John Edwards

Mr. EDWARDS

Mr. EDWARDS. I ask unanimous consent that a letter from Sandra Grissom be printed in the Record at the end of my bill, the Steve Grissom Relief Fund Act of 2003.

Mr. EDWARDS

Mr. EDWARDS. Mr. President, President Bush did the right thing today by taking personal responsibility for the inclusion of misleading intelligence information in this year's State of the Union. But he has yet to turn his full attention to the more urgent matter at hand, winning the peace in Iraq. To finish the fight and help build a free Iraq, President Bush must create a new national and international consensus for the benefit of our Nation's security, the future of the Middle East and the well-being of America's fighting men and women. A new consensus is only possible, however, if the administration is honest enough to admit what is not working in Iraq and courageous enough to design a new approach that will. The President must acknowledge a plain truth that everybody knows. This war is not over, and his administration declared a premature victory. Our military did a superb job toppling Saddam; now they need the support, the resources, and the right troops to defeat the significant pockets of guerilla opposition that remain. Unfortunately, unless we adjust our course, the management of postwar Iraq may well be viewed by history as the most consequential mismanagement of an international crisis by any U.S. administration since Vietnam. Notwithstanding the deaths of Qusai and Odai Hussein, the joint U.S.- UK mission is in deep trouble. Nine months ago, I called for the administration to enlist NATO in comprehensive planning for postwar Iraq. What we are seeing now is the costs of failing to plan and refusing to internationalize our approach. The departure of Saddam Hussein from power is an opportunity to change the course of history in the Middle East. That is one reason I supported and celebrated Iraq's liberation. It could have been, should have been, and still might prove a victory for people everywhere who respect human rights, cherish freedom, seek to halt the spread of weapons of mass destruction, and believe that peace between Arabs and Israel is both achievable and essential. To succeed, we will need all the help we can get--from NATO and other allies, the U.N., and friends within the Arab and Muslim communities. The President apparently believes that we can succeed largely on our own. The American people are starving for some straight talk. There is no reason except failed Presidential leadership that 90 percent of the foreign troops in Iraq are American. As commander in chief, he should be able to assure the families of our Armed Forces in Iraq that absolutely everything is being done to help them achieve their mission and come home safely and soon. He could not honestly provide such an assurance today. Our troops won't get the help or protection they need unless the administration offers to share authority and responsibility for reconstruction efforts in Iraq. The President should not let past disagreements or misguided ideology stand in the way. The administration has little patience for diplomacy, so they argue that a U.N. framework means a loss of American control. That is simply untrue. Like we did in Kosovo, we should ask the U.N. to provide a mandate for a coalition-led force that will work in consultation with, but not under the control of, the U.N. civilian administration. That will preserve the absolutely essential American control of our forces, but create a framework in which many nations can participate comfortably. The Bush administration must level with the world and with the American people. A new consensus must be built on the truth. Winning the peace in Iraq will require many months, probably several years. It will cost tens of billions of dollars more than can be accounted for by Iraqi oil revenues. It will entail grave, ongoing risks to our Armed Forces. But it is a necessary, even noble, mission in which every law- abiding and freedom-loving country has a stake, and to which each should be invited to contribute not as a favor to America, but as a gift to our common future.

Mr. EDWARDS

Mr. EDWARDS. Mr. President, the introduction of the Tobacco Market Transition Act is an important milestone for tens of thousands of farmers. I am proud to have been part of the bipartisan working group that crafted this bill. For decades, thousands of farmers in my state have depended on their tobacco quotas. They made significant investments in equipment and land. They paid into the no-net cost assessment program knowing that the quota system they were locked into would provide for them. They didn't get rich--most of the farmers in my State will tell you that their tobacco profits allowed them to send their children to college or just pay the bills. But that financial security has been eroded. The Federal quota is at an all-time low. In fact, just in the past five years tobacco farmers have seen their quotas cut in half. That same time has been particularly difficult for my farmers, who have had to adjust to the dwindling quota while losing their crops and in some cases their entire farms to three hurricanes, a massive ice storm and a severe drought. It is time to end the Federal quota system. It is time to give these hard working men and women a chance to transition to other crops or to retire with dignity. And for those who want to continue to grow tobacco, we must end the antiquated quota system and give them a chance to compete with foreign producers just as if they were growing any other crop like corn or sweet potatoes. Of course, this isn't just another crop. This is tobacco and the tobacco leaf is used to make addictive, deadly products. We must address that fact. I am certain that before the year is out, the Senate Health, Education and Labor Committee, of which I am a member, will consider relevant legislation to protect public health. I welcome that committee's efforts. But in the debate surrounding the tobacco industry, we cannot lose sight of the fact that thousands of honest, hard working people depend on the leaf for their economic livelihood. People like Blythe and Gwendolyn Casey of Kinston, NC. Mr. and Ms. Casey began farming tobacco decades ago. They made a decent living doing what they loved. As the years passed, they increased their production and made substantial investments in equipment and regulation barns. They paid into the no-net cost assessment program and played by the rules. They never got rich, but they were confident their investments would allow them to one day retire and remain on their farm. Through no fault of their own, they've watched the value of their quota essentially disappear. When they began farming, they never thought they would reach retirement age mired in debt. The Caseys, and thousands of tobacco farming families in eastern North Carolina face a bleak financial future unless Congress acts. The Federal quota system has reached a crisis point and we must intervene. The Tobacco Market Transition Act is our best chance to stave off economic disaster for tens of thousands of farmers. This bill represents a compromise literally years in the making. This bill is not perfect. But this bill could be the last hope for farmers.

Mr. EDWARDS

Mr. EDWARDS. Mr. President, the introduction of the Tobacco Market Transition Act is an important milestone for tens of thousands of farmers. I am proud to have been part of the bipartisan working group that crafted this bill. For decades, thousands of farmers in my state have depended on their tobacco quotas. They made significant investments in equipment and land. They paid into the no-net cost assessment program knowing that the quota system they were locked into would provide for them. They didn't get rich--most of the farmers in my State will tell you that their tobacco profits allowed them to send their children to college or just pay the bills. But that financial security has been eroded. The Federal quota is at an all-time low. In fact, just in the past five years tobacco farmers have seen their quotas cut in half. That same time has been particularly difficult for my farmers, who have had to adjust to the dwindling quota while losing their crops and in some cases their entire farms to three hurricanes, a massive ice storm and a severe drought. It is time to end the Federal quota system. It is time to give these hard working men and women a chance to transition to other crops or to retire with dignity. And for those who want to continue to grow tobacco, we must end the antiquated quota system and give them a chance to compete with foreign producers just as if they were growing any other crop like corn or sweet potatoes. Of course, this isn't just another crop. This is tobacco and the tobacco leaf is used to make addictive, deadly products. We must address that fact. I am certain that before the year is out, the Senate Health, Education and Labor Committee, of which I am a member, will consider relevant legislation to protect public health. I welcome that committee's efforts. But in the debate surrounding the tobacco industry, we cannot lose sight of the fact that thousands of honest, hard working people depend on the leaf for their economic livelihood. People like Blythe and Gwendolyn Casey of Kinston, NC. Mr. and Ms. Casey began farming tobacco decades ago. They made a decent living doing what they loved. As the years passed, they increased their production and made substantial investments in equipment and regulation barns. They paid into the no-net cost assessment program and played by the rules. They never got rich, but they were confident their investments would allow them to one day retire and remain on their farm. Through no fault of their own, they've watched the value of their quota essentially disappear. When they began farming, they never thought they would reach retirement age mired in debt. The Caseys, and thousands of tobacco farming families in eastern North Carolina face a bleak financial future unless Congress acts. The Federal quota system has reached a crisis point and we must intervene. The Tobacco Market Transition Act is our best chance to stave off economic disaster for tens of thousands of farmers. This bill represents a compromise literally years in the making. This bill is not perfect. But this bill could be the last hope for farmers.

Mr. EDWARDS

Mr. EDWARDS. I thank my distinguished colleague for the clarification. u.s.-mexico border vulnerability

Mr. EDWARDS. Mr. President, I applaud the Appropriations Committee's efforts to improve our public warning system in the event of a terrorist attack. Right now, we depend almost exclusively on television and radio, which most of us wouldn't hear should a disaster occur in the middle of the night. I support the Committee's efforts to include the full range of communications technologies in our alert system. Public warnings save lives, and we must ensure that warnings reach every American in times of danger. While terrorism warnings are vitally important, we must not forget that more than 95 percent of all public warnings deal with weather hazards like hurricanes and floods. I am concerned that creating a new public warning system to alert Americans in the events of a terrorist attack, rather than building upon an existing warnings network, like National Oceanic and Atmospheric Administration, NOAA, weather radio, could further confuse and frustrate the public. During consideration of the supplemental earlier this year, the Senate passed an amendment I introduced to incorporate terrorism warnings and updated technologies within National Oceanic and Atmospheric Administration, NOAA, weather radio. The House Appropriations Committee Report also includes language about incorporating terrorism alerts within NOAA weather radio. I believe very strongly that the Senate must also be on record supporting an integrated alert system. Such a system must make use of all existing communication technologies, including traditional telephones, wireless technology, including cellular telephones and pagers, and the Internet. This can only be achieved if the Chairman of the Federal Communications Commission, the Secretary of Commerce, representatives of State and local govermments, and representatives of the private sector, media, and academia are all involved.

Mr. EDWARDS

Mr. EDWARDS. Mr. President, I rise to enthusiastically express my support for the nomination of Allyson Duncan for the Fourth Circuit Court of Appeals and Louise Wood Flanagan for the U.S. District Court for the Eastern District of North Carolina. This is a historic day for my home state of North Carolina. Once confirmed, Allyson Duncan will be the first North Carolinian to join the Fourth Circuit Court of Appeals in 23 years. North Carolina is the only State in the Union with no judges on a Federal appellate court. And we have the longest-standing vacancy in the Federal appeals court system. I was very proud to support Judge Duncan's nomination and it was my pleasure to introduce her during her confirmation hearing. She will restore the voice of North Carolina to this very important Federal Court and breaks a logjam that has damaged our state for too many years. This historic development shows what can be done when the President truly respects the advice and consent role of the Senate. In this case, President Bush did more than just pay lip service to this important responsibility. He reached out to Senator Dole and me before he made his decision--he consulted with us--he sought our advice. In making his decision, the President selected a nominee who represents the mainstream of our state. I commend the President for consulting with us and for making an excellent nomination. If he takes this approach to future judicial nominations we have a real opportunity to find common ground in the search for excellence on the Federal bench. When we work together, we find outstanding nominees like Allyson Duncan who represents the best of North Carolina. As impressive as her resume is, even more telling is her steller repudiation throughout the North Carolina legal community. I have heard from folks all over the State who can't say enough about Allyson Duncan. What people keep telling me is that this is a woman of extraordinary intellect and skill, who loves the law, strives for justice and never allows politics to interfere with her commitment to fairness and equality. When the Senate confirms Allyson Duncan--which I hope will happen soon--her confirmation will mark a number of ``firsts.'' She will be the first North Carolinian to join the 4th Circuit in over 20 years; she will be the first African American woman to serve on that distinguished court. And most important, I hope she will be the first in a series of bipartisan, consensus judicial nominations from our State. I yield the floor.

Mr. EDWARDS

Mr. EDWARDS. Mr. President, I speak out for ordinary people. We all recognize that we need to do something about the medical malpractice problem in this country. Premium rates are too high and, in some cases, drive away the medical care these people need. I have spoken out loud and clear about this issue and recently published an op-ed piece in the Washington Post calling for common sense provisions included in our bill, which I am proud to cosponsor.

Mr. EDWARDS. We have to do something about this problem. But the answer is not to slap down the victims, which is exactly what the Republican plan will do. This is nothing new. Time and again, we have seen this administration and the Republican majority stand up for corporate interests with little regard for the people who will be harmed by this rush to protect big business. This time it is the malpractice insurance companies who are being protected at the expense of ordinary people. S. 11 comes right off the insurance companies' wish list. It might as well have been written by the insurance companies. It drastically limits the compensation these companies have to pay children and parents who have been blinded, paralyzed or otherwise severely injured. The victims who make the least money will suffer the most under this plan. The harm to the kinds of families I represented as a lawyer for nearly 20 years will be enormous. We need to stand up for these people. We need to fight for people like little Tristan Lewis, who lives in my State of North Carolina. Tristan was born 3 months premature, but her early signs were good. She was breathing on her own and had scored eight out of 10 on the APGAR tests, used to rate newborn babies. Unfortunately, nurses attempted to warm Tristan with heated IV saline bags that burned the tiny girl. They heated the bags in a microwave without doctor approval; they failed to check the temperature of the bags, and then left Tristan on the boiling hot bags for over 10 minutes, even though she was crying loudly. Black burns covered much of Tristan's back. The third-degree burns had penetrated her skin. Nine days after she was born, Tristan was sent to another hospital for a surgery, commonly needed by premature babies, to close a blood vessel near her heart. The doctors there discovered a dangerous infection. Tristan had meningitis, which likely entered her little body through the burn wounds. Tristan spent most of her first year in the hospital and she had more than a dozen surgeries. The pain and complications of the burns increased Tristan's blood pressure and caused or aggravated bleeding inside her brain. The bacteria that led to her meningitis probably entered her body through the burn wounds, where the skin's ability to serve as a barrier against infection had been weakened. Tristan, who is now 7, is legally blind. Her eyes bring in images, but her brain cannot process them. She is fed through a tube. Antiseizure medications make her groggy, so she spends most days sleeping. Tristan has no purposeful movement and cannot communicate. The hospital's insurance company agreed to settle the case. Now Tristan's mother knows that her little girl will always have what she needs. But if the administration had its way, the hospital would have been less likely to settle the case and Tristan would have been limited to $250,000 for her ``noneconomic'' suffering. That is just not right. It is wrong to try to protect the profits of big insurance companies at the expense of victims like little Tristan. But every time we point out these inequities, we are shouted down with cries of ``class warfare!'' Well, the American people need to hear the truth. We are engaging in class warfare. What we have here is a fight for fairness. The Republican plan is just plain, flat out unfair. And it won't work. It penalizes the worst injured people but it doesn't do a thing to solve the problem. It doesn't do anything to punish the bad lawyers while rewarding the good. It doesn't do anything to make doctors accountable for bad behavior. All this plan does is save insurance companies money by slamming the courthouse door in the face of innocent victims who have nowhere else to turn. But it doesn't require them to pass along one cent of this savings to doctors. So victims lose, doctors get nothing, and the insurance companies get richer. How can anyone claim that is fair? Our plan is fair and it will work. It will work because it cracks down on price gouging by the insurance industry and takes aggressive action against lawyers who bring frivolous lawsuits that don't belong in court. We have got to reform the insurance industry, something the Republican plan completely sidesteps. Today insurance companies use slow and burdensome processes to discourage both doctors and patients from filing legitimate claims. Worse still, these companies can fix prices and divvy up the country in order to drive up their profits. Even when companies don't explicitly collude, they set their rates based on a trade-group loss calculation that they know other companies will follow. In any other industry, this kind of conduct would be subject to scrutiny under the antitrust laws. But an obscure 1945 law gives insurance companies a broad antitrust exemption. Because of the insurance lobby's influence, Congress has even blocked the Federal Trade Commission from investigating insurance company rip-offs. These special privileges have go to go and our plan does just that. Next, we need to prevent and punish frivolous lawsuits. The vast majority of lawyers are responsible advocates for their clients, but the few who aren't hurt the real victims, make a bad name for the good lawyers and clog up our courts. But for all his talk about frivolous lawsuits, President Bush does nothing to address them. He has got it backward--instead of cracking down on irresponsible behavior and baseless cases, he is targeting serious victims who win in court and are believed by juries. Our plan requires that before a lawyer can bring a medical malpractice case to court, he or she must file an affidavit from a qualified health specialist verifying that real malpractice has occurred. Lawyers who file frivolous cases will face tough, mandatory sanctions. Lawyers who file three frivolous cases will be punished severely--in other words, three strikes and they are out. And, while it is important to clamp down on frivolous lawsuits, we also must do everything we can to prevent malpractice in the first place. That is why our plan includes measures that will help patients avoid doctors with bad track records. And, finally, our plan enhances patient access to quality health care by easing the burdens imposed on doctors by out-of-control insurance companies. First, it repeals the special interest antitrust exemption that allows insurance companies to collude and jack up premium rates with impunity. Second, it provides a tax credit for malpractice premiums paid, based upon the nature of risk in their areas of practice. And, third, our plan will help stem the tide of health care providers being driven out of certain geographic areas by out-of- control insurance rates by, among other things, providing grants and tax credits to areas experiencing shortages. Our plan is fair, it is reasonable, and it will work. The Republican plan is not only mean-spirited, but it won't do a thing to solve the problem it is supposed to address. Their plan doesn't do a thing but build more wealth for big insurance companies on the backs of ordinary people who have already suffered too much. And I won't stand by and let that happen. None of us should. That is why I urge all of my colleagues to stand up for what is right and fight for fairness by voting no on S. 11. [From the Washington Post, May 20, 2003] Let's Keep Doctors in Business (By John Edwards) The rising cost of malpractice insurance for doctors is getting in the way of good health care. In rural areas, some specialists can no longer afford to practice, and patients can't get the care they need. We need to fix this problem now, and we need to fix it in a way that is consistent with the doctors' own Hippocratic Oath: First, do no harm. Unfortunately, President Bush's proposed prescription comes straight off the insurance companies' wish list: a sharp limit on the compensation these companies have to pay children and parents who have been blinded, paralyzed or otherwise severely injured. The victims who make the least money will suffer the most under this plan. The harm to the kinds of families I represented as a lawyer for nearly 20 years will be enormous. What the president's proposal won't do is work. Insurance premiums have spiked recently because of insurance companies' losses on their investments, not their losses to victims. In fact, about half the states already have some limits on victim compensation, yet premiums in states with caps average about the same as premiums in states without caps. California finally controlled rates not by attacking victims--that didn't work--but by reforming the insurance industry and rolling back premium increases. We need a real solution that frees doctors from crippling insurance costs--without preventing the most badly injured victims from receiving the compensation they deserve. That real solution has three elements. Most important, we need to crack down on price gouging by the industry. We also need aggressive action against frivolous lawsuits that don't belong in court--not against the serious lawsuits that bring help to the most badly injured. And finally, we need to reduce the number of medical errors, many made by a very small fraction of the medical profession. The most critical step is reforming the insurance industry. Today insurance companies use slow and burdensome processes to discourage both doctors and patients from filing legitimate claims. Worse still, these companies can fix prices and divvy up the country in order to drive up their profits. Even when companies don't explicitly collude, they set their rates based on a trade-group loss calculation that they know other companies will follow. In any other industry, this kind of conduct would be subject to scrutiny under the antitrust laws. But an obscure 1945 law gives insurance companies a broad antitrust exemption. Because of the insurance lobby's influence, Congress has even blocked the Federal Trade Commission from investigating insurance company rip-offs. These special privileges must go. Next, we need to prevent and punish frivolous lawsuits. Most lawyers are responsible advocates for their clients, but the few who aren't hurt the real victims, undercutting the credibility of the legal system and clogging our courts. For all his talk about frivolous lawsuits, President Bush does nothing to address them. He's got it backward--instead of cracking down on irresponsible behavior and baseless cases, he's targeting serious victims who win in court and are believed by juries. Before a lawyer can bring a medical malpractice case to court, we should require that he or she swear that an expert doctor is ready to testify that real malpractice has occurred. Lawyers who file frivolous cases should face tough, mandatory sanctions. Lawyers who file three frivolous cases should be forbidden to bring another suit for the next 10 years--in other words, three strikes and you're out. Finally, we can reduce malpractice premiums by helping to reduce malpractice. The Institute of Medicine found that at least 44,000 people die from preventable medical errors every year. In medicine, as in law, a few people cause the most problems: Only 5 percent of doctors have paid malpractice claims more than once since 1990. This same 5 percent are responsible for more than half of all claims paid. One part of the problem is state medical boards whose discipline is as lax as state bar associations'. We need to provide resources and incentives for boards to adopt real standards on the ``three strikes'' model. At the same time, we need to encourage doctors to report more medical errors voluntarily, so we can learn more about systemic problems. Together these measures will give relief to most doctors who are suffering under the staggering weight of insurance premiums. But where premiums still cause shortages of medical care, Washington must provide a temporary subsidy so good doctors can continue their essential work. We shouldn't be padding insurers' profits and hurting people who have already suffered immensely, as the president proposes. But we should be protecting good doctors and the patients who depend on them. The writer, a Democratic senator from North Carolina, is seeking his party's nomination for president.

Mr. EDWARDS

Mr. EDWARDS. Madam President, yesterday we voted on the Edwards- Harkin amendment which had two provisions. The first provision dealt with the FDA approval process for ``me too'' drugs. There were concerns expressed by the Members of the Senate about that provision. Even though I disagreed with those concerns, I don't think it would have slowed down the FDA approval process. Because of those concerns, we have removed those provisions from this amendment. The amendment we are about to vote on deals only with advertising. It in no way bans advertising. All this amendment does is require that the advertising engaged in by drug companies and pharmaceutical companies be evenhanded. The only thing this amendment requires is that the information be accurate and evenhanded. In other words, you can't have kids dancing in a field as the image on television and in small print at the bottom saying the drug can cause strokes or have other side effects. We want to make sure the American people in these advertisements get accurate information and which is not misleading. This amendment does exactly that. We have eliminated the provision so many were concerned about yesterday. I urge my colleagues to support this amendment. Let us make sure the American people get true and accurate information in the advertising they are seeing on drugs on television.

Mr. EDWARDS

Mr. EDWARDS. Mr. President, reserving the right to object, I have a modification at the desk with additional modifications. I ask unanimous consent, first, that the modification be accepted.

Mr. EDWARDS. Mr. President, I rise today, together with my friend, Senator Tom Harkin from Iowa, to introduce an amendment to bring down the cost of prescription drugs. As everyone knows, the cost of prescription drugs has been skyrocketing. We have to bring these costs under control, not only to lower the drug costs for seniors but also to lower drug costs for all Americans, including those who will not get a prescription drug benefit under the Medicare Program. There are lots of reasons drug costs are rising, and I have offered several proposals to address that in the past. This amendment addresses two particular concerns. The first is what is called the ``me too'' drugs that provide minimal benefits for people but large profits for drug companies. The second is the massive growth in the direct-to- consumer advertising that does not genuinely educate consumers. This amendment, from Tom Harkin and me, would address these problems with two steps. First, we call on the Secretary of HHS to require drug manufacturers to prove that ``me too'' drugs actually provide benefits before they are approved. Second, we would impose new requirements for fairness and balance in drug advertising. Drug companies provide a very important service to America and to the sick. They deserve to make a profit for that, all of us agree on that. But they should also fulfill their mission as businesses, to generate innovative drugs that reduce pain, alleviate suffering, and cure disease. Unfortunately, many drug companies seem to be giving that mission short shrift. We know they spend far more on marketing, advertising, and administration than they spend on research and development. We also know that instead of focusing on truly innovative breakthroughs, drug companies are focusing on ``me-too'' drugs to compete against blockbuster treatments for chronic conditions like allergies and high cholesterol. I want to talk about that for a minute. Me-too drugs can be good things. They can help a specific population, or they can be safer and more effective. Of course those are good things. But here is the problem. Companies should not be able to profit off of a me-too drug just by misleading consumers about the benefits compared to existing drugs. Consumers should know how exactly the new drug stacks up against the existing drug. Senator Clinton spoke of the same need last night, when she introduced her very sound amendment. Consumers need to be given the ability to make an informed choice about the best drug for them. This amendment would give the Secretary of HHS the authority to require drug companies to test drugs against their competitors. And if the drug company is going to advertise its ``me-too'' drug, it should tell the consumer how that drug compares to what they may already be taking for that condition. Now, I want to talk about the larger point, which is drug advertising. Some drug advertising is a good thing. Drug ads can let people know about drugs about which they don't otherwise hear. The drug industry's major trade group, PhRMA, says the purpose of direct-to-consumer advertising is: . . . to educate consumers about diseases, about the symptoms that may help them identify diseases, and the available therapies developed to treat them. Those are good. Those are good goals. Here is the problem. Does anyone think drug advertising today is genuinely about educating consumers, as PhRMA says, rather than marketing? Does anyone believe that? Are drug companies educating consumers about allergy medicines by showing this picture of a woman running through a field? I think all of us know, when this kind of advertisement, as in this picture, is shown on television, it is clearly about selling and about marketing. This is not for the purpose of educating consumers, and the American people know that. They know that without anyone telling them that. Are they educating consumers about arthritis with images of a couple dancing in their kitchen? If this were about education, would an announcement read: ``Health warnings: Headache, nausea,'' and so on, while the picture on the screen still shows happy pictures of a mom and her kids? Absolutely not. These ads are not about education; they are about marketing. There is nothing wrong with marketing and persuasion in most contexts. If they are selling paper towels or shaving cream, companies should go ahead and market as aggressively as they can. But prescription drugs are different. There is nothing more important in our lives than our health, and there is nothing more important than drugs for our health. These are matters of life and death for families, for seniors, and for kids. Advertisements for these products should be held to a much higher standard. They should educate, not just market. That is not what these ads do. You don't have to take my word for it; that is what Consumer Reports says, that is what doctors say, and, most importantly, it is what common sense says. These ads make promises they cannot keep. They overstate benefits and they understate risks. Let me give just a couple of examples from recent research. This is from a study from the magazine Consumer Reports. They studied drug ads and they found: . . . a broad and disconcerting range of misleading messages: ads that minimize the product's risk, exaggerated its efficacy, made false claims of superiority over competing products; promoted unapproved uses for an approved drug; or promoted use of a drug still in the experimental stage. In a recent FDA survey of 500 general practitioners, family doctors, 7 out of 10 said advertisements about drugs confused patients about the risks and benefits of medicines. In another study, 75 percent of doctors said their patients came away with the impression that the drugs they saw in advertisements work better than they actually do. The Kaiser Family Foundation did a survey of nearly 2000 adults who saw drug advertisements; 7 out of 10 said they learned little or nothing about what the treated condition; 6 out of 10 said they learned little or nothing about the drug. Here are comments from Arnold Relman and Marcia Angell, two former editors-in-chief of the New England Journal of Medicine. They said: DTC ads mainly benefit the bottom line of the drug industry, not the public. They mislead consumers more than they inform them, and they pressure physicians to prescribe new, expensive, and often marginally helpful drugs, although a more conservative option might be better for the patient. So this amendment is simple. It says that drug ads should be balanced. They should include information about other drugs that may address conditions better. And they should have a real balance between the images selling the drug and the images questioning the drug. Now, the Bush administration sees it differently. They think see it as drug companies should be able to use whatever marketing gimmicks they want to sell their drugs. The FDA is supposed to stop ads that are misleading. But last year the Bush administration's FDA instituted a new policy that slows down the FDA's efforts. As a result, the FDA issued two-thirds fewer warning letters last year than the year before. The GAO looked into this and found that warning letters are often ``not issued until after the advertising campaign has run its course.'' This is a gift to the drug companies. Without the threat of a warning letter, they can basically air whatever kind of ad they want and just ask for forgiveness afterwards. Take the case of an ad for the prescription drug Tamiflu that ran on the radio last year. It featured Eric Bergoust, the Olympic gold-medal skier, who said ``I felt better so soon that I didn't miss a single day of training.'' The FDA told the drug maker Hoffmann-La Roche to stop running the ad because Bergoust's words ``misleadingly overstated the drug's efficacy.'' But the FDA's request came nearly three months after the company had submitted the ad for review, a month after the flu season had ended, and well after the company stopped running the ad. Our amendment would make sure this kind of thing cannot happen. The FDA should speed up the review process and use their authority to have misleading ads pulled before millions of consumers have already seen them. And drug companies need to be held accountable when they repeatedly violate FDA regulations. In this amendment, Senator Harkin and I call for stiff civil penalties for such offenders. So, in short, this amendment would not bar all direct-to-consumer advertising. It would simply require the advertising to educate, rather than simply market. I urge my colleagues to support this amendment. This amendment is for the purpose of doing something to control drug advertising, to make sure that it is, in fact, about education, and to make sure these ``me too'' drugs actually have a benefit before they are approved by the FDA. Thank you, Mr. President. Vote On Amendment No. 972

Mr. EDWARDS. Mr. President, I ask for the yeas and nays.

Mr. EDWARDS. Madam President, I ask unanimous consent to lay aside the pending amendments.

Mr. EDWARDS. Madam President, I have an amendment I send to the desk.

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

Mr. EDWARDS. Madam President, I ask unanimous consent that the amendment be laid aside.

Mr. EDWARDS. I suggest the absence of a quorum.

Mr. EDWARDS. Yes.

Mr. EDWARDS. Mr. President, the purpose of this amendment is to do something about the skyrocketing costs of prescription drugs in this country. Whatever we do to provide a real prescription drug benefit for seniors under Medicare, both for the purpose of keeping the cost of that plan down and for the purpose of doing something for all Americans who have no prescription drug coverage, we have to bring the cost of prescription drugs under control. There are two abuses at which this amendment is aimed: First, stopping the proliferation of ``me too'' drugs that have no meaningful benefit; second, stopping the abuses in advertising. Everyone has seen the ads: Couples dancing in the kitchen; people running through fields. These are not for the purpose of education. They are for the purpose of marketing. We are trying to bring this under control by putting fairness, honesty, and accuracy in that advertising. The purpose of the amendment is to help control both those activities and, in the process, bring down the cost of prescription drugs. Mr. President, I ask my colleague, the coauthor of this amendment, Senator Harkin from Iowa, what he believes we need to do to bring down the cost of prescription drugs. I yield to Senator Harkin.

Mr. EDWARDS. Mr. President, I ask for the yeas and nays.

Mr. EDWARDS

Mr. EDWARDS. Mr. President, I was not present for rollcall vote No. 221 on the Graham amendment. Were I present for that vote, I would have voted in favor of the amendment. Mr. President, I was not present for rollcall vote No. 222 on the Lautenberg amendment. Were I present for that vote, I would have voted in favor of the amendment.

Mr. EDWARDS

Mr. EDWARDS. Mr. President, today I am proud to join with two of my colleagues--Senator Reed and Senator Roberts--to introduce legislation that will help America meet a critical challenge that, during the past decade, it has faced over and over: helping countries that have suffered from conflict work to rebuild their societies. Over the past two years, America has proved again that we have the finest military force in the world. In Afghanistan and Iraq, the men and women of America's military performed with great bravery and skill. By defeating the Taliban and removing Saddam Hussein's regime from power, they showed that they are the world's best trained troops using the world's most sophisticated weapons. This is a powerful example of the leadership and commitment both here in the Congress and in successive Administrations--both Democrat and Republican--to ensure that our military remains the best equipped, best trained, most prepared fighting force in the world. But these decisive military victories have been followed by a peace where success has not been so clear. First in Afghanistan, and now in Iraq, our efforts to help these societies get back on their feet have produced mixed results. To be sure, the challenges in both countries are profound: Afghanistan suffered from nearly a quarter-century of civil war, and Iraq suffered for more than two decades under the thumb of Saddam Hussein and his brutal regime. Both countries have deep internal divisions and little experience with representative government. While it is reasonable to assume post-conflict reconstruction efforts in both nations will take considerable time, these realities cannot be an excuse for the overall shortcoming in our own efforts, especially because we have the resources and capabilities to do better. This is not the first time we have faced such challenges. Since the end of the Cold War, thousands of American military, diplomatic and humanitarian personnel have also been involved in major post-conflict reconstruction efforts in such places as Bosnia, Kosovo, Somalia, Rwanda, Haiti, and East Timor. Each of these efforts has had varying degrees of success, but on balance, I think we all can agree that we could have done better. Too often, our response to post-conflict situations has been haphazard and slow to start. And once underway, our efforts often suffer from a cumbersome chain-of-command, lack of resources, and inadequate accountability. The problem is that our government is still not well organized to deal with such situations. Each time we get involved in a post-conflict reconstruction effort we end up making it up as we go. We waste valuable time reinventing the bureaucratic wheel. And we get in unnecessary arguments about who should do what and who should be in charge. It is remarkable that even with all the commitments we have made during the past decade, next to nothing has been done to reform the way our government works to enhance our capacity to deal with these situations effectively. Governmental mechanisms developed during the Cold War are outdated and not suited to addressing the complex set of challenges created by failed states. We must do better. After more than ten years of improvising our responses to these challenges, it is time to change the way we do things. We need to improve our ability to plan, coordinate, and organize U.S. government resources to assist with post-conflict reconstruction. We need to train our people more effectively. We need a better sense of what works and what does not. We need greater accountability. And we need to promote the means for involving other countries in these efforts, including through institutions like NATO. I believe that the ``Winning the Peace Act'' is an important step toward accomplishing these goals. This legislation is based upon the work of the bipartisan ``Commission on Post-Conflict Reconstruction,'' convened by the Association of the U.S. Army and the Center for Strategic and International Studies, CSIS. This Commission was very ably led by Dr. John Hamre, the former Deputy Secretary of Defense, and General Gordon Sullivan, the former Army Chief of Staff. The Commission was composed of twenty-seven distinguished military, diplomatic and humanitarian experts, including myself and my two Senate cosponsors. The legislation includes five key proposals: First, it calls on the President to appoint a Director of Reconstruction for areas where the U.S. will assist with post-conflict reconstruction. These Directors will provide oversight, help coordinate, and have decision-making authority for all U.S. government reconstruction activities in a particular country. They will also coordinate with the representatives of the country in question, other foreign governments, multilateral organizations, and relevant NGOs. Second, it establishes a permanent office within the State Department to provide support to Directors of Reconstruction, ensuring that these Directors can hit the ground running and not waste valuable time hiring staff and getting office space. Third, it establishes within USAID an Office of International Emergency Management. This new office will develop and maintain a database of individuals with expertise in reconstruction, and provide support for mobilizing these experts. Fourth, it calls on NATO to develop an ``Integrated Security Support Component'' to assist with reconstruction. This NATO-led force will help provide security, including assistance with policing ensuring that America will not be forced to shoulder these burdens alone. Finally, this bill establishes an interagency training center for post-conflict reconstruction. This will be run by the State Department, and will help train personnel in assessment, strategy development, planning, and coordination related to providing reconstruction services. It will also develop and certify experts in the field, and conduct lesson-learned reviews of operations. Having these resources in place will enhance America's capacity to assist reconstruction in four critical areas: Security and public safety, such as assisting with disarmament and training of police forces; Justice, such as developing the rule of law, preventing human rights violations, and bringing war criminals to justice; Governance, such as reforming civil administration, restoring basic civil functions, and establishing processes of governance and participation; and Economic and Social Well-being, such as providing humanitarian assistance and developing national economic institutions. With these changes, we will not only make America's efforts to assist in post-conflict reconstruction more efficient and accountable. We will also make our efforts more effective contributing more to the safety and security of the people we are trying to help, and helping them run their countries on their own. By ensuring that we maintain the best military in the world, we have made a full commitment to winning wars. It is now time to ensure that we are capable of winning the peace. I ask unanimous consent that the text of the legislation be printed in the Record.

Mr. EDWARDS

Mr. EDWARDS. Mr. President, today I am proud to join with two of my colleagues--Senator Reed and Senator Roberts--to introduce legislation that will help America meet a critical challenge that, during the past decade, it has faced over and over: helping countries that have suffered from conflict work to rebuild their societies. Over the past two years, America has proved again that we have the finest military force in the world. In Afghanistan and Iraq, the men and women of America's military performed with great bravery and skill. By defeating the Taliban and removing Saddam Hussein's regime from power, they showed that they are the world's best trained troops using the world's most sophisticated weapons. This is a powerful example of the leadership and commitment both here in the Congress and in successive Administrations--both Democrat and Republican--to ensure that our military remains the best equipped, best trained, most prepared fighting force in the world. But these decisive military victories have been followed by a peace where success has not been so clear. First in Afghanistan, and now in Iraq, our efforts to help these societies get back on their feet have produced mixed results. To be sure, the challenges in both countries are profound: Afghanistan suffered from nearly a quarter-century of civil war, and Iraq suffered for more than two decades under the thumb of Saddam Hussein and his brutal regime. Both countries have deep internal divisions and little experience with representative government. While it is reasonable to assume post-conflict reconstruction efforts in both nations will take considerable time, these realities cannot be an excuse for the overall shortcoming in our own efforts, especially because we have the resources and capabilities to do better. This is not the first time we have faced such challenges. Since the end of the Cold War, thousands of American military, diplomatic and humanitarian personnel have also been involved in major post-conflict reconstruction efforts in such places as Bosnia, Kosovo, Somalia, Rwanda, Haiti, and East Timor. Each of these efforts has had varying degrees of success, but on balance, I think we all can agree that we could have done better. Too often, our response to post-conflict situations has been haphazard and slow to start. And once underway, our efforts often suffer from a cumbersome chain-of-command, lack of resources, and inadequate accountability. The problem is that our government is still not well organized to deal with such situations. Each time we get involved in a post-conflict reconstruction effort we end up making it up as we go. We waste valuable time reinventing the bureaucratic wheel. And we get in unnecessary arguments about who should do what and who should be in charge. It is remarkable that even with all the commitments we have made during the past decade, next to nothing has been done to reform the way our government works to enhance our capacity to deal with these situations effectively. Governmental mechanisms developed during the Cold War are outdated and not suited to addressing the complex set of challenges created by failed states. We must do better. After more than ten years of improvising our responses to these challenges, it is time to change the way we do things. We need to improve our ability to plan, coordinate, and organize U.S. government resources to assist with post-conflict reconstruction. We need to train our people more effectively. We need a better sense of what works and what does not. We need greater accountability. And we need to promote the means for involving other countries in these efforts, including through institutions like NATO. I believe that the ``Winning the Peace Act'' is an important step toward accomplishing these goals. This legislation is based upon the work of the bipartisan ``Commission on Post-Conflict Reconstruction,'' convened by the Association of the U.S. Army and the Center for Strategic and International Studies, CSIS. This Commission was very ably led by Dr. John Hamre, the former Deputy Secretary of Defense, and General Gordon Sullivan, the former Army Chief of Staff. The Commission was composed of twenty-seven distinguished military, diplomatic and humanitarian experts, including myself and my two Senate cosponsors. The legislation includes five key proposals: First, it calls on the President to appoint a Director of Reconstruction for areas where the U.S. will assist with post-conflict reconstruction. These Directors will provide oversight, help coordinate, and have decision-making authority for all U.S. government reconstruction activities in a particular country. They will also coordinate with the representatives of the country in question, other foreign governments, multilateral organizations, and relevant NGOs. Second, it establishes a permanent office within the State Department to provide support to Directors of Reconstruction, ensuring that these Directors can hit the ground running and not waste valuable time hiring staff and getting office space. Third, it establishes within USAID an Office of International Emergency Management. This new office will develop and maintain a database of individuals with expertise in reconstruction, and provide support for mobilizing these experts. Fourth, it calls on NATO to develop an ``Integrated Security Support Component'' to assist with reconstruction. This NATO-led force will help provide security, including assistance with policing ensuring that America will not be forced to shoulder these burdens alone. Finally, this bill establishes an interagency training center for post-conflict reconstruction. This will be run by the State Department, and will help train personnel in assessment, strategy development, planning, and coordination related to providing reconstruction services. It will also develop and certify experts in the field, and conduct lesson-learned reviews of operations. Having these resources in place will enhance America's capacity to assist reconstruction in four critical areas: Security and public safety, such as assisting with disarmament and training of police forces; Justice, such as developing the rule of law, preventing human rights violations, and bringing war criminals to justice; Governance, such as reforming civil administration, restoring basic civil functions, and establishing processes of governance and participation; and Economic and Social Well-being, such as providing humanitarian assistance and developing national economic institutions. With these changes, we will not only make America's efforts to assist in post-conflict reconstruction more efficient and accountable. We will also make our efforts more effective contributing more to the safety and security of the people we are trying to help, and helping them run their countries on their own. By ensuring that we maintain the best military in the world, we have made a full commitment to winning wars. It is now time to ensure that we are capable of winning the peace. I ask unanimous consent that the text of the legislation be printed in the Record.

Mr. EDWARDS

Mr. EDWARDS. Mr. President, I was unavoidably absent for rollcall vote No. 212 on the Dorgan amendment. Were I present for that vote, I would have voted in favor of the amendment.