Bob Graham

Mr. GRAHAM

Mr. GRAHAM. Mr. President, I will speak on the time that has been reserved for Senator Kennedy and ask unanimous consent to speak for up to 15 minutes.

Mr. GRAHAM. Mr. President, we are now debating a conference report that includes both the legislative branch and the Treasury and general government appropriations bills. Unfortunately, the Treasury and general government bill was never considered on the Senate floor. It went directly from the Appropriations Committee into this conference report. There are some critical deficiencies in the Treasury and general government appropriations bill, deficiencies that I had hoped to address on the floor with an amendment. I am now prevented from doing that. The deficiencies to which I want to call the attention of my colleagues involve counterterrorism funding, an issue that should be of particular concern to each of us. As you know, terrorism is a national security threat, a threat which Americans have experienced in reality. Just to mention the names: Oklahoma City, the World Trade Center, Khobar Towers, Pan Am 103. Each of these reminds us of how deadly terrorism can be and how vulnerable we are to it. What most Americans do not know is that there are many more instances of attempted terrorist activities that have been averted by a combination of good intelligence and effective law enforcement. The apprehension of a terrorist crossing into the United States by Customs agents just prior to the millennium celebration is one well- known example of the success that we have had in interdicting terrorists before they can strike. While terrorists have been around for a long time, their actions are becoming increasingly more deadly. In the past 5 years, over 18,000 people someplace around the world have been injured or killed in a terrorist incident. That 18,000 number of persons injured or killed by terrorism in the last 5 years represents a threefold increase over the preceding 5 years. With the proliferation of chemical, biological, radiological, and even nuclear weapons as a real threat, the potential for even deadlier attacks is a reality. This makes efforts to prevent attacks even more vital. Earlier this year, the congressionally mandated National Commission on Terrorism issued its report. The report is called: ``Countering the Changing Threat of International Terrorism.'' This report concluded that international terrorism poses an increasingly dangerous and difficult threat, and that countering the growing danger of this threat requires significantly enhancing U.S. efforts. It further states that priority one is to prevent terrorist attacks using U.S. intelligence and law enforcement as our principal tools to prevent such attacks. I would also like to cite a recent report by the Commission on America's National Interests. The Commission on America's National Interests is a commission on which Senators Roberts, McCain, and myself are members. The commission's report on ``America's National Interests,'' dated July 2000, lists as a vital interest that: Terrorist groups be prevented from acquiring weapons of mass destruction and using them against U.S. citizens, property and troops. The commission's report goes on to state: As one of the most free and open societies in the world, the U.S. is also among the most vulnerable to terrorism. . . . Protecting American citizens both at home and abroad requires a well-coordinated counter-terrorism effort by all U.S. government agencies, giving due regard for fundamental American civil liberties and values. The report on ``America's National Interests'' continues: Given the severity of the potential consequence of a weapon of mass destruction terrorist incident, as well as the rising technical capacity of non-state actors, the U.S. government should attach the highest priority to developing the capacity to preempt these threats if possible, and mitigate their consequences if necessary. Mr. President, I repeat from the report on ``America's National Interests'' that ``the U.S. government should attach the highest priority to developing the capacity to preempt these threats if possible, and mitigate their consequences if necessary.'' This report could not have been more clear. Yet still another group of experts studying U.S. national security, the U.S. Commission on National Security, commonly known as the Hart-Rudman commission, concluded in its April 2000 report that our No. 1 priority should be to ensure that the United States is safe from the dangers of a new era: the proliferation of weapons of mass destruction and terrorism. It specifically mentions ``strengthening cooperation among law enforcement agencies, intelligence services, and military forces to foil terrorist plots. . . .'' The words of these three significant reports, as well as many other Americans, did not go unheeded by the administration. The President recognized the growing importance of law enforcement and intelligence in countering the terrorist threat even before these reports were released. He sent to Congress a request for over $300 million in additional funding for exactly the types of enhanced counterterrorism efforts that these three commissions are recommending. What has happened in the Congress? Of the approximately $300 million requested, a portion of which was requested in a classified form, as it will be used by various intelligence agencies, $28 million of that $300 million was for reprogramming requests in the fiscal year that is about to conclude on September 30. What happened? That request for reprogramming was rejected, rejected including $10 million for the Department of the Treasury and $18 million for the Department of Justice. I am sad to report that in the bill before us today, the fiscal year 2001 appropriations request, which begins on October 1, did not fare much better. There was a $71.1 million request for the Department of Justice. This has been completely unfunded in both the House and the Senate appropriations committees and thus in this conference report. There was a $77.2 million request for the Department of the Treasury which should have been included in the bill we are currently debating; $74 million of that remains unfunded. In addition, the request for the intelligence community was not funded in the fiscal year 2001 legislation. In total, of those amounts which are available for public review, of the $300 million requested by the President, $146.1 million was unfunded. Let me describe a couple of specific initiatives that are particularly important and that so far have not been funded in either the House or Senate appropriations bill. First, the administration requested over $40 million to support the Joint Terrorism Task Forces. These are interagency law enforcement groups which combine resources and expertise for a more effective and efficient effort to deter and investigate terrorists. This is a proven concept that brings agencies together to solve problems, hopefully problems before they mature into tragic instances. The Joint Terrorism Task Forces were very successful in deterring and preventing terrorism during the millennium. I cannot understand why this Congress would not support this request. Second, the President requested $6.4 million to create a unit within the Office of Foreign Asset Control dedicated to uncovering and tracking the financial assets of terrorist organizations. This is an area of law enforcement in which America, in the area of terrorism, is woefully deficient. It is vitally important that we establish this new office and that we gain an insight and an ability to oversee and control terrorist financing. This was a specific recommendation of the National Commission on Terrorism. This item was rejected, and so our woeful deficiency will continue for another year, if the current position of Congress, including the position of the legislation before us this afternoon, becomes law. In fact, there were several items that were included in the President's request that the Commission on Terrorism specifically recommended. They include increased resources to meet technology requirements, expansion of linguistic capabilities, increased funding for investigative initiatives--all of those unfunded. There is also an as yet unfunded request to establish a Center for Anti-Terrorism and Security Training. This will provide a centralized training facility for those on the front lines fighting terrorists around the world, including our own Capitol Police, diplomatic security officers protecting our embassies abroad, and our allies who look to us to help them in their fight against terrorism. The counterterrorism funding I am highlighting is desperately needed. All agencies have agreed that we need to do more to step up our efforts against terrorism. These requests are supported by the bipartisan National Commission on Terrorism and, in more general terms, the Commission on America's National Interests, and the Hart-Rudman commission. What I find especially hard to imagine is why we would refuse this $300 million request when it is so widely recognized that the cost of failure, when it comes to terrorism, involves weapons of mass destruction and could be in the billions of dollars. This is an area where we must do absolutely everything we can on the prevention side to avoid, to interdict acts of terrorism before they are inflicted upon our citizens. Mr. President, there is yet another consequence of the action we are being asked to take by supporting an appropriations bill which is so deficient in meeting this key area of our Nation's security. All too often we are seen as pushing other governments to do more in the fight against terrorism, to help us in an international effort against terrorism. If we are unwilling to support what our own experts tell us is needed, what is in our national interest, how can we be effective in convincing others to do more? I don't think there is an answer to that question. We must practice what we preach. The good news is there is still time to remedy the situation. I hope the appropriations committees will fund the President's request for counterterrorism funding. This is about a real threat that is here today and cannot be ignored. Failing to take action on this modest request is irresponsible. Those who call for spending more for potential future threats and for increasing spending on other national security priorities cannot ignore the vital national interest, the first-line priority of an effective national protection against terrorism. I will express my dismay, my shock at what has been done by the Congress thus far by voting against this bill. And should the Congress, in its lack of attention or lack of appropriate recognition of the importance of terrorism, should we pass this appropriations bill, which is so deficient in responding to the challenges of terrorism, then I will urge the President to veto this bill and give the Congress an opportunity to redeem itself from what is potentially a very serious error--placing the national security of the United States at risk. I thank the Chair and suggest the absence of a quorum.

Mr. GRAHAM

Mr. GRAHAM. Mr. President, these immigrants are long-time employees of small businesses and other businesses in virtually every State. They are workers who do some of the toughest, hardest jobs in America. What affects them affects all of us, especially the businesses and the consumers who rely on their dedication, energy, and commitment to achieving the American dream. I urge all my colleagues to work with us and assure that this vital, long overdue legislation, legislation that is in the best American traditions of fairness and justice, becomes law and becomes law this year. Exhibit 1 EWIC Essential Worker Immigration Coalition, Washington, DC, September 8, 2000. U.S. Senate, Washington, DC. Dear Senator: The Essential Worker Immigration Coalition (EWIC) is a coalition of businesses, trade associations, and other organizations from across the industry spectrum concerned with the shortage of both semi-skilled and unskilled (``essential worker'') labor. While all sectors of the economy have benefited from the extended period of economic growth, one significant impediment to continued growth is the shortage of essential workers. With unemployment rates in some areas approaching zero and despite continuing vigorous and successful welfare- to-work, school-to-work, and other recruitment efforts, some businesses are now finding themselves with no applicants of any kind for numerous job openings. There simply are not enough workers in the U.S. to meet the demand of our strong economy, and we must recognize that foreign workers are part of the answer. Furthermore, in this tight labor market, it can be devastating when a business loses employees because they are found to be in the U.S. illegally. Many of these workers have been in this country for years: paying taxes and building lives. EWIC supports measures that will allow them to remain productive members of our society. We believe there are several steps Congress can take not to help stabilize the current workforce: Update the registry date. As has done in the past, the registry date should be moved forward, this time from 1972 to 1986. This would allow undocumented immigrants who have lived and worked in the U.S. for many years to remain here permanently. Restore Section 245(i). A provision of immigration law, Section 245(i), allowed eligible people living here to pay a $1,000 fee and adjust their status in this country. Since Section 245(i) was grandfathered in 1998, INS backlogs have skyrocketed, families have been separated, businesses have lost valuable employees, and eligible people must leave the country (often for years) in order to adjust. Pass the Central American and Haitian Adjustment Act. Refugees from certain Central American and Caribbean countries currently are eligible to become permanent residents. However, current law does not help others in similar circumstances. Congress needs to act to ensure that refugees from El Salvador, Guatemala, Haiti and Honduras have the same opportunity to become permanent residents. We are also enclosing our reform agenda which includes our number one priority: allowing employers facing worker shortages greater access to the global labor market. EWIC's members employ many immigrants and support immigration reforms that unite families and help stabilize the current U.S. workforce. We look forward to working with you to pass all of these important measures. Sincerely, Essential Worker Immigration Coalition. Essential Worker Immigration Coalition Members American Health Care Association, American Hotel & Motel Association, American Immigration Lawyers Association, American Meat Institute, American Road & Transportation Builders Association, American Nursery & Landscape Association, Associated Builders and Contractors, Associated General Contractors, The Brickman Group, Ltd., Building Service Contractors Association International, Carlson Hotels Worldwide and Radisson, Carlson Hotels Worldwide and TGI Friday's, Cracker Barrel Old Country Store, Harborside Healthcare Corporation, Ingersoll-Rand. International Association of Amusement Parks and Attractions, International Mass Retail Association, Manufactured Housing Institute, Nath Companies, National Association for Home Care, National Association of Chain Drug Stores, National Association of RV Parks & Campgrounds, National Council of Chain Restaurants, National Retail Federation, National Restaurant Association, National Roofing Contractors Association, National Tooling & Machining Association, National School Transportation Association, Outdoor Amusement Business Association, Resort Recreation & Tourism Management, US Chamber of Commerce.

Mr. GRAHAM

Mr. GRAHAM. Let's take another look at what Governor Bush and others in the House, as well as some of our colleagues, would offer to seniors. They would offer choice in their prescription drug plan, but the choice is not for seniors. It is for the private insurers, the States, and other entities that might choose to participate. HMOs which participate can choose to offer an affordable benefit or a prohibitively expensive one or no prescription drug benefit at all. According to the Health Care Maintenance Organization, this year some 900,000 Medicare beneficiaries who had signed up with a Medicare+choice HMO have seen those benefits yanked away, as the HMO terminates coverage. Many others have seen their HMOs either eliminate the prescription drug benefit, as have many in my State of Florida, or they have seen that benefit substantially reduced. The House Republicans' plan looks to private insurance to offer prescription drug policies to seniors. We have discussed time after time that the private insurance industry has said it doesn't want to offer these plans. Maybe a reason for their disinclination to offer these plans can be provided through the window of a type of plan which is very similar to the Republican House proposal. Under the current law, there are various types of Medigap plans-- plans that are provided by private insurers to fill gaps in the Medicare program. Three of these Medigap plans cover prescription drug benefits. All three of these have a $250 deductible and a 50/50 cost sharing for coinsurance. Plans labeled ``H'' and ``I'' cover drugs up to $1,250 in total spending and plan ``J'' covers up to $3,000 in total spending. None of these three plans offer what is referred to as a stop-loss. There is never a point in the process where the beneficiary is not forced to continue to pay half of the cost of their drugs. Now, what does Medigap charge to get these programs which limit coverage, in two cases, to $1,250, and in a third, $3,000, without a stop-loss provision? The average cost of these plans nationwide, per month, is $136. In my State of Florida, the average cost per month is $167. This gives you some idea of what seniors are going to be asked to pay should we go to a private insurance model as the means of providing prescription medication. These costs are well beyond what is affordable for most low-income and many middle-income seniors. With the history of broad variation, high, and unpredictable premiums and sub-par benefit packages, it is unclear to me why a Medigap-like approach to designing a Medicare prescription drug benefit would be in the best interest of America's seniors. Finally, there is now before us a proposal for an ``immediate fix'' for low-income seniors with incomes up to 150 percent of poverty in the form of block grants to States. Not only would this plan cover only a fraction of Medicare beneficiaries, it would provide a patchwork quilt of coverage for those individuals who did qualify for the benefit. States could offer coverage consistent with their current Medicaid or State drug assistance programs, or could punt their programs to the Federal Government if they chose not to participate at all. Seniors in some States would have coverage, but when they move to another State, they might have no coverage, or different coverage. It would be like Forrest Gump and his box of chocolates--seniors would never know just what kind of coverage they would get. The reason that 98 percent of Medicare-eligible beneficiaries sign up for the Medicare program is that it provides reliable, quality coverage for everyone equally and everywhere in the United States of America. So why would we treat a prescription drug benefit differently than we do for the rest of Medicare benefits? A third question is who is eligible under the program and what will they get? There is a great deal of rhetoric about who will be eligible under the prescription drug plans being offered. For Mr. and Mrs. Jones, who make $11,000 a year--100 percent of poverty--both of the plans offered in the Senate and by Texas Governor Bush claim that their drug coverage will be completely paid for. But what will that coverage be? In Texas, the Medicaid program only covers three prescription drugs a month. So Mr. and Mrs. Jones would be out of luck if they required more than that. But if they moved to Illinois, the program might only cover drugs for certain conditions, as is the case with that State's current drug assistance program. A prescription drug benefit within Medicare, such as those proposed by my colleagues and myself in the Senate and the Vice President, would ensure coverage of all medically necessary prescription drugs based on need without a benefit cap. That is the kind of reliability that seniors need. And what of my own constituent, Elaine Kett. Elaine Kett is a 77-year-old woman from Vero Beach. She is a widow living on a fixed income of approximately $20,000 a year. Like many of my constituents, Mrs. Kett sent me a list of all the prescription drugs that she takes to keep herself active and well. Every year, Elaine Kett makes sacrifices to ensure that she takes the medications she needs to live a normal active life. There are millions of seniors like Mrs. Kett in the United States today. None of them would be covered by a low income block grant to the states. Question Four: The final question, which approach would ensure that seniors have access to an affordable drug benefit--one which could be most effective in holding down the escalating prices of prescription medications? Individuals like Mrs. Kett are not alone. We are all witnessing prescription drug prices climbing at record levels of over 17 percent per year. We are all aware of the fact that buying in bulk yields discounts. Those seniors without insurance plans that cover drugs are on their own in the market and are faced with the higher drug prices than those of us who have prescription drug coverage negotiated by a pharmacy benefit manager. Tomorrow, we will discuss the impact of the high cost of prescription drugs on seniors--and what can and should be done to make prescription medications more affordable for seniors. Mr. President, our families should be secure in the fact that prescription medications are included in the big tent of Medicare and are not treated as the bearded lady outside the big tent at the circus. For many seniors, prescription medications are the main event--and we should treat them as such. A prescription drug benefit in the Medicare program is not ``one size fits all,'' but rather one program for all. I look forward to discussing why a prescription drug benefit must not only be universal and accessible, but truly affordable. Mr. President, when I give my fourth statement on this topic, I will elaborate on the question of which of the options that are before us inside the ``main tent'' of Medicare or the ``side tent'' of a separate non-Medicare administered prescription drug benefit, and which one will have the best opportunity of assuring affordability for America's seniors. Exhibit 1 [From the New York Times, Sept. 16, 2000] A Three-Part Attack on Gore (By Alison Mitchell) The Republican campaign of Gov. George W. Bush and Dick Cheney has begun broadcasting a commercial, ``Compare,'' in 18 states in its effort to take the offensive on the issues. It takes aim at Vice President Al Gore's stands on a prescription drug benefit in Medicare, on education and on tax cuts. Producer Maverick Media. On the screen. The 30-second commercial features statements about Mr. Gore's proposals in black on stark white background, counterposed with color pictures of Mr. Bush. It then shows pictures in color of Americans of different ethnicity, as it speaks of people who will not get a tax cut under Mr. Gore's $500 billion plan for tax relief. The script. A female announcer: ``Al Gore's prescription plan forces seniors into a government-run H.M.O. Governor Bush gives seniors a choice. Gore says he's for school accountability, but requires no real testing. Governor Bush requires tests and holds schools accountable for results. Gore's targeted tax cuts leave out 50 million people--half of all taxpayers. Under Bush, every taxpayer gets a tax cut and no family pays more than a third of their income to Washington. Governor Bush has real plans that work for real people.'' Accuracy. Health maintenance organizations are not popular, so it is not surprising that the commercial links Mr. Gore's prescription drug plan to H.M.O.'s. But to do so it has to stretch the facts. Mr. Gore does not force the elderly to accept his new prescription drug benefit. It is voluntary. And Medicare recipients can stay in traditional plans where they choose their own doctors. Mr. Gore's plan does rely on private benefit managers to manage the program--just like private insurers do--which encourages use of generic drugs and less expensive brand names. But these are not H.M.O.'s. Some critics argue that it is Mr. Bush's plan that would increase the number of older people enrolling in managed care. Mr. Bush would give people the ability to choose between the traditional Medicare program including a new drug benefit and government-subsidized private insurance packages. A question is whether the premiums would rise for traditional Medicare, causing more people to choose managed care. On schools, Mr. Bush and Mr. Gore both propose testing and different kinds of accountability measures, but Mr. Bush's proposal calls for tests that would cover more grades and be more frequent than does Mr. Gore's. It is true that Mr. Bush's $1.3 trillion 10-year tax-cut plan would give a tax reduction to every income bracket while Mr. Gore's plan for $500 million in targeted tax cuts would give tax breaks only for purposes like college education or child care. Score card. With its tag line, ``Governor Bush has real plans that work for real people,'' the spot suggests that Mr. Gore is not credible and neither are his programs. But Mr. Bush has his work cut out for him. Many polls show that voters trust the Democratic candidate more on health care and education. And while Mr. Bush may have the Republican's traditional advantage when it comes to tax-cutting, right now tax cuts are not one of the top concerns of voters.

Mr. GRAHAM. Mr. President, this is the third in a series of five statements I am making on the issue of providing a prescription drug benefit for senior Americans. This continues the discussion I began last Thursday on the subject of how to modernize the Medicare program into one which will meet the needs of 21st century seniors in America. Last week, we discussed the need to fundamentally reform the Medicare program by shifting its focus from treating acute illness to promoting and maintaining wellness, essentially converting the Medicare program from one which has an orientation towards dealing with the disease or the results of an accident after they have occurred--a sickness system--to one that attempts to maintain the highest quality of health--a wellness system. We discussed the fact that access to affordable prescription medications is crucial to the success of a health care system based on keeping seniors healthy, well, and active. And virtually every modality that is established to maintain the highest state of good health for seniors involves access to prescription drugs. Additionally, we discussed that, in the long run, providing seniors with access to those components of an effective wellness system, such as preventive screening, medical procedures, and appropriate prescription drug therapies, can yield significant savings for the Medicare program and thus for the American taxpayer as well as providing the enormous benefits to the senior of good health and the active lifestyle that that will allow. Let's look at the case of osteoporosis. Osteoporosis is a disease characterized by low bone mass, deterioration of bone tissue, leading to bone fragility and increased susceptibility to fractures, particularly of the hip, spine, and wrist. Osteoporosis is a major public health threat for 28 million Americans. Eighty percent of those 28 million Americans are women. Osteoporosis is responsible for more than 1.5 million fractures annually in the United States. Included in this 1.5 million are 300,000 hip fractures, 700,000 vertebra fractures, 250,000 wrist fractures, and more than 300,000 fractures in other parts of the anatomy. Estimated national direct expenditures, including those for hospitals and nursing homes, for osteoporosis and related fractures is $14 billion a year. The National Academy of Sciences and the National Institutes of Health agree that osteoporosis is highly preventable. A combination of a healthy lifestyle, with no smoking or excessive alcohol use, and bone density testing and medication and hormone therapies can keep men and women prone to this disease well and free of the debilitating, sometimes fatal, effects of fractures. Seniors and near seniors must have access to screening, counseling, and appropriate medication to keep this ``silent killer'' at bay. One of the most common prescriptions for osteoporosis prevention is a treatment referred to as Fosamax. The annual cost of Fosamax is approximately $750. Contrast that with a hip replacement where the surgery and followup therapy will cost the Medicare program and taxpayers over $8,000. It makes both programmatic and economic sense that these preventive interventions be included under the big tent of Medicare. They should be treated as all of the other benefits that 98 percent of those eligible for Medicare enjoy today. Let me restate the fact that Part B of Medicare--that is the part that, among other things, covers physicians and outpatient services--is a voluntary program that seniors must elect to get the benefits and to pay the monthly premiums for participation in Part B. How many seniors in America who are eligible for that component of Medicare in fact make that election and pay that monthly fee to get those benefits? The answer: 98 percent of eligible seniors voluntarily elect to participate in Part B of Medicare. Seniors trust and rely on Medicare. As a result, virtually all who are eligible to join voluntarily elect to do so. When the Federal Government decides that it should participate in providing a prescription drug benefit for American seniors, that benefit is best placed under the same big tent of the Medicare program. Now, this is not a unanimous opinion. Some of my Senate colleagues believe that a prescription drug benefit should be left outside the tent, left to a sideshow status, if you will. In order to determine which way is truly the best way, the main tent of Medicare or a sideshow, it is important to answer some key questions. Question 1 is what do the customers, the seniors and the people who live with disabilities, what do they want? How would they prefer this program to be organized and administered? We all know the old saying that the customer is always right. This will surely be true for the new drug benefit that we will offer to Medicare beneficiaries. Congress must learn to ask and to listen--in health care terminology, to first diagnose before we proceed to prescribe. This should have been the lesson learned from Congress' ill- considered decision to add catastrophic coverage to Medicare in the late 1980s. We prescribed before we listened. When we listen, seniors tell us they like the Medicare program. Ninety-eight percent of them voluntarily elect to participate. In 1998, the Kaiser Family Foundation found that 74 percent of seniors surveyed believed that Medicare was doing a good job serving their interests. Seniors tell us that while Medicare is not perfect, it is convenient, affordable, and dependable. They never worry that the benefits will suddenly disappear or become too expensive. They like the universality of the Medicare program. No matter where they are--in Kansas, in Utah, or in Florida--the benefits are available and affordable. They don't want to worry, as they would in some plans, that an income of $16,000 a year would make them ``too wealthy'' to qualify for help. Including the prescription drug benefit in Medicare would offer peace of mind. But don't take my word for it. Another recent poll conducted by the Kaiser Family Foundation and Harvard University showed that when seniors are given the choice of having the Federal Government administer a Medicare prescription drug benefit versus the alternative of having the Government help to pay for private insurance plans, 36 percent chose the private option; 57 percent of the respondents preferred to have the benefit as part of an expanded Medicare program. We hear over and over in statements on the Senate floor and occasionally even in political ads that Americans will be better off if prescription drug benefits are not made part of the Medicare program. But when we listen to the people, not to just political rhetoric, what we find is that Medicare beneficiaries do not complain about Medicare. Rather, we hear a desire to expand Medicare to include real prescription drug benefits. We should listen to these voices of the customers. Question 2: Will a true Medicare benefit or a program that relies on private and State insurers be the most reliable? Predictability, sustainability, reliability are important qualities for America's seniors. The bill I have introduced with Senators Robb, Bryan, Conrad, Chafee, and Jeffords assures that all beneficiaries, including those in underserved and rural areas, would be guaranteed a defined, accessible, affordable, and stable benefit for the same monthly premium nationwide. Medicare would subsidize benefits directly and pay for prescription drug costs as any other Medicare benefit. In contrast, the plan that is being proposed by Governor George W. Bush and by House Republicans and by some Members of this body asserts that prescription medications are a sideshow act and should not be included under the big tent of Medicare. They have outlined plans and introduced legislation to accomplish that objective. We have heard from our colleagues that seniors do not want big government involved in their prescription drug benefit. My colleagues have said that the Vice President's plan and even the plan that has been introduced by a bipartisan group of our colleagues is a one-size- fits-all plan without adequate choice. Governor Bush attacks the Vice President's plan in his latest television ad entitled ``Compare,'' saying that ``Al Gore's prescription drug plan forces seniors into a government-run HMO.'' I would like to quote from the New York Times of September 16, which analyzes this latest ad. This is what the New York Times has to say under the category of Accuracy: Health maintenance organizations are not popular, so it is not surprising that the commercial links Mr. Gore's prescription drug plans to HMOs. But to do so is to stretch the facts. Mr. Gore does not force the elderly to accept his new prescription drug benefit. It is voluntary. And Medicare recipients can stay in traditional plans where they choose their own doctors. Mr. Gore's plan does rely on private benefit managers to manage the program--just like private insurers do--which encourages use of generic drugs and less expensive brand names. But these are not HMOs. Some critics argue that it is Mr. Bush's plan that would increase the number of older persons enrolling in managed care. Mr. Bush would give the people the ability to choose between the traditional Medicare program, including a new drug benefit and government-subsidized private insurance packages. A question is whether the premiums would rise for traditional Medicare, causing more people to choose managed care. Mr. President, I ask unanimous consent that the article from the New York Times of September 16 be printed in the Record immediately following my remarks.

Mr. GRAHAM

Mr. GRAHAM. Mr. President, I appreciate the courtesy of the Senator allowing me to speak on another matter during the debate on the legislative branch conference report. (The remarks of Mr. Graham are located in today's Record under ``Morning Business.'')

Mr. GRAHAM. Mr. President, am I correct that I have 20 minutes reserved at this time?

Mr. GRAHAM

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

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

Mr. GRAHAM. Mr. President, I ask unanimous consent that during today's session the following Senators be recognized in morning business for the times specified: Senator Graham of Florida and Senator Edwards of North Carolina for up to 10 minutes each, and Senator Dorgan of North Dakota for up to 20 minutes.

Mr. GRAHAM. Mr. President, I will now proceed to use the 10 minutes which I have been allocated.

Mr. GRAHAM

Mr. GRAHAM. Mr. President, I want to close with a comment about an article that appeared in today's Washington Post under the headline, ``Bush Hits Gore on Drugs and Taxes.'' I ask unanimous consent that this article be printed in the Record immediately after my remarks.

Mr. GRAHAM. Mr. President, according to this article, there is a new 30-second ad being run that is entitled ``Drugs and Taxes.'' According to the Washington Post article, the audio of this tape begins as follows: Al Gore's prescription plan forces seniors into a government-run HMO. Governor Bush gives seniors a choice. The Post, in its analysis of this statement, makes the following comment: In a classic contrast ad furthering the theme that Gore is untrustworthy, Bush misrepresents the vice president's drug plan. First, it isn't mandatory; seniors can opt for drug coverage or not. Second, Medicare recipients could remain in traditional choose-your-own-doctor plans. Drug payments would be administered through private cost-control groups--such as those now employed by the insurance industry--that are not ``government-run'' or health maintenance organizations. In fact, many analysts say Bush's plan, while providing choices, would encourage more seniors to join cost-conscious HMOs. I only add to that analysis of this ad that it is interesting to me that the word ``HMO'' is inserted in the ad of Governor Bush as a pejorative. This Senate has been trying for the better part of the last 2 years to pass a Patients' Bill of Rights in order to lay out some basic standards of protection as they relate to the beneficiaries of HMOs, the citizens who look to the HMO to finance their health care, the providers--doctors and hospitals--who are the source of that health care, and the HMO which has received the premium dollars from the patients and is now called upon to pay the providers for the cost of services delivered to the beneficiaries. It has been my position--and I believe today a majority of the Senate's, as well as a very strong majority in the House of Representatives--that it is a Federal responsibility to establish some basic standards of that relationship so that there will be a comfort level that people know what will be expected. They will know how they would be treated, whether it is in the emergency room, whether it is in access to a specialist physician, whether it is a woman's right to use her gynecologist as her primary care physician; all of those very intimate issues will have a known, federally established standard. Yet in spite of that majority support in both Houses of the Congress, we have gone month after month after month unable to even have the conference committee report out a bill that we can debate and decide whether it meets the appropriate standards of providing those standards of treatment for patients, providers, and the HMO itself. It is surprising to me, therefore, in that context that now Governor Bush apparently has concluded that the HMOs are sufficient pejorative that he can use them as the target of his attack of what we don't want in our health care system. I hope this ad might serve the probably unintended purpose of galvanizing an even broader coalition within the Congress behind the necessity for HMO reform and for the establishment of a basic set of patients' rights. If Presidential candidate Governor Bush has seen the HMO as such a pejorative figure that he is now attacking it in his ads, that might send a signal as to what the American people want us to do in terms of beginning to rectify that negative image by providing some effective nationwide standards of Patients' Bill of Rights for HMOs. So I will conclude with that side comment. I do hope that on this important issue of the provision of prescription drug benefits, we will deescalate the misrepresentation of both parties' plans. I happen to have my own strong preference as to which plan I think will best serve the needs of the American people, and particularly our 39 million Medicare beneficiaries, but I think we ought to treat both plans with the respect they deserve, have a full and serious debate on those plans, use the election of November 7 as a national referendum as to how we wish to proceed, and then if, unfortunately, we have failed to act on prescription drugs during the remaining weeks of this session, we would reconvene in January of 2001 with a President who has a mandate from the people for a clear direction, and we will respond to that mandate by effective action. If we achieve that goal, then to the extent of this very critical issue, the democratic process is alive, healthy, and performing one of its fundamental functions of converting public aspirations into policy that will benefit their lives. Exhibit 1 Bush Hits Gore on Drugs, Taxes (By Howard Kurtz) Candidate: George W. Bush. Markets: Michigan, Ohio, Pennsylvania, Florida and 14 other states. Producer: Maverick Media. Time: 30 seconds. Audio: ``Al Gore's prescription plan forces seniors into a government-run HMO. Governor Bush gives seniors a choice. Gore says he's for school accountability, but requires no real testing. Governor Bush requires tests and holds schools accountable for results. Gore's targeted tax cuts leave out 50 million people--half of all taxpayers. Under Bush, every taxpayer gets a tax cut and no family pays more than a third of their income to Washington. Governor Bush has real plans that work for real people.'' Analysis: In a classic contrast ad furthering his theme that Gore is untrustworthy, Bush misrepresents the vice president's drug plan. First, it isn't mandatory; seniors can opt for drug coverage or not. Second, Medicare recipients could remain in traditional choose-your-own doctor plans. Drug payments would be administered through private cost- control groups--such as those now employed by the insurance industry--that are not ``government-run'' or health maintenance organizations. In fact, many analysts say Bush's plan, while providing choices, would encourage more seniors to join cost-conscious HMOs. Bush's education plan does place more emphasis than Gore's on holding schools accountable, though the Texas governor would spend less. Bush's $1.6 trillion tax cut would reach far more Americans than Gore's $500 billion cut, which would be tied to specific behavior, and the Gore camp essentially concedes the point by saying that 40 million taxpayers, not 50 million, would get no benefit.

Mr. GRAHAM

Mr. GRAHAM. Mr. President, yesterday I started the first of what will be five or more brief statements on issues related to the subject of the Federal Government providing a prescription medication benefit to Medicare recipients. Yesterday, I opened this series with a discussion of what I consider to be the most important reform required in the Medicare system; and that is reforming a 35-year-old health care system which was established to provide acute care; that is, care after an illness had matured into a major condition, or after an accident had caused a person to require specific medical attention largely in a hospital setting. What was not included as part of the 1965 Medicare program was an emphasis on what seniors want today; and that is, they want a system that will not just treat them after they are seriously ill but to have treatment that will avoid or reduce the impact of those illnesses through effective preventive strategies. Those preventive strategies have many components, including regular screenings for those conditions that can be detected at an early time; and then the management, through a variety of sources, of those chronic conditions so that they do not mature into serious health concerns, in some cases even death. To me, the conversion of Medicare from a sickness program to a wellness program is the fundamental reform that this Congress must achieve. If we are going to have this new orientation on wellness, prescription drugs will play a critical role. Prescription drugs are a part of almost every methodology of managing a medical condition which, if not appropriately managed, could mature into serious complications. Prescription drugs are a key to providing true quality preventive care for our senior citizens. My point is illustrated by an example. Mrs. Jones is a Medicare beneficiary. She has, like an increasingly large number of Medicare beneficiaries, no drug coverage. Unfortunately, Mrs. Jones also has diabetes, hypertension, and high cholesterol. These are three conditions which in the past would have been debilitating, even fatal. Today, thanks to the miracle of modern medicine, Mrs. Jones can treat these conditions and continue to live a healthy life. Mrs. Jones is likely to be treated with Glucopahge, Procardia XL, and Lipitor. The annual cost of Glucophage will be $708. The annual cost for Procardia XL will be approximately $500 to $900, depending on whether 30 or 60 milligram tablets are prescribed. The annual cost of Lipitor is approximately $700. The total annual spending for these three drugs alone for Mrs. Jones will range between $1,900 and $2,300. These costs, for most seniors--I would argue, for most Americans--are likely to cause significant economic hardship. But if Mrs. Jones does not take these drugs, she will find her conditions raging out of control and will surely be a candidate for expensive hospital stays and surgery. Those last two comments underscore the fact that this is a medical issue in terms of will we make available and affordable to our older citizens those drugs which are available to manage conditions and avoid those conditions maturing into the need for expensive hospitalization, surgery, or even conditions that are beyond the ability of those heroic measures to stop the unending pace towards death. It is also an economic issue. For most seniors, there are many years of preparation for retirement, preparation which is particularly oriented to assure that there will be an economic foundation under their retirement years. There are many challenges and risks to that economic foundation. Today the most prominent of those risks, the one which is most feared by millions of older Americans, is the fact that they will, in fact, be diagnosed as having some condition which, the good news is, is treatable and controllable. The bad news is, it will wreck their economic foundation to pay the cost of those drugs. We are dealing not only with an issue of medical humanity but also of economic security. We owe it to our Nation's seniors that they have the chance to live a full, healthy, and economically secure life in retirement. Prescription medications are a key to allowing them to do so. When Medicare was established in 1965, Mrs. Jones may have benefited most by a system that provided effective hospital care, that did not have a particular focus on preventive benefits, where outpatient prescription drug coverage was not a particularly significant factor. But in the 35 years since that time, medical science and our set of values of what we want from our health care system have changed dramatically. Today pharmaceuticals, not surgery, are the first line of defense against illnesses. The number of prescriptions for American seniors grew from 648 million as recently as 1992 to more than 1 billion in the year 2000. One example of this transition from surgery to pharmaceuticals is the treatment of ulcers. It used to be that the standard treatment was surgery. Today surgery for ulcers is a very rare event. What has happened is the substitution of effective pharmaceuticals to treat, remedy, and reverse ulcerous conditions. A senior is better because he or she has avoided the necessity of intrusive surgery. Our taxpayers are better because they have avoided the cost of that surgery, and the senior is able to resume a normal quality of life. We should think of preventive medication today as the anesthesiology of the last century. I have suggested that if Medicare had been created, not in 1965 but at the end of the Civil War in 1865, there would have been the same debate that we are having today over whether we should include anesthesiology. As we know from our study of Civil War history, it was not uncommon for very serious surgical procedures to be conducted without anesthesiology. Today we would think it to be ludicrous to the extreme and inconceivably inhumane not to have anesthesiology as a core part of a health care system. I suggest that in a few years people will look back on this debate with the same shock and surprise that we thought there was any debate over the question of whether pharmaceuticals should be part of an appropriate humane health care system as we begin the 21st century. Medicare beneficiaries should not have to choose between bankrupting themselves and their families or succumbing to a preventable disease. The key to modernizing Medicare is turning it from a sickness program to a wellness program. Prescription drug coverage is a crucial component of that change. Let me give another example. A senior with gastrointestinal problems is most likely to be prescribed a drug known as Prilosec. Based on 1998 data from the Pennsylvania Pharmaceutical Assistance Contract for the Elderly program, which is the largest outpatient prescription drug program in the country, Prilosec is the second highest selling drug prescribed for seniors. The annual cost is $1,455. For a senior who, for instance, is at 200 percent of the poverty level, $16,700 per year, Prilosec will consume $1 out of every $11 of that senior's income. This price is very high for that senior. But the price the senior would pay if he or she did not take Prilosec is even higher. They would sacrifice an active, pain free life for one riddled with chronic pain. This body should recognize that prescription drugs are an integral part of a preventive care strategy for the Medicare program. As one of the primary guardians and trustees of the Medicare program, the Senate has the responsibility to reform and modernize Medicare so that it focuses on health promotion and disease prevention for all of our Medicare beneficiaries. It can improve the quality of life for older citizens through making this conversion from a sickness to a wellness program. The Medicare program can also slow the cost to the taxpayers by making this transition. The cost of one senior, typically an older woman who falls and, because of her shallow bone mass, injures her hip and requires hospitalization, often surgery, and always a long and painful recovery period, the cost of that to the taxpayers is much greater than the cost of one of the preventive measures which is now being recommended but which is yet to be covered by Medicare; that is, effective hormone management techniques which will contribute to maintaining strong bone conditions and reducing the vulnerability to that kind of a serious mishap. It has been proven time and time again that a combination of preventive services and appropriate medication can reduce the incidence of stroke, diabetes, heart disease, and other potentially fatal conditions. Detailed programmatic changes--changes based upon the realization that prescription drugs and preventive services go hand in hand--are necessary to convert the current Medicare system into one that best serves our citizens by keeping them well as long as possible. Mr. President, we are very fortunate to be living in an era of unprecedented prosperity. This period gives to us, the trustees of the Medicare system, an even greater responsibility and opportunity. We can use this period of prosperity to reform the Medicare program, to assure that our seniors will be able to live longer, healthier lives through preventive care and the treatments that are available to us today. To capitalize upon this opportunity we must provide a prescription benefit which is affordable and comprehensive for our Medicare beneficiary citizens. I implore each of us to take advantage of this opportunity and use the funds that are available to us now to implement change that will benefit our seniors today, our children and grandchildren tomorrow. We have discussed the need to reform the Medicare program to shift its focus from the treatment of illness to the maintenance of good health. We have discussed the critical role that prescription medications play in ensuring a successful preventive care strategy for Medicare. If we agree on these issues--and I believe there is broad consensus--the next question we must answer is: How should a prescription drug benefit be made available for our Medicare beneficiaries? Next week, I will discuss the critical question of whether a prescription drug benefit should be part of the big tent of Medicare program, or if it should be placed as a sideshow act outside of Medicare. I look forward to discussing this with my colleagues next week.

Mr. GRAHAM

Mr. GRAHAM. Mr. President, I ask unanimous consent that my communications director, Kimberly James, be accorded floor privileges for the remainder of my remarks.

Mr. GRAHAM

Mr. GRAHAM. Mr. President, prescription medication is one of the most significant issues before the family of America. Unfortunately, the family is hearing most of this through 30-second television ads. These ads tend to be long on rhetoric and short on substance. I hope the Senate can serve its national purpose as a great deliberative body by bringing some deeper focus on an issue which affects, in the most intimate way, tens of millions of our citizens. I hope I can contribute to this by a series of floor statements on different aspects of this important national issue of prescription medication, especially for older Americans. Older Americans often must take their medicine on a daily basis. It is important that the Senate also get a daily dose of reality of life for those older Americans. I invite my colleagues with similar or differing perspectives to join me so we can have a daily discussion on this important issue. I am pleased today to be joined by my colleague, Senator Kennedy, and invite others to join. We have before the Senate the opportunity to achieve a broadly shared objective--reforming Medicare. Many of my colleagues have discussed Medicare reform in the context of administrative changes and organizational restructuring. While there is certainly merit to that discussion, I believe the most fundamental reform that must be made to the Medicare program is changing Medicare from a program that is based on acute care, illness, treatment after the fact, and to move it to a program that emphasizes prevention, wellness, and the maintenance of the quality of life. That is the fundamental reform we must make in Medicare. To accomplish this shift we must first recognize that the face of health care has changed dramatically since the inception of Medicare in 1965. Thirty-five years ago, America's health care system was almost wholly reacting. Patients sought help from chronic conditions that flared up, or waited to see a doctor when acute conditions hit or if they had a serious accident. Their care was typically delivered in hospitals. Medicare responded to this acute care, hospital-based health care system. The fundamental reason the program was structured as such was based on the fact that most Americans lived only a few years after they reached retirement. As we know from our colleague, Senator Moynihan, the original rationale for 65 as the basis of retirement was the fact that date was set in Europe at the end of the 19th century when the average life expectancy of a European male was only 62. There was a high degree of cynicism in the selection of that date. That date has continued to be an important part of our culture. Only a few decades ago the average American could only expect 7 years of life expectancy after they reached 65. Today the average American has almost 20 years of life expectancy after they reach the age of 65, and by the end of this century an American can expect almost 30 years of life expectancy after attaining the age of 65. We must reform Medicare to assure that today's seniors can spend that gift of years living healthy, productive lives. This can be done if we make an investment in prevention care, which includes screening, early intervention, and the management of the conditions which are detected through those early interventions. The Medicare program should treat illness before it happens. New preventive screening and counseling benefits of the Medicare program give us that opportunity. The U.S. Preventive Services Task Force and the Institute of Medicine have recommended to the Congress that we add new preventive screening and benefits to the Medicare program. These benefits will address some of the most prominent underlying risk factors for illness that face all Medicare benificiaries. These include coverage for medical nutrition therapy for seniors with diabetes, cardiovascular disease or renal disease, screening for hypertension, counseling for tobacco cessation, screening for glaucoma, counseling for hormone replacement therapy, screening for vision and hearing, expanded screening and counseling for osteoporosis, and screening for cholesterol. In addition to adding to our current relatively short list of preventive efforts within Medicare, we need to change the basic structure of how Medicare goes about determining when a new preventive methodology is both medically appropriate and cost effective. Today we rely upon the conventional congressional process to add new prevention methodologies. What I believe we should do is to establish a scientific nonpartisan basis to arrive at these determinations. I suggest we assign this responsibility to the Institute of Medicine and direct that institute conduct ongoing studies of prevention methodologies to assess their scientific validity and economic cost effectiveness. When they make such a determination, they should submit it to Congress, and Congress, using a fast-track process, as we typically do in trade matters, would make a determination either to accept or reject but not to modify those recommendations made by a scientific panel. I believe that approach would assure us that we would be providing to our older citizens the most modern scientifically tested means of maintaining a high standard of living. It is critical that we assure Medicare beneficiaries, both present and future, those most appropriate health care possibilities. By making preventive care the cornerstone of Medicare reform, we can do just that. This discussion of a new Medicare, a Medicare focused on wellness, reminds me of an anecdote. A man walks into the doctor's office and the doctor says: I have both good news and bad news. The good news is that because we have done a screening process we have detected your disease early and we have the opportunity to prescribe the medicines and other medical treatments to stop its spread and reverse its adverse effect on your health. The bad news is you cannot afford the medicine to do this. Sadly, this is not a joke. The list of diseases that were once fatal and are now preventable is long and growing. Years ago, people with high cholesterol could almost count on developing heart disease. Today, cholesterol levels can be kept in check with a number of drugs. One of those is Lipitor, a widely prescribed drug for high cholesterol. This drug has an average yearly cost of nearly $700. As with many other near-miracle drugs, Lipitor is too expensive for many seniors. Yet Medicare, the Nation's commitment to take care of its elderly and disabled, does not cover Lipitor or most other outpatient drugs. Medicare will, however, pay for the surgery after the heart attack which that man is likely to have because he was unable to treat his condition while it was still subject to management. That policy may have made sense in 1965 when the man would only live a few years after retirement. Are we prepared in the year 2000 to tell an American who reaches 65 and has an average of almost 20 years of life expectancy that we are going to treat them only after they have a heart attack; that is the point when we are going to provide access to the means of managing a health condition? I will soon address the critical link between prescription medications and preventive medicine. Prevention and prescription drugs are a key to a modern health care system for our Nation's seniors. This Senate should contribute to delivering that key, and do it now.

Mr. GRAHAM

Mr. GRAHAM. I thank the Chair.

Mr. GRAHAM

Mr. GRAHAM. Today I offer a tribute to a great Floridian who has advanced the cause of quality judicial appointments to an independent Federal judiciary: Mr. Benjamin Hill III of Tampa. For four years, Mr. Hill has served as chairman of Florida's non- partisan Federal Judicial Nominating Commission, which screens candidates for federal judgeships. Mr. Hill has done an outstanding job of leading the Commission and saluting the principle that those appointed to the federal judiciary should be among the best in the legal profession. This year the United States Senate has confirmed six new federal judges for Florida; five in the Middle District and one in the Southern District. The investiture ceremony for two of those new judges, the Honorable James Moody and the Honorable James David Whittemore, will be held September 18, 2000, in Tampa, Florida, followed by other investitures elsewhere in our state. The federal judiciary, the legal profession and the public welcome these new federal judges. As we applaud new jurists, we also recognize the tireless work of Mr. Hill in managing a judicial-selection process focused on meritorious appointments. A leader in his community, his church and his profession, Mr. Hill is a past president of the Florida Bar and a current member of the Board of Governors Executive Committee of the American Bar Association. The United States Constitution specifies that one of the functions of the United States Senate is to offer ``advice and consent'' on the executive branch's nominations, which includes the nomination of federal judges for our independent judiciary. Perhaps the most visible aspect of the advise-and-consent clause is the Senate's power to confirm nominations or reject them, thus denying consent. There are myriad ways to offer advice to the executive branch; here's a brief description of our process in Florida. Florida's Federal Judicial Nominating Commission, a diverse non- political panel comprised of attorneys and lay persons, receives and reviews applications from prospective federal judges. The Commission forwards top candidates to my attention. This screening process evolved so that Senator Connie Mack and I jointly interviewed leading applicants and made joint recommendations to the White House. During the period that Mr. Hill has served as chairman of this Commission, the United States Senate has confirmed the nominations of the following Floridians to serve as United States District Court judges: Middle District The Honorable John Antoon II The Honorable Richard Lazzara The Honorable James Moody The Honorable Gregory Presnell The Honorable John Steele The Honorable James David Whittemore Northern District The Honorable Stephan Mickle Southern District The Honorable William P. Dimitrouleas The Honorable Alan Gold The Honorable Paul C. Huck The Honorable Adalberto Jordan The Honorable Donald Middlebrooks The Honorable Patricia A. Seitz By any measure, this is an impressive list. We express our appreciation to the Senate Judiciary Committee and its chairman, Senator Orrin Hatch, for prompt and thorough review of nominees from Florida. As we approach the end of the 106th Congress, we salute the citizen involvement of the dedicated men and women who serve on Florida's Federal Judicial Nominating Commission. Its members and its chairman, Mr. Benjamin Hill III, personify public service.

Mr. GRAHAM

Mr. GRAHAM. I thank the Chair. Finally, we will not prevent the continued importation of Chinese products to the United States by voting against this legislation. For example, under the WTO agreement on textiles and clothing, U.S. import quotas on Asian textiles will be phased out in 2005. China is currently scheduled to benefit by that 2005 phaseout of Asian quotas. It is anticipated that this phaseout of Asian quotas will result in significant increases in imports of textiles and garments that have been manufactured and assembled generally from Asian raw materials and textiles into the United States. However, under the bilateral accession agreement, the United States negotiated a special textile-specific import safeguard which will remain in place until the end of 2008. Therefore, by defeating this underlying legislation to grant permanent normal trade relations to China, we will actually be doing harm to the U.S. textile and apparel industry. We will not, by failure to pass this legislation, affirmatively address any of the genuine concerns which have been expressed about our relations with China. None of those concerns will be affirmatively addressed by voting against this bill. In fact, a ``no'' vote will result in both tangible losses, such as the loss of the special textile safeguard, as well as some important intangible losses. Killing this legislation now may create the illusion that we are making a strong, positive statement about our relationship with China when, in fact, the failure to engage China now may have much more serious negative effects into the future. What have we accomplished thus far? In considering this modification of our trade relationship with China, it is helpful to examine the substance and scope of our most recent bilateral trade negotiations. First, in April of 1999, the United States and China signed a bilateral agricultural cooperation agreement which removed unfair trade barriers to U.S. wheat, meat, citrus, and poultry products. The agreement signified a new era in our bilateral agricultural relationship, an era based on sound science and the mutual benefits of open markets. When the agreement was signed, Agriculture Secretary Dan Glickman stated it was a fundamental breakthrough for American agriculture. He estimated that Chinese trade restrictions had cost America's competitive producers billions of dollars in sales. This agreement to lift longstanding and contentious barriers to our grain, citrus, and meat would have significant benefits in terms of greatly expanded exports of these products to the vast Chinese market. Second, it is important to note the critical provisions of the bilateral WTO accession agreement signed by the United States and China in November of 1999. These provisions include: First, on U.S. priority agricultural products, tariffs will drop from an average of 31 percent today to 14 percent by January of 2004, with even sharper declines for beef, poultry, pork, cheese, and other commodities. China will significantly expand export opportunities for bulk commodities, such as wheat, corn, and rice, and it will eliminate trade-distorting export subsidies. These are all goals that have been long sought by the United States. Second, the industrial tariffs on U.S. products will fall from today's average of 24.6 percent--that was the average in 1997--to an average of 9.4 percent by 2005. Third, China will participate in the information technology agreement and will eliminate tariffs on products such as computers, semiconductors, and related products by 2005. Fourth, under the agreement, China will phase in trading rights and distribution services over 3 years and also will open up sectors related to distribution services, such as repair and maintenance, warehousing, trucking, and air courier services. Presently, China severely restricts trading rights and the ability to own and operate distribution networks, both of which are essential to move goods and compete effectively in any market. Fifth, the agreement opens China's market for services. For the first time, China will open its telecommunications sector and significantly expand investment and other activities for financial services firms. It will greatly increase the opportunities open to professional services, such as law firms, management consulting, accountants, and environmental services. Finally, with regard to safeguards, no agreement on WTO accession has ever contained stronger measures to strengthen guarantees of free trade and to address practices that distort trade and investment. For example, for the first 12 years of its WTO membership, China has agreed to a country-specific safeguard that is stronger and more targeted relief than that provided under our own current section 201 law. This safeguard applies to all industries, permits us to act based on a lower showing of injury, and permits the United States to act specifically against imports from China. The agreement includes a provision recognizing that the United States may employ special methods designed for nonmarket economies to counteract dumping for 15 years after China's accession to the World Trade Organization. For the first time, Americans will have a means to combat such measures as forced technology transfer, mandated offsets, local content requirements, and other practices intended to drain jobs and technology away from the United States. However, if we fail to pass this legislation, all of these benefits-- all of the benefits which I have just enumerated--will be lost. So what is at stake? With the passage of this legislation, and China's accession to the WTO, the United States stands to reap enormous benefits. My home State of Florida provides many excellent examples of this potential windfall. In 1998, China was Florida's 11th largest export market. Under this negotiated accession agreement, China will reduce tariffs on fresh citrus by 70 percent, on vegetables by up to 60 percent, and on poultry by 50 percent. In addition, China will substantially reduce tariffs on value-added wood products and will eliminate tariffs on a wide variety of information technology products and civil aircraft materials, all of which are important export industries for Florida. We must accept the fact that China is going to be a member of the World Trade Organization. One obligation of the World Trade Organization is to provide every other member with unconditional normal trade relations status. In order for the United States to fulfill our WTO commitments, we must grant China permanent normal trade relations status. By refusing to grant China permanent normal trade relations status, we only deny benefits to ourselves. In fact, if we fail to give them permanent normal trade relations status, every other WTO member country--every other country in the world--will be able to take advantage of the benefits that we negotiated except ourselves. Voting no on this measure does not deny anything to China, but it will put all U.S. industry and agriculture at a severe disadvantage in relation to our competitors around the world. Furthermore, China will enjoy all the benefits of WTO membership, and it will still have the same access to the U.S. market that they have had for 21 years. As many Americans, I have been concerned about China's compliance with trade agreements. In the past, it has taken intensive work to assure that the Chinese fully comply with the provisions of trade agreements that we have negotiated with them. I am certain that compliance will continue to be an issue that will require close monitoring. It will require considerable and sustained effort. It is important to note that thus far, China has lived up to the concessions the U.S. gained as a result of the April 1999 agricultural cooperation agreement. For the first time in over two decades, the Chinese have opened their market to wheat from the Pacific Northwest. They have already purchased 50,000 metric tons of wheat. In an important breakthrough for the Florida citrus industry, the first shipment of fresh citrus from Florida left for China during the last week of March of this year. In his May 3, 2000, testimony before the House Ways and Means Committee, former Commerce Secretary William Daley stated that the administration intends to vigorously monitor and aggressively enforce the terms of this agreement. To that end, the administration has requested a $22 million budget increase to fund new compliance and enforcement resources for Commerce, the U.S. Trade Representative's Office, the U.S. Department of Agriculture, and the State Department. He also outlined the administration's five-point plan for monitoring China's compliance with its commitments and ensuring that we will get the full benefits of the WTO from our bilateral agreement. The plan includes: One, a rapid response compliance team, led by a new Deputy Assistant Secretary for China within the Commerce Department; two, prompt redress of market access problems with tight deadlines for investigating market access and commercial problems inside China; three, statistical monitoring of Chinese trade flows and a special trade law enforcement program modeled on the import surge monitoring program established for the steel industry; four, a comparative law dialog and technical assistance to closely monitor China as it amends its laws and regulations; and fifth and finally, a China-specific WTO training and export promotion program to assure that our exporters take advantage of all the opportunities presented by China's new commitments. Those were the commitments made on behalf of the President and the administration by the former Secretary of Commerce, William Daley. The new Secretary of Commerce, Norman Mineta, restated the Department's commitment to implementing such enhancements in a July 27, 2000, speech at the Washington International Trade Association. I have asked myself this question: Is compliance better served by granting or denying China permanent normal trade relations status? By denying them permanent normal trade relations status, we will be prevented from using the dispute settlement tools that exist within the WTO system, tools such as the bilateral dispute mechanism, where the United States has won 23 of the 23 cases that we have pressed before that panel. It seems clear to me, then, that U.S. trade with China under the auspices of a multinational body such as the World Trade Organization can be more easily monitored, with fewer political obstacles, than can trade on a strictly bilateral basis. In summary, the U.S. goal of an open Chinese market is more likely to be achieved through the WTO discipline than by unilateral actions. Denying China permanent normal trade relations status gives us no additional leverage with the Chinese Government. In fact, it serves exactly the opposite purpose. Denying China PNTR status does not in any way constrain China. They receive all the benefits of any WTO member. Denying them PNTR status will only hurt us, the United States of America, by preventing our workers and our companies from taking advantage of the benefits that we have for so long negotiated and now have achieved. This will actually help China keep our goods out of its market and make it easier for them to ignore compliance with the bilateral agreement. More importantly, we will also deny ourselves the special surge protections that were negotiated in the bilateral agreement. These surge protections are particularly critical for industries such as steel. Again, it seems clear we will be more likely to get compliance to the agreement from China by using these special surge protections and the WTO dispute settlement mechanism than we would without them. To me, the implications of a denial of permanent normal trade relations to China are clear, ominous, and negative. The historical importance and gravity of this vote cannot be overstated. Given the current state of the world and the almost universal recognition of the United States as the lone remaining global superpower, economically, militarily, politically, culturally, the next President of the United States may well represent the most powerful concentration of power in one human being in the history of this planet. How he exercises such enormous power in foreign affairs will be critical in shaping the future of this planet. Granting permanent normal trade relations to China, working to strengthen ties between our two nations, further developing a relationship of mutual respect and peace are all critically important challenges which we, the world's superpower, must be ready to meet. We stand on the threshold of a new and substantially improved economic relationship with the People's Republic of China. By voting yes, we will reaffirm the leadership of the United States in matters of trade and global economic expansion. I ask my colleagues to oppose the Thompson amendment, reserving the complex issues of global proliferation to a more comprehensive measure, avoiding the likely consequence that by the passage of the Thompson amendment, we will kill permanent normal trade relations with China. Rather, I urge our colleagues to vote in favor of permanent normal trade relations with the People's Republic of China and, by so doing, vote in favor of a policy of constructive engagement, mutual respect, and peace among our peoples. Exhibit 1 [From the Los Angeles Times, March 22, 2000] Taiwan's New President Backs Sino-American Trade (By Jim Mann) Taipei, Taiwan.--In a gesture to Beijing and the Clinton administration, Taiwanese President-elect Chen Shui-bian said Tuesday that he hopes to see China enter the World Trade Organization and have normal trade relations with the United States. ``We would welcome the normalization of U.S.-China trade relations, just like we hope the cross-strait relations [between Taiwan and China] can also be normalized,'' Chen said. ``We look forward to both the People's Republic of China's and Taiwan's accession to the WTO.'' Chen made these remarks during an hour-long exclusive interview with the Times, the first he has granted since his election Saturday as Taiwan's next president. He will be the first leader from the Democratic Progressive Party, which has in the past advocated independence for the island. Beijing claims sovereignty over Taiwan. Chen's support for Sino-American trade is certain to be welcomed and distributed widely by supporters of the pending legislation to grant China normal trade benefits in the United States on a permanent basis. The bill--strongly supported by the White House and the business community, but opposed by organized labor--faces what could be a close vote later this year in the House of Representatives. Despite the friction between Taipei and Beijing on other issues, Taiwan has a strong but little-recognized economic interest in making sure that China has normal trade relations with the United States. Many Taiwanese companies manufacture on the Chinese mainland and export their products from China to the U.S. market. Nevertheless, over the past decade while Hong Kong leaders repeatedly campaigned in Washington on behalf of unrestricted U.S. trade with China, Taiwan stayed in the background. Chen's praise for Sino-American trade thus represents a departure from the approach of the outgoing Nationalist Party government. During the wide-ranging interview at his office, Chen looking relaxed and speaking in Mandarin Chinese through a translator, made these other points: He doesn't believe that last week's bellicose attack on his candidacy by Chinese Premier Zhu Rongji had any impact on the Taiwanese election. ``The effects were not significant,'' Chen said, neither scaring voters away from him nor pushing undecided Taiwanese to vote for him. Despite some divisions within his own party, there is a ``mainstream consensus'' in favor of Chen's own pragmatic approach toward dealing with China. For example, Chen said, the Democratic Progressive Party's mainstream agrees that Taiwan should be willing to discuss with Beijing the idea that Taiwan and the People's Republic are both part of ``one China.'' Peace and coexistence across the Taiwan Strait will be his ``top priority'' as president--more important that domestic concerns such as the economy or fighting corruption. ``Only with peace in the strait'' can his other goals be achieved, Chen asserted. Chen repeatedly came back to the theme that he is eager to improve Taiwan's relations with China. He said he is trying to be especially cautious as he prepares to take office. ``Not only are people of Taiwan watching us,'' Chen said, ``China is watching us. The whole world is watching us. And history is also watching us.'' Yet while proclaiming his desire for peace, Chen also made it plain that he doesn't think Taiwan should be intimidated by China. ``What we mean by peace is a very firm and free, autonomous peace,'' he said. ``We don't want the peace that is weak or peace that comes under pressure.'' Chen repeated an assurance made during this campaign that, as president, he won't hold a popular referendum on whether Taiwan should be independent or reunified with China. The idea of such a referendum had often been proposed by leaders of his party, but China vehemently opposes it. Furthermore, Chen promised that, despite his party's past support for independence, as president he will not declare Taiwan to be independent ``unless Taiwan faces a military attack or invasion from China.'' Asked whether he felt prepared to deal with any military action or threats from China, the president-elect replied: ``I believe that across the strait, leaders of both sides want peace. . . . The Chinese leaders have said repeatedly that `Chinese do not fight Chinese.' But if they use threats or force against us, then wouldn't that phrase be meaningless?'' Chen asserted that when leaders in Beijing threaten force against Taiwan while at the same time proclaiming that ``Chinese do not fight Chinese,'' their words could be interpreted to mean that ``they don't see us [Taiwanese] as Chinese.'' Although Chen said he would be willing to discuss with Beijing the idea of ``one China,'' he rejected Chinese President Jiang Zemin's assertion this week that Taiwan should embrace ``one China'' as a precondition for talks. If Taiwan accepted Jiang's idea, he said, ``it would be very difficult actually to enter into discussions [with China] on an equal basis.'' Instead, Chen suggested, perhaps the two governments could reach agreement on other, smaller issues that do not define Taiwan's relationship to China. ``We feel that we can first put aside the differences and discuss areas of agreement and cooperation,'' He said, ``And maybe once these other areas of agreement are resolved or improved, then we would in the process gradually overcome the differences that we have and build more trust.'' Chen went out of his way to court the goodwill of the Clinton administration. Chen praised President Clinton for ``his very strong and firm rejection of [China's] threat to use force'' against Taiwan. He also quoted with approval Clinton's recent statement that any settlement of Taiwan's future should have the consent of the people of Taiwan. Chen insisted that he has a sufficient mandate to govern in Taiwan, even though he won the presidency with only 39% of the vote. His closest rival, independent candidate James Soong, won 37%, while Vice President Lien Chan of the Nationalist Party, which has ruled Taiwan for 51 years, garnered 23%. ``In many countries, the presidents are elected with only 20% or 30% of the vote,'' Chen said. ``[Former President Fidel] Ramos of the Philippines had 20-something percent. Former South Korean President Roh Tae Woo only had 30- something percent, and President Kim Dae Jung had roughly 40%. But this did not affect their ability to govern. ``In the same way. President Kennedy defeated his opponent by only 0.1% of the vote, and that was 110,000 votes, which is a very small number compared to the population of the U.S. But this did not affect his ability to govern effectively.'' Chen is clearly hoping to broaden his political appeal beyond his party base. ``Although I am a very proud member of the Democratic Progressive Party, and I hope to continue to contribute to this party and the democratic values it represents, as president of Taiwan or as the national leader, I am the leader not just of the DPP but of the entire nation,'' he said. ``And therefore, the national interest must come before partisan interests or individual interests. When there is a conflict of interest between the national interest and party interests, I must consider first the national interest.'' At the end of the interview, Chen--the son of an impoverished family in rural Taiwan who entered politics as a lawyer for imprisoned Taiwanese dissidents--said he never imagined he would become president. ``I didn't even dream of it,'' he said. ``Growing up, when I was small, I was so poor, and we were under such hardship, that my first dream was to become an elementary school teacher.'' Moreover, he continued, ``after I started taking part in politics, I did not imagine that one day, the president of Taiwan would be directly elected. [And] two years ago, when I lost the reelection bid for Taipei mayor, I did not know if I could stand up again. ``The spirit of Taiwan is going from having nothing to creating, and from the bottom to the top.''

Mr. GRAHAM. Mr. President, in March of 1999, I traveled, for the first time, to the People's Republic of China with a number of our colleagues. At the end of a long flight from Detroit to Beijing, I looked out the window as we were on the final approach to the airport. I was struck by the mass of humanity, from horizon to horizon, that lay before me. That scene underscored one of the greatest challenges in the 21st century, and it will be that we and China together take all necessary steps to work to assure and maintain peaceful relations between our peoples. With almost one-quarter of the world's population within its borders, China could represent the greatest threat to our Nation's national security. However, if we maintain a sense of respect and strive for peace between the United States and China, and if that remains among the highest priorities of U.S. diplomacy, we can continue to build the permanent institutional relationships that will give us the greatest assurance of peace in the years to come. As we enter the new millennium, I can think of no better way to demonstrate America's leadership than by advancing and expanding our trade and investment policy with the world's most populous nation. Before we discuss the details of this vote, I would like to take this opportunity to recognize the enormous cooperative effort of the President, the leadership of the Congress, the agricultural communities of the United States, and many other citizens in support of this measure. Today we are debating an amendment offered by Senator Thompson of Tennessee. I wish to commend Senator Thompson for calling the attention of the Nation and of this body to the proliferation of weapons of mass destruction and their delivery systems. I agree that this is an issue that is vital to our national security and merits the closest attention. This is an issue which I have personally followed through my work on the Senate Select Committee on Intelligence. Unfortunately, the amendment that is before us, an amendment which has been entitled ``The China Nonproliferation Act,'' does not give the issue of proliferation the comprehensive and serious treatment which I believe it deserves. We need to do more than send a message to the Chinese. We need to develop a comprehensive program that will effectively deal with the proliferation problem on a global basis. If our goal is to deter proliferation, it must be a global effort at deterrence. Although I will oppose the Thompson amendment when we vote on it tomorrow, I do hope we will be able to work together to develop legislation that will effectively and comprehensively deal with proliferation. As we commence this stage of the debate, it is important that each of us completely understand the specific issue which we are debating, the details of what the Senate is being asked to vote upon, and the likely consequences of this vote. Let me first describe in very simple terms the substance of the vote to grant permanent normal trade relations to China. In order to clarify the fact that this status is not a unique or a special status, Congress, in 1998, passed legislation to redefine the designation, to redefine from the phrase ``most favored nation'' to the more appropriate phrase ``normal trade relations.'' China has had most favored nation and now normal trade relations status each year since 1979, when the United States first established diplomatic relations with the People's Republic of China. This status has been subject to annual review and annual renewal. It is worth mentioning that not once in the past 21 years has China been denied normal trade status. Currently, the United States denies normal trade relations status to Cuba and North Korea. That denial is required by the Jackson-Vanik amendment to the Trade Act of 1974 because those nations deny, seriously restrict, or burden their citizens' right to emigrate. The United States also denies normal trade relations status to Afghanistan, Laos, Serbia, and Montenegro, as directed by more recent legislative or Presidential action. It is important to note that, although economic sanctions have been levied against Iran, Iraq, and Libya, these nations still legally retain their normal trade relations status with the United States. By granting China permanent normal trade relations status, we will fulfill our commitments under the World Trade Organization and will then be able to take advantage of the special concessions which were obtained from China in bilateral agreements negotiated by this administration. However, if we fail to grant China permanent normal trade relations status and China is granted membership in the World Trade Organization, every other WTO member country in the world will be able to take advantage of the range of benefits that we, the United States, negotiated for ourselves, except the United States of America. With that brief description in mind, it is important to clearly outline the issues that will not be affected by this vote. First, we are not voting on whether or not we agree with, like, or trust the Chinese Communist Government. We are simply voting on a change and, in my view, an enhancement, in our 21-year economic relations with China. Second, we are not voting on whether or not to allow China to enter the World Trade Organization. This will take place regardless of what actions the Senate takes on permanent NTR status. Third, we are not voting on the bilateral WTO accession agreement between China and the United States. That agreement has been signed and will not be changed or renegotiated. Fourth, we are not voting on a trade agreement with multilateral concessions like the North American Free Trade Agreement. The bilateral agreement this administration has already negotiated is a one-way agreement in which China agrees to eliminate or reduce tariffs and makes other concessions to WTO members. All WTO members, including the United States, have made no concessions to China. Granting permanent normal trade relations status to China does not require us to give the Chinese any additional access to our markets. They have made all of the concessions. Fifth, we are not voting on any of the issues surrounding the relationship between mainland China and Taiwan. In fact, the Taiwanese position on this vote could not have been more clearly stated than by the Taiwanese President, Chen Shui-bian, in a March 22, 2000, interview with the Los Angeles Times. In that interview, the President stated: We would welcome the normalization of U.S.-China trade relations, just like we hope the cross strait relations [between Taiwan and China] also can be normalized. We look forward to both the People's Republic of China and Taiwan's accession to the WTO. If the United States continues to be concerned about protecting Taiwanese security and other interests, then should we not pay close attention to the strong support of the President of Taiwan for granting PNTR to China? I ask unanimous consent to print the full text of this March 22, 2000, Los Angeles Times interview in the Record immediately following my remarks.

Mr. GRAHAM

Mr. GRAHAM. Mr. President, I ask unanimous consent that Mr. Jason McNamara, a fellow in my office, be granted the privilege of the floor during the remainder of the debate on this legislation.

Mr. GRAHAM

Mr. GRAHAM. Mr. President, it has been more than a year since the Columbine tragedy, but still this Republican Congress refuses to act on sensible gun legislation. Since Columbine, thousands of Americans have been killed by gunfire. Until we act, Democrats in the Senate will read the names of some of those who have lost their lives to gun violence in the past year, and we will continue to do so every day that the Senate is in session. In the name of those who died, we will continue this fight. Following are the names of some of the people who were killed by gunfire one year ago today. September 8, 1999: Frederick Boone, 37, Baltimore, MD; Franklin Brown, 41, Seattle, WA; Rico Brown, 25, Baltimore, MD; Antonio Daniely, 24, Atlanta, GA; Anthony Harris, 17, Cincinnati, OH; Bruce A. Howard, 35, Madison, WI; Fred Miller, 76, St. Louis, MO; Victor Manuel Rios-Baheva, 35, Salt Lake City, UT; Robert Somerville, 21, Baltimore, MD; Robert Winder, Jr., 23, Baltimore, MD; Unidentified Male, 19, Norfolk, VA. One of the gun violence victims I mentioned, 41-year-old Franklin Brown of Seattle, was shot and killed by a stranger who approached him in the street and started an argument. Franklin died from several gunshot wounds to his back. We cannot sit back and allow such senseless gun violence to continue. The deaths of these people are a reminder to all of us that we need to enact sensible gun legislation now.

Mr. GRAHAM

Mr. GRAHAM. Mr. President, I look forward to working with Senator Mack and Chairman Stevens to secure funding for this important project. Crusader Program

Mr. GRAHAM. This will be the only SAR facility of its kind in the east, and the Department of Defense has indicated to us, its' strong interest in developing this capability further in South Florida. It was for this reason that we asked the Senate to approve, which it did, an amendment for up to an additional $5 million dollars specifically for drug interdiction activities at the facility.

Mr. GRAHAM

Mr. GRAHAM. Mr. President, today along with my Finance Committee colleague, Senator Mack, I am introducing the Professional Employer Organization Workers Benefits Act of 2000. This legislation will expand retirement and health benefits for workers at small and medium-sized businesses in this country. The bill makes it easier for certified professional employer organizations (PEO's) to assist small and medium-sized businesses in complying with the many responsibilities of being an employer. It permits PEO's to collect Federal employment taxes on behalf of the employer and provide benefits to the small business' workers. For many of these workers, the pension, health and other benefits that a PEO provides would not be available from the small business itself because they are too costly for the small business to provide on its own. The average client of a PEO is a small business with 18 workers and an average wage of $20,000. PEO's have the expertise and can take advantage of economies of scale to provide health and retirement benefits in an affordable and efficient manner. A recent Dunn & Bradstreet survey of small businesses reveled that only 39 percent offered health care and just 19 percent offer retirement plans. We must take every opportunity to assist these small businesses in providing retirement and health benefits to their employees. PEO's offer one creative way to bridge the gap between what workers need and what small businesses can afford to provide. In fact, one analyst at Alex. Brown & Sons estimates that 40 percent of companies in a PEO coemployment relationship upgrade their total employee benefits package as a result of the partnership with the PEO. Twenty-five percent of those companies offer health and other benefits for the first time. Over the past few years, small and medium-sized businesses have sought out the services offered by PEO's. In response, many states have created programs to recognize, license and regulate PEO's to ensure that a viable industry could grow. Unfortunately, federal law has not kept pace. Current rules for who can collect employment taxes and provide benefits do not fit with the PEO model. Under some interpretations, PEO's would be prohibited from performing the very services that small businesses are asking them to undertake. This legislation clarifies the tax laws to make it clear that PEO's meeting certain standards will be able to assist small businesses in providing employee benefits and collecting Federal employment taxes. This bill is a narrower version of a provision that was included in the pension legislation I sponsored in the last Congress. This new bill incorporates comments we received from interested parties over the course of the past year, including those received from the Treasury and Labor Departments. As a result the bill we are introducing today is much improved from previous versions. In addition, I would like to make clear what this bill does not do. Unlike earlier versions, this legislation applies only to PEO's, and not to temporary staffing agencies. Further, this bill applies only to the two specific areas of tax law--employment taxes and employee benefits. It does not affect any other law nor does it affect the determination of who is the employer for any other purpose. The bill specifically provides that it creates no inferences with respect to those issues. I am hopeful that, with this narrower focus, this legislation can be considered on its own merits, without getting bogged down in larger disputes involving contingent workforces and independent contractors. Those issues are important ones that Congress may want to examine, but we should not allow them to delay resolution of the unrelated PEO issued addressed by this bill. I look forward to working with Senator Mack, my other colleagues on the Finance Committee, and the administration to move this bill during the 106th Congress so that we can help small- and medium-sized businesses operate more efficiently while at the same time expanding the benefits available to their workers. Mr. President, I ask unanimous consent that the following explanation of the bill be printed in the Record.