Phil Gramm

Mr. GRAMM

Mr. GRAMM. Mr. President, whenever the Senator from New York and the Senator from Virginia offer an amendment, we know it is well reasoned and we know it is well intended and so I think, as a result, we are always correct in being cautious in opposing such an amendment. But I am opposed to this amendment because, while I think their argument is well reasoned as far as it goes--it is certainly well intended--I think it is an amendment which does not belong in this legislation and which is fundamentally destructive. If our colleagues want to encourage the European Union to expand and to grant membership to Poland, Hungary, and the Czech Republic, I am for that. I think that EU membership expansion to Poland, Hungary, and the Czech Republic should occur, I strongly support it, and if we were voting on that issue, and that issue alone, I would vote for this amendment. I remind my colleagues that NATO membership today is not made up of countries that are solely members of the European economic community. Iceland, Norway, Turkey, Canada and the United States are not members of the European Union. I, for one, would support American membership in the European Union, but I don't think they are going to let us join. Might I say that while we are encouraging the European Union to expand its membership, we ought to start with Turkey. It is absolutely outrageous that the opposition of one country is preventing Turkey from having an opportunity to be part of the European economic community when Turkey has been an anchor of NATO for 46 years, when Turkey did as much as any other country to keep Ivan back from the gate, when Turkey provides the largest land army of any European NATO nation. These contributions ultimately helped check the Soviet expansion and through the power of ideas and freedom tore down the Berlin Wall, liberated Eastern Europe, and freed more people than any victory in any war in the history of mankind. If our objective is to start urging the European Union to expand its membership as a precondition for membership in NATO, let's begin by urging them to expand their membership to nations which are already part of NATO and which contributed greatly to winning the cold war. I think this is an arbitrary distinction that does not belong in this bill. If we want to do something to encourage the European Union to expand, I am in favor of that. I would certainly vote for a resolution urging them to expand, to take in Poland and Hungary and the Czech Republic, but I think we ought to begin with Turkey. But that is not what is before us today. What is before us today is a fundamental decision as to whether we are going to let an arbitrarily drawn line, a line drawn by Stalin in Europe through the Iron Curtain at the end of World War II, stand as a permanent division of Europe in terms of military alliance. I am not oblivious to concerns that have been raised about the cost of expanding NATO. I am not oblivious to other concerns with regard to Russia and to its response, but in the end, I am sway by the argument that we should not allow communism, which is now on the ash heap of history, to determine the composition of our military alliance in Europe. Therefore, I intend to vote to expand NATO, but I do not believe that that expansion should be conditioned on membership in the European Union. Let me also remind my colleagues that Austria, Finland, Ireland, and Sweden are members of the European Union, but they are not members of NATO. This is a clear-cut choice. I think this amendment is the wrong thing to do, and I urge my colleagues to oppose it. I yield back the remainder of my time.

Mr. GRAMM

Mr. GRAMM. I thank the chairman.

Mr. GRAMM. Obviously, a great deal of compromise has occurred on our side of the aisle with regard to arrearages at the United Nations. That is now, obviously, a focal point of this bill. I have to assume that the President would have to understand that if this bill is defeated today, his chances of getting any arrearage funding for the United Nations in this Congress would be diminished substantially and probably would not happen. I ask the chairman his views on that.

Mr. GRAMM. I want to ask the distinguished chairman of the committee a question, if I might, if he will yield for that purpose.

Mr. GRAMM

Mr. GRAMM. I move to lay that motion on the table. The motion to lay on the table was agreed to. Amendment No. 2300

Mr. GRAMM

Mr. GRAMM. Parliamentary inquiry, Mr. President.

Mr. GRAMM. How much time do we have on each side?

Mr. GRAMM. Mr. President, our leader on this issue, Senator Coverdell, is at a press conference out on the steps. We have no further requests to have speakers on our side. If the distinguished senior Senator from Ohio is through with his portion of the debate, I would be happy, on behalf of Senator Coverdell, to move to table the pending amendment.

Mr. GRAMM. I thank the Chair.

Mr. GRAMM. Mr. President, I move to table the pending amendment and ask for the yeas and nays.

Mr. GRAMM

Mr. GRAMM. I move to lay that motion on the table. The motion to lay on the table was agreed to. Amendment No. 2226, as amended

Mr. GRAMM

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

Mr. GRAMM

Mr. GRAMM. Mr. President, I think we are having an interesting and enlightening conversation. I agree with the Senator from Oklahoma. But I want to go back one more level below this to talk about the real issue here. Our dear colleague from Minnesota talks about how much he and the administration care about this program and about how they want to try to see this done, provide this $16 million. But they didn't care enough about it to cut $16 million out of another discretionary program to pay for it. They didn't care enough about it to reduce discretionary spending in the Federal budget by 0.003 percent to pay for it. They cared so much about it that they weren't willing to take 65 bureaucrats from the 4,000 people they already have working in the Health Care Finance Administration to do this work. They didn't do any of those things. What they did is they cut Medicare and they reduced peer review, which is looking at the practice of doctors who are providing medical care to my mother and to other people's parents. We take money from peer review and the oversight of doctors practicing medicine under Medicare--we take money away from Medicare to fund more bureaucrats at HCFA. That is what this amendment is about. This is robbing Medicare to pay for bureaucrats at HCFA. Now, first of all, I know the public doesn't care about these things, but I don't understand how the Appropriations Committee is cutting Medicare. The last time I looked, Medicare was under the jurisdiction of the Finance Committee. I am chairman of the subcommittee that has jurisdiction over Medicare. What we have here is an extraordinary shell game, which the President started and which this committee has continued to perpetuate. Here is the shell game in English that anybody can understand. The President wants to hire 65 more bureaucrats. He already has 4,000 bureaucrats working for HCFA. They want 65 more bureaucrats to do work that has absolutely nothing to do with Medicare in shape, form, or fashion. And they want 65 more bureaucrats. But they are unwilling to cut another discretionary program to pay for it. They want these 65 bureaucrats, but they are unwilling to take them away from the current work that the 4,000 are doing. It is not important enough to move 65 of them to do it. It is not important enough to cut any other discretionary program of the Government to do it. But it is apparently important enough to reduce physician oversight of the practice of medicine on 39 million elderly and disabled Americans who qualify for Medicare. This is another blatant effort to rob Medicare, a program that is going broke, a program that will be a $1.1 trillion drain on the Federal Treasury over the next 10 years, a program where we are going to have to raise the payroll tax from 2.9 cents for every dollar you make to 13 cents for every dollar you make to pay for it over the next 30 years. So what they are doing is using Medicare as a piggy bank to hire bureaucrats. Let me say that this is outrageous, and I believe that if the American people knew about this, they would be outraged. Our colleague from Minnesota said, but we need these 65 bureaucrats for this important function. Look, I am not going to argue whether it is important or not. Our dear colleague here has pointed out that the issues raised wouldn't even be dealt with by those 65 bureaucrats. But that is not the point here. If it is all that important, cut a program to pay for it. If it is all that important, do what every American working family does every day: They decide that buying medicine, or buying a book, or sending their child to special training is important, so they cut spending they would have spent on vacation, or something less important, to pay for it. My argument is not against the spending of this money. It is not even against these 65 bureaucrats, although I do not believe the world will come to an end if we do not have them. My point is, if they are all that important, cut money from a program, another discretionary account, that is of less importance. Is there nothing in the $550 billion every year spent by the Federal Government on discretionary spending that is less important than this? If there isn't, we probably ought not to be doing it. If there are programs that are less important, I suggest you find them and cut them. But this is a rotten shell game, to be cutting Medicare and reducing peer review oversight over the treatment of 39 million senior and disabled citizens in order to fund more bureaucrats. What are we doing, cutting Medicare to fund discretionary programs? Whoever heard of cutting Medicare to fund HCFA bureaucrats? I think it is an absolute outrage. What all this shows is, despite all of our flowery rhetoric--put Social Security first, put Medicare first--we are all for doing that, but when it gets right down to it, this provision that Senator Nickles is trying to strike is a provision that says, put bureaucrats before Medicare, cut oversight of patient treatment for 39 million senior and disabled citizens in this country so that we can fund the hiring of 65 more bureaucrats. That is a position that you can take. I happen to say that the answer to it is no--clear-cut, unequivocally, no. We ought not to be cutting Medicare to increase the number of bureaucrats working at HCFA. And that is exactly what this proposal does. If somebody can make the case that we don't need as much oversight of physicians who are treating my mother and everybody else's mother, then we ought to take the savings and we ought to use it to save Medicare. But there are two problems here: No. 1, nobody has made that case; I am not convinced of it. And, No. 2, if we are going to save the money, it ought to go to Medicare, where the money is coming from; it ought not to be used to hire bureaucrats. So we are going to vote at some point on the Nickles amendment. I know our colleagues are threatening to hold up this bill. But let me say, this is not my bill. This is a bill that spends $5 billion that we do not have. This is a bill that raises the deficit by $5 billion. This is a bill that puts Social Security last. This is a bill that takes $5 billion away from our efforts to save Social Security. And if we are going to hold this bill up so that we can steal money from Medicare, let it be held up. If this bill never passes under those circumstances, that will suit me just fine. I am not going to have to explain why it does not pass, because I am not holding it up. But if somebody is going to threaten me that I am not going to raise the deficit by $5 billion unless you let me steal $16 million from Medicare, I am not imperiled by that threat. No. 1, I think it is outrageous that we are not offsetting this $5 billion so that it is not being added to the deficit. I think that is fundamentally wrong. So I am not hot for this bill, to begin with. But secondly, your ransom is simply too high. It is absolutely unacceptable to say we are not going to spend the $5 billion and raise the deficit by $5 billion and steal the money from Social Security unless you let us steal $16 million from Medicare. That ransom is too high. And maybe our colleagues can look people in the face and say, ``We had to cut oversight of medical practice for senior citizens in Medicare so that we can hire 65 bureaucrats at HCFA.'' Maybe they feel comfortable doing it. I would like them to try to explain it to my 85- year-old mother. I don't think she would be convinced. But, in any case, we every once in a while have acts of piracy. People say, ``If you do not give me this money, or you do not do this, I am not going to let you do what you want to do.'' But what our colleagues are saying is, ``We won't raise the deficit by $5 billion unless we can take $16 million away from Medicare.'' A, I am not for raising the deficit by $5 billion; B, I am not for taking the $16 million away from Medicare. So I don't feel threatened. Finally, let me say to our dear colleague from Oklahoma, who yesterday tried to prevent us from raising the deficit by $1.8 billion--and it was an hour well spent, but I don't think we have to apologize for spending hours trying to save $16 million--there are a lot of people in Oklahoma and Texas who work a lifetime, and their children work a lifetime, and their grandchildren work a lifetime, never to make $16 million. So I think this is time well spent. Do not take this money out of Medicare. Do not take this money out of Medicare to hire 65 new bureaucrats. That, I think, is a clear issue. And if our colleagues want to debate forever, I would love for the American people to hear this debate. I don't believe they can sustain that case. This was a slick idea by the President, to do it when nobody knew it was in here. I didn't know this was in this bill, and I am on the Finance Committee, and I am chairman of the subcommittee that oversees Medicare. I didn't know it was in this bill until we discovered it. So it was a slick idea until people discovered it. Piracy normally works until somebody discovers it is occurring. And then they send out the sheriff, and the sheriff stops it. We are the sheriff. So if you want to stop, if you do not want to raise the deficit by $5 billion, if you do not get the $16 million, it doesn't break my heart. Go right ahead. I yield the floor. Mr. KENNEDY addressed the Chair.

Mr. GRAMM. Mr. President, let me first say that what we have before us is an effort to take $8 million out of Medicare, money that is now being spent to monitor the quality of health care provided to 39 million Medicare beneficiaries. This amendment will cut Medicare in order to hire, it was initially 65 bureaucrats, now I guess it is 32\1/2\ at $92,000 a year to implement programs that have absolutely nothing to do with Medicare. My argument is not with the program that the Senator is for. I don't have any doubt that all those groups who wrote those letters are for this program, but I don't believe they want to cut Medicare to pay for it. The problem the Senator has is that HCFA and the Department of Health and Human Services, which has one of the biggest budgets in the Federal Government, cannot come up with $8 million to hire these 32\1/2\ bureaucrats, despite the fact that it is so important. So they have said, ``We won't take any one of our 4,000 people doing other things to do this work; it is not that important; we won't cut any program anywhere else to do it; it is not that important; but we will take it out of Medicare and reduce the oversight of physician practice on 39 million senior citizens in America to pay for it.'' I don't think we should take the money away from Medicare to hire 32\1/2\ bureaucrats. I think it is wrong, and I think if they don't want it enough to take the money away from other programs in HCFA, it suggests to me they don't want it very much. So I hope our colleagues will not start raiding Medicare to pay for the ongoing programs of HCFA and to hire bureaucrats at the expense of Medicare. I think it is fundamentally wrong. I think if you put the question before the American people, that 90 percent of the American people would agree with Senator Nickles' argument. I am not saying that hiring the bureaucrats is bad or what they would do is bad. I am just simply saying take the money away from something other than Medicare, and in order for us to guarantee that is the case, we have to defeat this amendment, and I am hopeful that we will. I yield the remainder of my time.

Mr. GRAMM. I move to lay that motion on the table. The motion to lay on the table was agreed to.

Mr. GRAMM. I move to reconsider the vote.

Mr. GRAMM. Mr. President, how much time do we have left?

Mr. GRAMM. Mr. President, I will try to be brief. I hope we are getting ready to vote on this. I want to go back, since so much has been said, and review exactly where we are. Here is where we are: The President wanted $16 million to, in part, hire 65 new bureaucrats at HCFA. Here are the choices the President had: He could have cut another program in HCFA and used it to pay to hire the 65 new bureaucrats. We have $550 billion of discretionary programs in the Federal budget and he could have cut $16 million out of any one or combination of those. Or he could have cut each one of them by 0.003 percent. But the President could not find in a discretionary budget of $550 billion a single program that could be cut. He could not find anything that was less important than hiring these new 65 bureaucrats. So what he did is he cut Medicare and slipped the provision into the supplemental and it is now before us. Where did he cut Medicare? We have a program where we hire doctors who go in, on a selective sample basis, and look at procedures that are being provided to Medicare patients. Someone goes in and does a procedure on my mother, where they insert a balloon and open her artery and save her life and save a lot of money. And then we have Medicare that goes in to look and see, did they do it well? Did they do it in the most efficient way? Are they practicing good medicine which the Government is paying for? What the President said is, let's cut the amount of money that we are spending for this oversight of medical practice where 39 million people who qualify for Medicare under the President's provision will have less oversight of their medical treatment they receive. That is what the President proposed to do, cut Medicare by reducing the oversight of the medical practice that we are paying for and take that money from Medicare and hire 65 bureaucrats in HCFA to perform functions that have absolutely nothing to do with Medicare. There are two debates going on. To some extent the Senator from Oklahoma and the Senator from Minnesota are arguing about whether we need to hire these 65 bureaucrats at all. We already have 4,000 of them in the same agency but not a one of them is doing something less important than this. I am not getting involved in that debate. Maybe the Senator from Minnesota and the Senator from Massachusetts are right. Maybe we just have to have 65 new bureaucrats at HCFA. But my point is, if you really need them that badly, take money away from another HCFA program. Don't cut Medicare, don't take oversight of medical practice on our senior citizens, don't take that money to spend it on a program that has nothing to do with Medicare. Our colleague from Massachusetts is still chafing that at one time we actually debated cutting taxes around here. I long to get those days back, myself, and I am not the least bit shy about them. I don't remember anybody ever proposing cutting Medicare to pay for them, but I guess if you are against tax cuts they have to be evil; and wherever, whatever is being done to get them, that in itself must be evil. But here is my point. We are getting ready to go into a series of issues this year where our Democrat colleagues are going to be taking money away from Medicare. So, if they don't like being criticized for it, they better get used to it. We are going to have a tobacco settlement on the floor of the U.S. Senate, and we are going to have it on the floor of the Senate this spring or summer. There is going to be a debate about what to use that money for. We are providing money for education. We are going to raise the price of cigarettes, which everybody says is the most effective way to get teenagers not to smoke. But the question is going to come down to where should the money be used? We are going to hear this same debate again. I say the Senate Budget Committee says that 14 percent of the cost of Medicare comes from people smoking; $30 billion a year in costs are imposed on Medicare by people smoking, and the whole logic of the tobacco settlement, the reason that the tobacco companies have agreed to pay the States and to pay the Federal Government, is to compensate the taxpayer for costs imposed on the taxpayer by people smoking. In the Federal Government, those costs have been imposed on Medicare. So the Budget Committee has said, and I hope the Senate says, take the money from the tobacco settlement and use it to pay for Medicare to save Medicare and, in fact, if people were not smoking we would have $30 billion a year less in costs, and compensating Medicare for that is what the whole settlement is about. Many of our colleagues on the other side see the settlement as this giant piggy bank which can be used to fund seven or eight different Government programs. So we are going to have this debate again, only then they are going to take the money away from Medicare to fund building schools and hiring teachers--the list goes on and on. I am not saying any of those are bad things, just as I am not saying that hiring 65 new bureaucrats is a bad thing. I suspect it is, but I am not saying that. All I am saying is, don't take the money away from Medicare to do it. This provision should have never been put in this bill. It desperately needs to be taken out, and I believe when we do vote we will take it out. And I appreciate the Senator from Oklahoma offering the amendment, and I enjoyed getting an opportunity to come over and talk about it.

Mr. GRAMM

Mr. GRAMM. Mr. President, I think we all wish we had additional options, but the law is very clear. The law says, have they cooperated fully? Have they taken adequate steps? For 12 years, knowing that the answer to both of those questions was no, I voted yes because I thought we wanted to encourage Mexico, we wanted to work with Mexico. I still want to work with Mexico. I still want to encourage Mexico. But you reach a point where it cannot be good public policy to say publicly something that is clearly untrue. I am going to vote tonight to decertify Mexico. I know the strategy we are following today is failing. I know from 12 years of hoping, wishing the best, that hoping and wishing the best does not change reality. We are either going to change strategy or we are going to lose the war. That is why I intend to vote to decertify. I hope by doing that we can induce Mexico to do more. I am not apologizing for what we are doing. I think our war on drugs is phony and a sham and an embarrassment. We have taken no real efforts to try to stop people from consuming drugs in this country, and we have, from the point of view of public policy, a more serious, more dedicated policy to stop people from smoking than we do to stop people from using illegal drugs. But the point is, the law is very clear. Have they cooperated fully? Have they taken adequate steps? And the answer to both those questions, regrettably, is, ``No.'' Maybe by telling the truth, maybe by saying ``No,'' in the future the answer will be ``Yes.'' And I hope it will be. I reserve the remainder of my time.

Mr. GRAMM

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

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

Mr. GRAMM. Mr. President, what is the pending business of the Senate?

Mr. GRAMM. Mr. President, let me ask unanimous consent that the amendment of the Senator from North Carolina be temporarily set aside so that Senator Santorum and I might offer an amendment.

Mr. GRAMM. Mr. President, I send an amendment to the desk.

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