of evaluation and study that is occurring at the NIH routinely. As we double the funding for the National Institutes of Health, there are all of these wonderful scientists and researchers doing this massive amount of research--research to decode the human genome, research to grow new heart valves around parts of the heart muscle that are clogged, deep brain research to uncover the secrets of Parkinson's disease. As all of this research occurs through the doubling of funding at NIH, we should say thanks to Senator Harkin and Senator Specter for their leadership and commitment over several years to move this Congress to invest in these efforts that are so important to this country's future. Now, let me go from that compliment to talking about how this research is dispersed across this country. There is a trend for how this research funding is allocated throughout the country that is very similar to what happens in other areas of the federal Government's research budget. The research that comes through the billions and billions of dollars that we spend--nearly $20 billion proposed for fiscal year 2001 at the NIH alone --has historically been clustered in a few areas of the country. In most cases, big universities get big grants that make them bigger, and from around those universities, you see the development of businesses springing up from that research. You will see the result of NIH research in a few areas of the country producing very significant opportunities. Then you will see other significant parts of America with almost no research base through the NIH. Should research be done where it is done best? Yes, of course. But the largest universities in this country, in a handful of States, get most of the research dollars in part because the grants are peer reviewed by people from the same institutions that get the grants in the first place. It becomes a self-fulfilling prophecy. The chart I have here shows the way NIH funding is currently distribution across the country. If you look at the States in this country shown in the white shaded areas--mostly in the middle of the country--you will see that these States get very little funding for medical research. The States shown in the blue and red areas--California, Texas, New York, Massachusetts, and so on--are the States that get most of the research grants. This pie graph here shows what happens as a result of this imbalance. As you can see, three States get 35 percent of all of the medical research funds provided by the NIH. Institutions in three States get over a third of all the Federal dollars on medical research. In fact, one state alone received 15 percent of total NIH funds. This little white slice shown on the chart represents 21 States that share only 3 percent of the research. Why does that matter? If you live in one of these States, and you have Parkinson's disease, or you have breast cancer, or you have any one of a number of very serious health problems, and you want to participate in the cutting-edge medical research conducted by the NIH through one of its grantees, you may well have to travel hundreds and hundreds or perhaps thousands of miles to avail yourself of the clinical trials. Second, there are wonderful institutions in the middle part of America that have the capability to provide unique and beneficial research on a range of issues ranging from cancer, to heart disease, to diabetes, and more through the funds we are providing at NIH. But they do not get the opportunity because the system is stacked against them. At the NIH, we have a program called IDeA, or the Institutional Development Award program, that is intended to rectify this geographical inequity by helping historically under funded states to build their medical research capacity. IDeA is very similar to the EPSCoR program that exists in other federal agencies. This program is under funded at NIH. The IDeA program is funded at the level of $100 million in the House-passed bill, which I think is too low. But it is funded at only $60 million here. That is an increase from $40 million to $60 million, and for that, I appreciate the efforts of Senators Specter and. But we ought to at least meet the House level. And we ought to do even more. My amendment will take our proposed funding to the level of $100 million in the House bill. Through this amendment, we will simply say that we want to encourage the distribution of research across this country to all of the centers of genius--no matter where they are--that exist. In States such as North Dakota, Iowa, South Dakota, and up and down the farm belt, we are losing a lot of population. This map shows that. All these red blotches on this map indicate counties that have lost more than 10 percent of their population. What you see is that the middle part of our country is being systematically depopulated. Why has that happened? Why, when you have so many people living on top of each other in apartment buildings in big cities and fighting through traffic jams just to get to and from work each day, is the middle part of our country being depopulated? At least part of the answer to that question relates back to what we do at the Federal level. We say that $20 billion will be made available through the National Institutes of Health to form centers of excellence for scientific research in medicine. We move that money to specific areas of the country where there is already a significant population, and from that springs economic opportunity and biotechnology companies and new jobs. We simply exacerbate all of these problems with the way we spend our money at the Federal Government. There are centers of genius in the middle part of this country, in Minnesota and North Dakota and South Dakota and Kansas and Oklahoma. There are small centers of excellence that could do wonderful scientific research, but they do not get the funding. Why? Because the biggest States get all the money. Three States get a third of all the money through the NIH. I am not suggesting that anything illegal is going on. It is just that we have a system that perpetuates itself and creates a circumstance where three States get fully one-third of the billions of dollars we provide for medical research and 21 other States are left to share 3 percent of the medical research. And that predicts and predetermines where the centers of excellence will be in the future. It also, in my judgment, is unfair to all of those folks who live so far away from the biggest centers, where most of the money is moving to, because it is not going to be very easy for them to be involved in clinical trials for such things as their breast cancer, their lymphoma. They are going to have difficulty getting cutting-edge medical therapies. That ought not be the case. I want to change that. I am hoping, with the cooperation of Senator Specter and Senator Harkin, and with a new determination in the House and the Senate, that we can come to an understanding that, as we double the funding for the NIH, we can also do much better for this program at NIH called IDeA. Again, this program lets us reach out and find ways to use NIH funding all across this country, to get the best of what everyone in this country has to offer, to find all the centers of excellence that exist everywhere, and have them come to bear on research and inquiry. I am convinced that this represents our best chance to try to find ways to cure some of these diseases that ravage people who live in this country and the rest of the world. We are making a lot of progress. With this amendment, I do not mean in any way to suggest we are not making great strides. Doubling the NIH budget is a terrific thing to do. It will produce enormous rewards for all who live in this country and those who will come after us. But it is also the case that we must do better in the distribution of this research money if we are going to be able to have access to all the best minds this country has to offer. That is the purpose of my amendment. Mr. President, I yield the floor and suggest the absence of a quorum.

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

Mr. DORGAN. Mr. President, I ask unanimous consent to speak as in morning business for 5 minutes.