Bill Frist

Mr. FRIST

Mr. FRIST. Mr. President, tomorrow the Senate will resume consideration of the Homeland Security appropriations bill. We have several important amendments pending, focusing on first responders. Additional amendments will be offered and debated through the day. Due to scheduling issues, any votes ordered with respect to amendments will be stacked to occur later in the day. We will alert Senators as to the exact timing of that series of votes tomorrow. We will complete the Homeland Security appropriations bill this week, and therefore we will need to make good use of our time on Wednesday, Thursday, and Friday, if necessary. Again, the intention is we will complete this bill this week. I mention that because I know there are a lot of scheduling challenges and problems, but we need to keep moving ahead. We will be stacking the votes, as I mentioned earlier in the day, to try to accommodate as many Members' schedules as possible.

Mr. FRIST

Mr. FRIST. Mr. President, last Thursday, a series of four explosions struck the heart of London during the morning rush hour. At least 49 innocent victims were killed and 700 others were injured. A previously unknown group called the ``secret group of al-Qaida's jihad'' in Europe claimed responsibility in the name of al-Qaida for the attacks. On behalf of the U.S. Senate and the American people, we express our heartfelt condolences to the victims, their families, and to the British people, our cousins across the Atlantic. We share in your grief and in your determination to hunt down the criminals who carried out this despicable act. We consider the attack last week on British soil an attack on the civilized world. We stand with the British people just as they have long stood with us. For nearly two centuries, the United States and the United Kingdom have enjoyed a special relationship. We speak the same language. We share a heritage of freedom and our economies are inexorably intertwined. Our militaries, our intelligence services, our great corporations, and our distinguished universities share deep relationships. Today, our forces fight side by side in Iraq and Afghanistan, sharing the sacrifices and the victories. As we learned on 9/11, our enemies are coldblooded killers who deliberately target innocent victims--women and men on their way to work, schoolchildren starting the new school year, and vacationers at the beach. Our enemies pervert religion. They despise freedom. They seek to overthrow regimes and dominate the world. But as they learned on 9/11, America, the United Kingdom, and the free people of the world will not stand by. We are taking the fight to their soil, to their caves, to their hideouts. We are disrupting their terror cells and financing operations. We are strengthening our homeland defenses and sharing information among intelligence agencies and nations. Brave men and women are working every day to thwart the enemy, to find him and bring him to justice. But as President Bush observed today, the terrorists need to be right only once. Free nations tend to be right 100 percent of the time. They need to be. And the best way to defeat the enemy is to stay on the offense. We will call upon the international community to renew and strengthen its efforts to defeat the terrorists, dismantle their networks, and to drain the swamps of injustice, oppression, poverty, and extremism that feed their hateful ideology. In the war on terror, we will not stop. We will not waiver. We will stand united against the enemies of freedom. And whatever it takes, wherever it takes us, we will win. Mr. President, under the previous agreement, we will now have a moment of silence in memory of those whose lives were lost.

Mr. FRIST. Mr. President, I ask for the yeas and nays on the adoption of the resolution.

Mr. FRIST

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

Mr. FRIST

Mr. FRIST. Mr. President, before we leave for the Fourth of July recess, I want to congratulate my colleagues for their hard work and focus over the past 6 months. We have worked hard to deliver meaningful solutions for the American people, and we have succeeded. From lawsuit reform to trade and energy policy, we have tackled a number of key issues that will make America stronger, more prosperous and more secure. We also confirmed six new members of the President's administration, including Secretary Condoleezza Rice, Homeland Security Chief Michael Chertoff, Attorney General Alberto Gonzales, Trade Representative Rob Portman, EPA Administrator Stephen L. Johnson, and the first ever National Intelligence Director, John Negroponte. As I reflect on the goals set out in January, we took on big and urgent challenges. And our actions have translated into solutions. Together we are moving America forward. When we began the 109th Congress 6 months ago, America faced a number of structural problems threatening our safety, prosperity, and freedom. America was drowning in lawsuit abuse. Our highways and ports were falling into disrepair. We were hitting our 10th year with no energy plan and becoming ever more dependent on foreign oil. Partisan obstruction was tearing apart the confirmation process. Our troops in the field needed our support. And over the Christmas holiday, a tsunami disaster devastated Southeast Asia. We needed to take bold action, so I laid out a plan. We began by passing the 5th fastest budget in Senate history. That allowed us to move on to the issues starting with class action. Frivolous lawsuits were so out of control that litigation in America had become the most expensive in the world. In 2003, the tort system cost an incredible $246 billion--more than the total economic output of my home State of Tennessee. Frivolous filings dull our competitive edge, clog up state courts, waste taxpayer dollars, and lead to outrageous settlements that award trial attorneys multimillion-dollar fees while their clients get pennies. Reform was long overdue. So we pulled together and finally passed a comprehensive class action reform bill with nearly three-quarters of the Senate voting in favor. One week later, the bill was signed into law. And we delivered to America a victory for fairness. With this success at our backs, we turned to bankruptcy abuse. Bankruptcy reform had long been in the works. Similar bills had passed the 105th, 106th and 107th Congresses. In this Congress, we passed the most sweeping overhaul of bankruptcy law in 25 years to restore fairness, integrity and personal responsibility to the system. And like class action, the bankruptcy bill passed with broad, bipartisan support. I thank my colleagues for finally getting these reforms through. It was not easy. A rich and powerful constituency had a lot to lose from reform. But common sense prevailed and we were able to return fairness to the system. There is still much to do to curb the lawsuit culture: asbestos, gun liability, and medical malpractice. But I am hopeful that the bipartisan spirit that carried us this far will continue to push us across the finish line. The highway bill was another area where we were able to come together and keep America moving forward. The highway bill was the result of a long, bipartisan process. It was based on more than 3 years of work, over a dozen hearings, testimony from more that 100 witnesses, and countless hours of negotiation. It was supported by a deep and broad coalition--from State and local highway authorities to national safety advocates. As every commuter knows, America's roads have become choked with traffic. In many American cities, rush hour now lasts all day long. Worse yet, car crashes are the No. 1 cause of death for every age from 3 to 33. Last year, nearly 43,000 people died in car accidents. Transportation Secretary Norm Mineta rightly observed that, ``If this many people were to die from any one disease in a single year, Americans would demand a vaccine.'' This year, we were able to provide relief. By a vote of 89 to 11, we passed the long overdue SAFETEA bill. As communities improve their roads and ports, America's drivers will face less time sitting in traffic, burning up time and gas. Which brings me to energy. Like the highway bill and lawsuit abuse reform, energy policy had languished for years--in this case, for over a decade. While Congress dithered, oil prices soared. Likewise, instead of the lowest natural gas prices in the industrialized world, we have the highest. And because of high natural gas prices, manufacturing and chemical jobs have been steadily moving overseas. Farmers are taking a pay cut. Consumers are paying too much to heat and cool their homes. Communities across the country are suffering. And as many as 2.7 million manufacturing jobs have been lost because of soaring prices. All the while, we have grown dangerously reliant on foreign sources of energy. And some of those foreign sources do not have America's best interests at heart. With all of this as a backdrop, we were finally able, this week, to pass a comprehensive Energy bill. It took 10 years, but we made it. And I am hopeful that, soon, we will be able to deliver to the American people an energy plan the makes America safer and more secure. Another area where we simultaneously strengthened America's national and economic security was with the passage of the Central American Free Trade Agreement last night. The agreement, which President Bush signed in May of 2004, will eliminate most trade barriers between the United States, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, and the Dominican Republican. CAFTA will open the doors to 44 million new consumers of American goods. And more sales to Central America mean more jobs here at home. It also means a more shared values. Twenty years ago, only two of the CAFTA nations were established democracies--Costa Rica and the United States. Today, all seven can be counted among the free nations of the world. By linking their economies with democratic capitalism, CAFTA will help gird these nations against the threats posed in the neighborhood, mainly Venezuela and Cuba. It will strengthen their democracies and provide a model for freedom seekers around the world. Which brings me to our outstanding work on the world stage. In April, by a near unanimous vote, we passed the emergency defense and war supplemental and Tsunami relief. On the morning of December 26th, the world woke up to the terrible tsunami disaster in Southeast Asia. Deep in the Indian Ocean, an enormous earthquake, estimated at a magnitude of 9.0 on the Richter scale--possibly one of the most powerful earthquakes in history--caused a devastating tsunami which killed over 155,000 people, seriously injured half a million, and displaced as many as 5 million from their demolished homes. Thousands of people were literally washed out to sea as the enormous wall of water traveling at speeds of up to 500 miles per hour in the open ocean struck the coasts of the Indian Ocean rim. As the waves receded, they took with them whole towns and villages. In the face of this terrible tragedy, America took swift action. We immediately dispatched military ships, planes and helicopters to deliver aid. Twelve thousand of our men and women in uniform worked around the clock to reach survivors. And Americans here at home, moved by the terrible images and stories, gave millions out of their own pockets to help. I had the opportunity to travel to the region with Senator Landrieu to survey the damage and meet with local doctors and government officials. We learned that it will take years for the region to recover. Many families never will. The legislation we passed in April provides an additional $880 million to help the victims recover and rebuild. The tsunami story may no longer be grabbing headlines, but America is still hard at work doing its part. We are still also hard at work fighting the war on terror. And the emergency defense bill provides $75.9 billion in support for our brave soldiers in Afghanistan and Iraq hunting down the enemy, helping to rebuild and spread freedom and democracy. As the President reminded the Nation this week, we are engaged in an epic struggle. The terrorists and insurgents want to deny the Iraqi people the freedoms that are the right of all mankind. They want democracy in Iraq to fail, so that they can seize power and spread their poison. But they will not succeed. We will win this war. But to do so, we must continue to stand together, united in support of our troops and in support of our values. The terrorists are no match for the will of the American people. And as Senators, we have no higher duty than to protect our fellow citizens' safety and well being. The past 6 months were not without their tense and dramatic moments in the Senate--none were more dramatic than the battle to confirm the President's judicial nominees. We appear to have begun to repair the confirmation process and restore dignity, fairness, and respect to our debates. As we said all along, each of these candidates was amply qualified, and enjoyed the majority support of the Senate. Each would be confirmed if brought to the Senate floor. And each of them were: Priscilla Owen, Janice Rodgers Brown, William Pryor, Richard Griffin, David McKeague, and Tom Griffith were all confirmed to the Federal bench. Unfortunately, in the process, they had to endure continuous, unfair attacks on their character. Some of the nominees in the last Congress found the process so painful, they dropped out rather than continue on. It is no wonder that we now hear reports that smart, qualified judges do not want to be considered for confirmation to the Federal bench. They have concluded that Washington is no place to risk your reputation--you may never get it back. Unfortunately, we see this now with the nomination of John Bolton to the United Nations. I have listened to my Democrat colleagues and heard their requests. I have no choice but to conclude that some on the other side are engaged in plain, partisan obstruction. John Bolton has a long record of successfully serving his country. He has been confirmed by the Senate no less than four times. I have been more than willing to try to reach a fair accommodation with the various requests, but the goalposts keep moving. This is a critical time for the United States and for the world. Because of the President's vision and commitment, democracy is on the march around the globe. And with sensible reform, the United Nations can and should be vital in advancing these developments. But we need to get a U.N. ambassador in place to make that change happen. We have before us a smart, principled, and straightforward candidate who will effectively articulate the President's policies on the world stage. We were assured that the partisan obstruction would stop. But as we see with the John Bolton nomination here we are again. I urge my colleagues to do what is right for the country, to set aside partisanship and let the Senate do its work, vote up or down, yes or no. We have much to do when we get back. It will be a busy month. I look forward to getting down to business and passing more legislation, like the Genetic Non-Discrimination Act we passed in February, that makes America more secure. I thank my colleagues for their hard work. I wish them a safe, productive and energizing holiday recess.

Mr. FRIST

Mr. FRIST. Mr. President, I rise to pay tribute to a truly distinguished American--U.S. Supreme Court Justice Sandra Day O'Connor, who announced her retirement earlier this morning. The current group of nine Justices, including Justice O'Connor, represented the longest serving Supreme Court since the 1820s. Today marks a great loss for America. But it is also a day to reflect on all that we have gained because of Justice O'Connor's service to our country. For nearly 23 years, Justice O'Connor lent America her brilliant mind and her fair and impartial judgment. Sandra Day O'Connor, who turned 75 this year, was born in El Paso, TX. The daughter of Harry and Ada Mae, she was raised on her family's cattle ranch, in southeastern Arizona. Sandra Day O'Connor began her academic journey at Stanford University. Upon earning a bachelor's degree in economics and graduating magna cum laude, she stayed on at Stanford, pursuing an education in law. And at Stanford she thrived. She earned a coveted position on the Law Review's Board of Editors and completed law school in only 2 years. Not only did she graduate in record time, but she finished third in her class. Coincidentally, she finished with a man who would later become her colleague on the highest Court in the land--Chief Justice William H. Rehnquist. It was during law school that Sandra Day O'Connor met her future husband, John Jay O'Connor. Seeking her first job as a young, female attorney, Sandra Day O'Connor faced many challenges in a male-dominated law profession. After having difficulty finding a job in the private sector, she began her legal career as Deputy County Attorney of San Mateo, CA. When her husband was drafted into the JAG Corps in 1953, the young couple moved to Frankfurt, Germany, where she worked as a civilian attorney for the U.S. Army. After 2 years in Europe, Sandra Day O'Connor returned to Maryvale, AZ, where she experienced difficulty finding employment in the legal world. As a result, she decided to start her own legal practice. After practicing law for 2 years, Sandra Day O'Connor took a break from her career to start a family. She and her husband raised three sons--Scott, Brian, and Jay. I must say, as a father of three sons, this may be her greatest accomplishment--certainly, one of the most challenging. In 1965, Sandra Day O'Connor transitioned from the private sector, to the public, when she became Arizona's Assistant Attorney General. In this capacity, she served for 4 years before being appointed to fill an unexpired seat in the Arizona State Senate. Her constituents agreed it was a good match--as they elected her twice more. In the Arizona Senate she rose to the highest level, becoming majority leader and the first woman ever to hold such an office in the United States. As majority leader of this body, I understand the challenges and rewards of being leader and admire Justice O'Connor for her tremendous achievement. In 1975, Sandra Day O'Connor was elected, judge of the Maricopa County Superior Court and served until 1979, when she was appointed to the appellate bench in Arizona. There she served, until late President Ronald Reagan appointed her Associate Justice to the Supreme Court. On September, 21, 1981, the Senate unanimously confirmed her nomination to the Supreme Court. And that day, Sandra Day O'Connor made history. She became the first female Justice in the Court's history. This 51-year-old Arizona-Court of Appeals judge shattered the 190- year-long tradition on the High Court of addressing Justices: ``Mr. Justice.'' When asked for her reaction to her nomination, Sandra Day O'Connor said: I can only say that I will approach [my work on the bench] with care and effort and do the best job I possibly can do. Most would agree that she has done just that. Since 1981, Justice Sandra Day O'Connor has served with distinction on the U.S. Supreme Court. She has served as an example to all Americans--demonstrating that through persistence and hard work anything is possible. In the face of obstacles--including being a woman in a male-dominated law profession--she never surrendered her determination nor did she surrender her Southwestern pride and love of the outdoors when she moved to the city. Rather, she brought it with her. Anyone who has entered the inner confines of Justice O'Connor's Supreme Court office is familiar with a sign that reads ``Cowgirl Parking Only: All Others will be Towed.'' Fiercely proud of her heritage, Justice O'Connor and her brother, H. Alan Day, authored a best selling memoir ``entitled Lazy B: Growing up on a Cattle Ranch in the American Southwest.'' Having grown up in the South--in Nashville, TN--I appreciate Justice O'Connor's pride in her roots. She has not forgotten where she came from. The values she learned through life on the range were values that left their brand mark. Indeed, hard work, self-reliance, and survival are the core values that make Sandra Day O'Connor the successful woman she is today. As she writes in her memoir, working alongside cowboys on the Lazy B, she learned a system of values that was ``simple and unsophisticated and the product of necessity.'' Throughout her tenure on the Court, she has not wavered from her well-grounded views. I've had the privilege of meeting Justice O'Connor on various occasions during my time in the United States Senate. Each time that I've had the opportunity to interact with her, I've found her to be thoughtful, kind, and extraordinarily intelligent. To echo the words of Ronald Reagan on the day he appointed Sandra Day O'Connor: She is truly a ``person for all seasons,'' possessing those unique qualities of temperament, fairness, intellectual capacity and devotion to the public good which have characterized the 101 ``brethren'' who have preceded her. Today, more than 23 years later, President Reagan's words still ring true. When she took the oath of office as the 102nd Associate Justice, she pledged to uphold the Constitution, and since this time, Justice O'Connor has proven her steadfast commitment to uphold the Constitution. During her confirmation hearing, she emphasized that the court's role was to interpret the law and not to make public policy. Her record demonstrates that she has lived up to that commitment, respecting the rule of law and judiciously interpreting the Constitution. Often cited as the ``swing vote'' on many important cases, Sandra Day O'Connor has taken exception to that characterization, stating that ``if my vote has not been a hundred percent predictable, that's because I try to look at each one as it comes to us.'' Sandra Day O'Connor is an independent thinker and has made great contributions in many substantive areas of the law. On the bench, she has not allowed the pressures of popular opinion to sway her decisions. Rather, she has consistently decided each case before her based on the underlying facts. Despite being the first woman to serve on the high Court, Justice O'Connor has not used this position to influence decisions of the majority. She once said: The power I exert on the court depends on the power of my arguments, not my gender. Her wisdom, intellect, and humility have earned her deep respect from her colleagues, even those with opposing judicial philosophies. For they see that she embodies all the ideal qualities in a judge-- fair, impartial, and open-minded. Through her experiences, Justice O'Connor has brought a unique perspective and understanding of checks and balances to the Court. A true public servant--Sandra Day O'Connor has served our Nation for almost four decades: As an Arizona State Senator and majority leader, State court judge, assistant State attorney general, and in the capacity for which she will long be remembered, as an Associate Justice on the Supreme Court. Throughout her life, Justice O'Connor has displayed her civic loyalties through her participation in various community organizations including the boards of the Smithsonian Institution, the Heard Museum, and the Salvation Army. She was recognized for her service in 1995, when she was inducted into the National Women's Hall of Fame. Sandra Day O'Connor has accomplished more in a lifetime than many would imagine possible. Yet, throughout that breathtaking journey to the top, she never lost sight of her humble roots, and never lost sight of the people she served. As she told a reporter in a 1996 interview that she never expected or aspired to be a justice, and still considers herself ``just a cowgirl from Arizona.'' While the ``cowgirl from Arizona'' may never have dreamed of riding to the highest court in the land, America is fortunate that she did. A brilliant jurist, a bright legal mind, and a compassionate woman-- she has earned her place in history for more reasons than one. I am sure that Justice O'Connor is looking forward to spending time with her husband, John, and their family during her retirement. And Karyn and I wish her and her family much joy and happiness in this new chapter of life. On behalf of the entire United States Senate and a grateful Nation, I commend Justice Sandra Day O'Connor for a lifetime of distinguished service to our great Nation. As the Senate moves forward to confirm a new nominee for the high Court, it's important that we remember her legacy. America needs judges who are fair, independent, unbiased and committed to equal justice under the law. I am confident that the President will select a qualified replacement justice who embodies these qualities. And I look forward to working with my colleagues to ensure a fair confirmation process in the Senate that will ensure the Supreme Court is at full strength to start its next term in October. I yield the floor.

Mr. FRIST

Mr. FRIST. Mr. President, this morning we are in session for a period of morning business. There are several Senators who have indicated their desire for time today to introduce legislation and to make general statements. There will be a number of statements over the course of the morning and possibly into the early afternoon--in part because we have had such a busy week with legislation on the floor so that people will take advantage of this opportunity today. Last night we were able to complete both the CAFTA legislation and the Energy and Water appropriations bill. I hesitated a little bit because, by the time we finished here--it was not that long ago, about 9 hours ago. We finished about 1 o'clock in the morning. But we had a very full day, a very productive day yesterday, passing the appropriations bills as well as the legislation that will do a great deal in terms of lowering trade barriers to very important countries, most of which are recently emerged democracies. Because we were able to finish our work late last night into the wee hours of the morning, we will not have rollcall votes today. When we finish our business today, we will adjourn for our recess and return on Monday, July 11. At that point in time the plans are to take up the Homeland Security appropriations bill. We will have a vote late Monday afternoon--later this morning we will say more about that--in relation to an amendment on the Homeland Security bill. I do thank all of our Members for their hard work and their assistance over the last week, indeed the last several weeks. In the last week alone, the last 5 days, we were able to initiate the appropriations process and pass three appropriations bills as well as the Central American Free Trade Agreement bill. It could not have been done without a lot of understanding and participation by both sides of the aisle, including the Republican leadership working with the Democratic leadership very effectively, hand in hand. We had long, late, busy sessions, but they were very productive and we moved America's business forward in a very positive way. I know several people will have statements over the course of the morning, looking back over the past several weeks, in that we have had a very productive session that delivered to the American people.

Mr. FRIST

Mr. FRIST. Mr. President, I would like to make a statement that I regard as a very important one because it reflects what I think is a needed change in behavior that affects health care across America. Let me begin with a few phrases: ``Keep the spark alive,'' ``The healing purple pill,'' ``If a playful moment turns into the right moment you can be ready,'' ``For everyday victories.'' You turn on your TV anytime of the day and that is what you will hear and that is what you will see. These are the advertising tag lines for some of America's best selling and most advertised prescription drugs-- in the last several weeks, months and years. We all know them when I read them. Some even have the images that pop up into their minds, because we see them again and again and again and again. We are barraged by them. I mention this as a physician, because 10 years ago you would not have seen any of that advertising on television. We have heard them on our television sets, we hear them on our favorite radio programs, we see them in newspapers, we see them in magazines. Those who go to NASCAR races see them on the cars. You see them on billboards along the highways. We are barraged with this information. It is called direct- to-consumer advertising. When I was practicing medicine before coming to this body--not that long ago, in 1994--it didn't exist. This is what direct-to-consumer advertising is. When drug companies, pharmaceutical companies, market their products, the marketing used to be done to physicians who could accumulate that information and help patients make decisions. But the direct-to-consumer goes over the heads of physicians with this advertising, direct to the American people, direct to the consumer. It is called direct-to-consumer advertising, or DTC is the terminology people use. It is a two-edged sword. Obviously there can be huge health education benefits to such advertising because you are exposed to it, you are barraged with it, and information is provided, information to which you might not otherwise have access. But let there be no mistake, drug advertisements are fuel to America's skyrocketing prescription drug cost. It is a two-edged sword. The advertising is new over the last 10 years. Now it is time to assess the efficacy of advertising, but also potential damage that is done by this proliferation, this skyrocketing of advertising to which we are being exposed. These ads do influence consumer behavior; otherwise, drug companies wouldn't be putting money into them. Their real purpose at the end of the day is to have a drug that, yes, helps people, but also makes money for them. It affects consumer behavior and it also--though it is not said very much but I will speak to it here shortly--affects physician behavior in a way I think is detrimental. Physicians don't want to talk about it very much because it is a little embarrassing. I will come back to that. But it affects physicians' behavior in a way that I think is not healthy, as well as affecting consumer behavior. These ads cause people to take more prescription drugs. They have the potential to create an artificial demand and thereby they can drive up health care costs for everybody listening to me as individuals, but also our overall health care cost for the Nation. I believe it has reached a point where they--again, it can be very positive with the health education--are needlessly and wastefully driving up health care costs. Thus it is time for us to get more information but also address the issue. Moreover, a lot of the direct-to-consumer advertising is misleading. I know, as people listen, you tend to believe, unfortunately, what you see on TV and that can be dangerous in certain cases. This direct-to- consumer advertising can oversell hope, and people want hope; it can oversell results; and it can also undersell the risk. Every drug has side effects. Every drug has a side effect. We may not know all of the side effects, but the idea of promoting a drug without adequately enumerating, spelling out, highlighting the risk is wrong. Misleading advertising, especially when we are barraged with it, when that is all we see--a little bit of hyperbole, on TV between shows, if it is misleading, hurts patients and definitely pressures doctors to overprescribe or to change prescribing habits in response to that request, that specific request from a patient. So today I rise to urge all pharmaceutical companies to voluntarily restrict consumer drug advertising during the first 2 years that a new drug is on the market. Today I am also requesting a Government study into the cost and into the consequences and any potential benefits of direct-to-consumer advertising. It is time for the drug companies, I believe, when it comes to direct-to-consumer advertising, to clean up their act. If they do not, I believe Congress will need to act in this arena. In its proper place, direct-to-consumer drug advertising gives patients, gives consumers, information. It empowers them to make decisions. It can give them the information they need in order to make informed decisions about their health, about the advantages of a particular drug. It can instruct them and open their eyes to symptoms they have that might be very serious but they might not otherwise go to see a doctor about. It can inform them about new therapies, the breakthrough therapies that are so powerful--made in large part because of the research and development in our private sector by our pharmaceutical companies. These are good things. These are the good things that advertising can do, that education can do, that knowledge can do. Indeed, I envision a health care system--and we are not yet there today, but I think we are moving in that direction, in part through legislation on the floor of the Senate, to move to a system that is centered not on big Government and not on us micromanaging from the floor of the Senate prices and decisions, but, no, move toward a system that is patient centered. We are moving toward a health care system that centers on the individual patient, that is provider friendly, and that is driven by three things. Those are knowledge or information that is given the patient, the individual, the opportunity to choose and make choices for themselves, and to make sure that patient is empowered, they have resources to make those decisions. So if you are looking at a consumer-driven, patient-centered health care system, having timely information, accurate information, complete information, and balanced information has to be one of the major pillars. Direct consumer advertising can be very helpful in that regard if that is the purpose and if it meets those standards. I don't think the advertising we see today--and I base this on people coming up to me all the time as a physician and policymaker--I don't think the advertising today meets those standards. I will have more to say about that issue. With today's advertising, perhaps you are at a ball game with your family, going to a movie or to dinner--ask somebody about it--and today's advertising will likely leave parents having to explain to their young children, their 10-, 9-, 8-year-old, what erectile dysfunction is rather than a discussion of the importance of getting your blood pressure checked to see if you have hypertension so you will not have a stroke or heart disease. That would be useful information. That is the problem. How did we get to this point? Prior to the 1980s, drug manufacturers almost always introduced and explained their products to physicians. Physicians had a body of knowledge and the training to make an assessment of whether, based on the information the drug companies gave them, this would be an efficacious drug, a useful drug to use, or whether the side effects would be appropriate for individual patients. In 1981, just over 20 years ago, Boots Pharmaceuticals ran the first U.S. print advertisement--just 24 years ago. It was directed to consumers for the ibuprofen product brufen. In 1980, print advertising picked up. In the 1990s, drug companies began to use more print advertisements to promote their products--again, directly to consumers, not going through physicians--and during that period they ran television advertisements sparingly. Rarely would consumers turn on the television and actually see an advertisement directed at the consumer on a drug. Looking back over the last 40 years since 1962, the FDA has had a requirement--the FDA is the Government institution in charge of regulation and oversight. Since 1962, the FDA has required ads to include a brief summary of a drug's side effects, indications for use, the contraindications, the warnings and precautions. Regarding the massive changes we are exposed to today, look back to the Clinton administration in 1997 when the disclosure rules for television ads were liberalized. The door was opened. That is not that long ago--3 years after I formally left the practice of medicine to come to the Senate. Rather than providing a full picture of a drug's risk and benefits, the new laws required only that drug companies disclose the most significant risk and then refer patients to a secondary source of information, leaving this whole inadequacy of the risk and adverse effects on the ad as presented. As a direct result of this 1997 ruling, spending on direct consumer advertising skyrocketed 145 percent between 1997 and 2001. It passed the $1 billion mark in 1997. It was almost nonexistent 7 years before that and skyrocketed to about $1 billion in 1997. Then 4 years later, it kept skyrocketing and reached $2.7 billion. Indeed, last year, the drug companies spent over $4 billion advertising medications directly to consumers. This 145 percent over that 4-year period from 1997 to 2001 for direct consumer advertising, reaching consumers, should be compared to an increase of only 59 percent for research and development for drugs-- clearly, a heavy investment in direct consumer advertising. Why? Because that advertising increases utilization of that drug and sells more drugs. The Clinton administration at the time they opened this door--under intense pressure by the drug industry--not only opened the door but opened the door too widely, and our regulatory body has not kept up with what has come through that door. As a result, the direct-to- consumer advertising exploded to levels that at least I did not anticipate. As we watched this unfold through the 1990s, I don't think anyone anticipated the level that we see when we turn on the television today. That drives up drug use, that drives up drug spending, and, of course, that will drive up the cost of health care generally. In addition to all that, it has led to inappropriate doctor-physician prescribing. We have to be careful because until we really study it, we will not know all effects. My doctor friends tell me again and again, when a patient comes in with a specific request for a drug written down and the doctor has 30 or 40 patients waiting outside, it is almost easier--I am embarrassed to say this--almost easier for a doctor to write the prescription and give it to them even though there may be a generic drug or a much less expensive drug. The patient comes in and says: I have to have this drug. This drug is what I have in mind, the hope for the cure for my disease. This misallocation of resources and inefficiency that results from inappropriate prescribing from the physician's standpoint is something we can rip out of the system if we turn to a balance between very good and direct-to-consumer advertising, which includes patient education, but get rid of the inappropriate, imbalanced state we are in today. If we consider the recent labeling changes in market withdrawals of just one class of drugs, the nonsteroidal anti-inflammatory, it tells a story. These drugs were the most heavily advertised in America. They were used by millions and millions of patients. Millions of patients benefited, I should say, from these drugs, but many people today believe--looking back at what happened in response to the advertising-- that they were overprescribed. In the case of one drug people have heard a lot about, Vioxx, 93 million prescriptions had been written since its approval in May 1999. Millions of prescriptions were also written for similar drugs such as Celebrex and Bextra. In the case of Vioxx, indeed, it was a better drug. It did prove to be better than competing products for patients who had gastrointestinal problems or stomach problems. America did conduct postmarket research that was not required by the Food and Drug Administration. Of course, we cannot foresee every risk. It does take time to accumulate information to fully assess risk. Quite simply, we should always strive to make safety the top concern, not selling the most drugs through increasing utilization, through advertising, but ultimately to make safety our top concern, especially for newly approved products that are used for the very first time in millions and millions of patients. It takes time for the adverse reactions and side effects to be fully explored and to fully surface. Doctors should have more time to use the drugs to gain experience with them, to collect more balanced information, and to be able to weigh the risks and benefits of a product. In a 2002 report on the practice, the Government Accountability Office, the GAO, highlighted two studies. The last time it has been studied--and that is why I want to study it now, because we have had this explosion--but in the two studies they highlighted in 2002, the last report, each showed a 10-percent increase in direct-to-consumer spending within a drug class increased sales in that class by 1 percent. For one popular, very heavily advertised prescription drug, $1 of consumer advertising translated into $4 in increased sales--$1 dollar in advertising, $4 in sales. So we see the motivation from the drug companies in advertising particular drugs. It is no wonder the drug companies are flooding our airwaves today. The GAO findings in that 2002 report were clear: Increased direct-to- consumer advertising has helped fuel escalating drug costs. These drug costs, as we know, are skyrocketing. In 2003, Americans consumed 134 billion prescription pills and spent over $216 billion on prescription drugs. That is as much as Americans spent on gasoline and oil. During the past few years, drug costs have gone up more than twice as fast as inflation, faster than nearly all other health care items and services. Congress has paid attention to these skyrocketing, escalating drug costs, and we have acted on the 2003 Medicare Modernization Act. We took major steps toward providing more affordable prescription drugs. I add the ``more affordable'' because we did a number of things. First and foremost, recognizing the importance of prescription drugs, centrality of prescription drugs to health care delivery today, we provided seniors with an outpatient prescription drug benefit under the Medicare Program for the first time in history--something I feel strongly about, something I am very excited about as we look over the next year, couple of years, where implementation begins. We also established health savings accounts that allow individuals to own and take care of their own health care. We reformed patent laws and closed loopholes to help speed lower cost generic drugs to market and set standards to encourage more efficient electronic prescribing and improved patient safety. We provided funds to the Department of Health and Human Services to study the clinical comparative effectiveness of drugs and then take that information and share it with patients, to share it with consumers so they can make prudent decisions. We have taken some good steps, moved in the right direction, but we clearly have a lot more to do. Part of this effort, and the reason I bring it to the Senate today, is a responsibility we have to look at prescription drug advertising. Unbalanced and misleading prescription drug advertising hurts the American people. We will look at it. It adds tension to the relationship between doctors and patients, the physician-patient relationship. It can lead to inappropriate prescribing, and it can overwhelm our current regulatory system. As consumers, we are all familiar with these ads. They adorn major magazines, Web sites, newspapers, and flood the airwaves. Particularly on television, they present upbeat images, a parade of images that bring hope and beauty with these positive images, but often the warning and the cautions are in either fine print or as an afterthought. As I mentioned earlier, think how many parents have found themselves watching a sporting event with their son or daughter, only to be assaulted by an ad for erectile dysfunction. Think back to advertising during this year's Super Bowl, the nature of those ads and the focus of those ads. Only rarely do these ads provide consumers with enough time to absorb the risk information. In a 2002 FDA study, nearly 60 percent of patients reported drug advertisements did not provide enough risk information. In that study, 58 percent of patients felt these ads portrayed products as better than they are. In another 2002 FDA survey, 75 percent of physicians said ads led patients to overestimate the efficacy of the drugs, and 65 percent of physicians noted that patients confused the risk and benefits of drugs advertised to consumers. What this means is sometimes a patient may request a drug, even insist upon a drug, even if it does more harm than good. They may too heavily rely on a pill when an overall lifestyle change might be more appropriate. They may come in and demand the latest, most expensive medication when an old standby could do just as well. Patients seeing the ads place new demands on their doctors. As I mentioned, when my medical colleagues are pressed for time, they tend to respond with the easy way of responding to a specific demand--even if it might not be either the most cost-effective or efficacious drug. Thinking of one example, after one year of directly advertising the bone-mass-increasing drug Fosamax to consumers, physician visits for osteoporosis evaluation nearly doubled. That in some ways may be good because it shows the double-edged sword in that people go to the doctor and they ask appropriate questions. But then you have to ask the question: Did these ads provide the patients with the appropriate information to go see that doctor for the appropriate information on the side effects of that particular drug? An interesting study from the University of California-Davis was where the researchers sent actors in good health to 152 doctors' offices in three cities to find out if they could get prescriptions for simulated symptoms. Half of the actors imitated patients suffering depression. The other half expressed symptoms of stress and fatigue. The study found that if an actor requested Paxil, which is a heavily promoted antidepressant, he was five times as likely to walk out of the doctor's office with a prescription for the drug. The research suggested that direct-to-consumer advertising increases patient demand for specific medications, even in situations where prescriptions are not needed. Finally, we need to ask questions about how we regulate this drug advertising. Right now, the Food and Drug Administration simply has neither the resources to scrutinize direct-to-consumer advertisements nor the power to review them for accuracy before they are viewed by the public. In 2002, the FDA received over 137,000 pieces of promotional material for review. Some of these materials appeared on the airwaves or in print even before they arrived at the office of the FDA. The entire division responsible for this oversight consists of 40 employees--just 40 employees--who have to review almost 40,000 complex, medically sensitive advertisements. It is not enough. The FDA knows it is not enough. We have not given them enough resources. Two years ago, Dr. Janet Woodcock, then the FDA's Acting Deputy Commissioner for Operations, told the Senate Committee on Aging: It would be impossible for the FDA to try to track the number of different broadcast advertisements that are aired. Almost unbelievable to me is the fact that the FDA review comes after the fact. It cannot require drug companies to submit their advertisements before they appear on the airwaves or on the Internet or in print. The FDA simply cannot keep up. Our failure, our Government's failure, to appropriately regulate drug advertising hurts the very people I believe the drugs are intended to help, and that is the patients. We are not serving the American people as well as we should. Mr. President, 2 weeks ago, the pharmaceutical company Bristol-Myers Squibb announced a voluntary ban on advertising its new drugs to consumers in their first year on the market. The company said it wanted to give doctors more time to understand new products before patients start asking for them. I think this shows leadership. It shows responsibility. Bristol-Myers is setting an example in showing restraint in the industry. I know PhRMA--that is the drug industry's trade association--has announced it will adopt an industrywide voluntary code governing direct-to-consumer advertising next month--another good move. Mr. President, what should we do? I believe, at a minimum, the pharmaceutical industry should include a voluntary restriction on the direct-to-consumer advertising of prescription drugs in their first 2 years on the market. This restraint is important because a typical clinical trial for a drug includes about 5,000 patients. A blockbuster drug can attract as many as a million patients in the first year on the market. But since no drug is free of a side effect, we may not fully know what those side effects are. Doctors and patients need time to learn about the new treatments to be able to assess their benefits and find out more about the risk. Education should come before persuasion. Patient safety should be paramount, not the bottom line. So what should we do? Three things. First, we should give the FDA prior review and approval authority for all direct-to-consumer drug advertising. By the time the FDA reprimands a company for running a misleading drug commercial, that advertisement may have already deceived consumers. Advertising should boldly and responsibly address safety head on, replacing the upbeat fantasyland images with a frank discussion of a product's risks and benefits. Second, we should increase resources devoted to reviewing advertising, to determine the advertisement's accuracy and to ensure all standards are met. The FDA must have the resources, must have the capability to more thoroughly monitor drug advertising and make sure that companies fully comply with the advertising guidelines. The American people assume this is being done today when they see those ads, and it is not. A staff of 40 is simply not sufficient. And third, we should give doctors and patients greater access to clinical data and postmarketing surveillance efforts about drugs after they become available. For the drug industry, which has long touted the educational benefits of its advertising and of its mission, it has to know that the success of their mission inherently depends upon the quality of information they give to physicians and patients--not just the enticing images, but the quality of information. Mr. President, in closing, as a doctor who has witnessed both the good but also the bad in this explosion of drug advertising direct to the consumer, I feel I have a responsibility to watch this issue closely. If the pharmaceutical industry's voluntary restrictions are not strong enough, I will support congressional action to make sure consumers get the protection they deserve. In the meantime, today, I am asking the Government Accountability Office, the GAO, to investigate FDA's oversight of prescription drug advertising, the pharmaceutical industry's spending on such advertising, and this advertising's impact on utilization, health care spending, and patient education and awareness. Wherever I go--whether it is to meet with a group of doctors at a medical meeting at the Harvard Medical School or back at the University of Tennessee or at the Coca-Cola 600 in Charlotte--people come to me and say the direct-to-consumer advertising has gone overboard. We have to return balance. I believe we can and we should move into a health care system that is centered on the patient, where they have appropriate information to make decisions-- a consumer-driven, provider-friendly, patient-centered system. I know my colleagues share these or similar priorities. I believe the steps I have proposed today will be to the benefit of patients. It will save money. It will save lives. Prescription drugs, I believe, are the most powerful tools in American medicine today. We really could not and should not do without them. But we have to use them and market them and promote them with care. Mr. President, I yield the floor.

Mr. FRIST

Mr. FRIST. Mr. President, I suggest the absence of a quorum.

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

Mr. FRIST

Mr. FRIST. Mr. President, this resolution concerns a pro se civil action filed against the Congress. The plaintiff contends that article III, Sec. 2, cl. 1, of the Constitution, which extends the judicial power to all cases arising under the Constitution, ``preempts'' the later ratified 11th amendment to the Constitution, which affords the States an immunity from certain suits. Plaintiff seeks a judicial order directing the Congress to rescind the 11th amendment and $30 million in damages. This suit is subject to dismissal on numerous threshold grounds, including lack of constitutional standing, sovereign and legislative immunity, and the political question doctrine, as well as on the merits. This resolution authorizes the Senate Legal Counsel, in conjunction with counsel for the House of Representatives, to represent the Congress in this suit and to move for its dismissal.

Mr. FRIST

Mr. FRIST. Mr. President, Members have been asking about the schedule for tonight. We are proceeding to the Energy and Water appropriations bill. The chairman and ranking member will begin shortly. I do not believe we have many amendments to the bill. We will finish the bill tonight. I know the Senator from California will have an amendment, and it will require some debate and a vote. We can begin that amendment--or I will leave it to the chair and ranking member at this time. But the plans will be to have further rollcall votes, and we will complete the bill tonight. I yield the floor.

Mr. FRIST. Mr. President, at this juncture, I ask unanimous consent that the Senate proceed to the immediate consideration of calendar No. 130, H.R. 2419, the Energy and Water appropriations bill. I further ask that the committee substitute amendment be agreed to and considered as original text for the purpose of further amendment, with no points of order waived by this agreement.

Mr. FRIST

Mr. FRIST. I ask unanimous consent that there now be a period for morning business with Senators permitted to speak for up to 10 minutes each.

Mr. FRIST

Mr. FRIST. Mr. President, I ask unanimous consent that the Senate now proceed to the consideration of H. Con. Res. 198, the adjournment resolution, provided that the concurrent resolution be agreed to and the motion to reconsider be laid upon the table.

Mr. FRIST

Mr. FRIST. Mr. President, I ask unanimous consent that when the Senate completes its business today, it stand in adjournment until 10 a.m. on Friday, July 1. I further ask consent that following the prayer and pledge, the morning hour be deemed expired, the Journal of proceedings be approved to date, the time for the two leaders be reserved, and the Senate then begin a period of morning business, with Senators permitted the speak for up to 10 minutes each.

Mr. FRIST

Mr. FRIST. Mr. President, this morning we will resume consideration of the pending CAFTA legislation. Last night we began debate under the 20-hour time limitation. We now have 16 hours remaining and we do not expect to use the entire debate time allocated. Chairman Grassley has indicated that he would not require all of the 8 hours remaining under his control. Thus, I hope we would be able to yield back some time, which would allow us to vote on this bill at a reasonable time today. As mentioned yesterday on a number of occasions, we have two additional appropriations measures to complete this week, one of which is the Legislative Branch appropriations bill. It is ready for floor consideration. That bill will require only a short debate and could be finished without a rollcall vote. Also, we expect to consider and complete the Energy and Water appropriations bill. It is possible we could finish both of those late tonight. It depends on how much debate time is used on the CAFTA bill and also how much time Energy and Water will require. We have a number of other items to be completed before our recess, including the highway extension, as well as some nominations. It will take a lot of cooperation and a lot of hard work to be able to complete all of this. Again, there is a possibility we could finish late tonight but, if not, we are going to complete all this business, including the two appropriations bills, by Friday, and we could have votes into Friday as well. We have our jobs and our tasks laid out for us. We need to stay here until we complete them before we leave for our recess. Central American Free Trade Agreement Mr. President, I want to comment on the CAFTA legislation which we turned to last night, the Central American Free Trade Agreement. We will vote on final passage of that agreement later today. CAFTA is a good bill. It is a fair bill and an evenhanded bill that Members from both sides of the aisle should be able to support in that this legislation expands the market for America's goods and thereby grows jobs here at home. The agreement which President Bush signed in May of 2004 promises to eliminate trade barriers between the United States, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, and the Dominican Republic. By doing so, it will level the playing field and by leveling the playing field will stimulate economic growth which, in turn, will stimulate job creation. America's market is already open. Nearly 80 percent of exports from the CAFTA region to the United States come into America duty free. Those barriers are already down. Under CAFTA, the six CAFTA countries would reciprocate and immediately allow 80 percent of our exports to enter their countries duty free, lowering that barrier. As a result, CAFTA will create our second largest export market in Latin America, behind only Mexico. From Washington State apples all the way across the country to Florida oranges, America's producers will thrive. This represents a tremendous opportunity both for sellers and buyers and for all the people who make transactions happen--again, economic growth, creation of jobs. If I look back--and become a little bit provincial--to my home State of Tennessee, we are the third largest agricultural exporter to the CAFTA countries. Last year Tennessee businesses sold $271 million worth of goods and services to the CAFTA region. Tennessee farmers and factory workers rely on exports for their jobs and their livelihoods. One plant, the Levi Straus plant in Powell, TN, for example, exported $34.8 million in apparel last year to these countries. The Memphis- based company, Drexel Chemical, has been exporting to Guatemala for the last 30 years, since the early 1970s. Its chairman tells the Memphis Commercial Appeal newspaper that CAFTA would have a tremendous impact on her business. She has good cause to be optimistic. Since America signed NAFTA, the North American Free Trade Agreement, in 1993, Tennessee's combined exports to Canada and Mexico have grown a whopping 190 percent. Free trade grows America's businesses and puts more money in the pockets of America's families. It is estimated that NAFTA and the Uruguay Round generate $1,300 to $2,000 a year for the average American family of four. CAFTA will open the doors to 44 million new consumers of American goods. More sales to Central America means more jobs right here at home. Strengthening our mutual economic interest also will strengthen our national security. Twenty years ago, only two of the CAFTA nations, Costa Rica and the United States, were established democracies. Today, all seven can be counted among the free nations of the world. Unfortunately, however, the forces of totalitarianism and oppression still hover on the edges of these young democracies. Fidel Castro still oppresses the Cuban people and denies them precious human freedoms. Hugo Chavez moves Venezuela closer and closer to Castro every day. These regimes tend to work to spread their brutal methods and totalitarian philosophies, trying to infect the rest of Latin America and we simply cannot let them succeed. The free nations of Latin America need our support. They deserve our support. That support can be reflected through CAFTA. By linking their economies with democratic capitalism, CAFTA will help gird these nations against the threats at their door. It will strengthen their democracies and provide a model for freedom, a model for freedom seekers--indeed, freedom seekers around the world. The Washington Post agrees that: CAFTA and similar alliances provide hard evidence of America's lasting commit to strengthening alliances, fighting global poverty, and creating the building blocks of democracy. In 1823, James Monroe warned that continued European efforts to colonize the New World would endanger American peace and safety. He understood that advancing liberty throughout the world required that we begin in our own backyard. Since then, the United States has worked to protect the freedom and independence of our hemisphere. I urge my colleagues to support growth and prosperity. The United States has always stood for freedom and liberty around the world. Under CAFTA we will help keep the Americas moving forward. I yield the floor.

Mr. FRIST

Mr. FRIST. Mr. President, I ask unanimous consent that the bill be read a third time and passed, the motion to reconsider be laid upon the table, and that any statements relating to the bill be printed in the Record.

Mr. FRIST. Mr. President, I ask unanimous consent that the Senate proceed to the immediate consideration of H.R. 3021 which was received from the House.

Mr. FRIST

Mr. FRIST. Mr. President, the Senate will shortly vote on CAFTA--the Central American Free Trade Agreement. This agreement will eliminate most trade barriers between the United States, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, and the Dominican Republic. Over the last half century, the United States has led the way to opening new markets and encouraging free trade around the globe. These efforts have had tremendous success. Everyday, American consumers and businesses benefit from the competition and choice that trade expansion brings. As we promote free and fair trade agreements, we create economic opportunity and build relationships that will continue to grow for years to come. Under the agreement, six CAFTA countries will allow 80 percent our exports to enter their countries duty-free. As a result, CAFTA will create our second largest export market in Latin America, behind only Mexico. This agreement is a huge opportunity for both sellers and buyers, for all people who make transactions happen. It's like opening a huge new store for American businesses--where we get the same price for our goods but--because we pay fewer tariffs--our customers pay less. This is a win-win. CAFTA will open the doors to 44 million new consumers of American goods. And more sales to Central America means more jobs here at home. With this agreement, over 27,000 new jobs will be created in its first year of implementation--over 500 of which will be in Tennessee. And 9 years after implementation, thanks to CAFTA over 137,000 Americans--including over 2,000 Tennesseans--will have the benefit of a new job. CAFTA means jobs. American jobs. Tennessee jobs. It means more prosperity in our pockets. Even more, CAFTA will allow our Nation to strengthen its bonds with countries in the region. A stronger relationship will allow us to more effectively work together to fight the war on terror and enhance the social stability of these nations. We can also make positive strides in combating the trafficking of illegal drugs. And, as a result, reduce the supply of drugs on our Nation's streets and in our neighborhoods. Furthermore, strengthening our mutual economic interests will strengthen our national security. Twenty years ago, only two of the CAFTA nations--Costa Rica and the United States--were established democracies. Today, all seven can be counted among the free nations of the world. CAFTA will bolster democracy in Central America and provide a model for freedom seekers around the world. We simply cannot leave the United States on the sidelines as other nations rush to embrace free trade. We have an opportunity to act with CAFTA. I urge my colleagues to support this agreement. A vote for CAFTA is a vote for America's farmers and manufacturers. It is a vote for more jobs for hardworking Americans. It is a vote for stable democracies and the spread of freedom to all corners of our globe. CAFTA will move America forward. It will move all the Americas forward. I ask for the yeas and nays.

Mr. FRIST. Mr. President, I move to reconsider the vote.

Mr. FRIST

Mr. FRIST. Mr. President, I wish to acknowledge an important feat of one of our Members. At 10 o'clock this evening, the distinguished Presiding Officer, the Senator from North Carolina, Mr. Burr, reached his 100th hour of presiding. I should clarify that it is 100 hours since the beginning of this year. I know sometimes it has probably felt like he has presided 100 hours in a week. The reason this is important, according to the Senate Historian, is this is the fastest time in reaching the 100- hour mark since presiding records have been kept. (Applause.) Senator Burr will be the first Senator in the 109th Congress to receive the Golden Gavel Award. Most Members recognize that sitting in that chair is the best way to learn Senate procedure. He has done so with distinction and honor. He has done so with a firm but fair gavel. In addition to his regular presiding times, he has been here on many Mondays and Fridays, when a lot of us are at home and elsewhere. We thank him for that. We owe a debt of gratitude to him for doing that, and we thank him and congratulate him on this outstanding achievement. (Applause.)

Mr. FRIST

Mr. FRIST. Mr. President, I ask unanimous consent that the Senate proceed to the immediate consideration of H.R. 3104 which was received from the House.

Mr. FRIST. Mr. President, I ask unanimous consent that the bill be read a third time and passed, the motion to reconsider be laid upon the table, and any statements relating to the bill be printed in the Record.

Mr. FRIST. I appreciate the courtesy of the manager and ranking member, and I yield the floor.