Chuck Grassley

Mr. GRASSLEY

Mr. GRASSLEY. I agree with my colleague, Senator Baucus. I have been working a long time on legislation to permit the use of Medicare data to improve drug safety. After all this is some of the best and most complete data available. In fact, Senator Baucus and I joined together to introduce legislation to accomplish just that during the 109th Congress, S. 3987, the Medicare Data Access and Research Act, and this Congress, S. 1507, the Access to Medicare Data Act of 2007. Improving drug safety is a top priority of mine and the appropriate use of Medicare data will likely enhance drug safety. That will benefit all Americans. I look forward to completing our goals for Medicare data later this year and including this on legislation within the purview of the Finance Committee. We intend to clarify how Federal health agencies may use and release Medicare data and make the appropriate amendments in the Social Security Act. At that point, it will be important that the use of Medicare data be appropriately tied into the drug safety provisions of the FDA bill under consideration today. We would hope that our colleague, Senator Kennedy, would agree to make conforming amendments to the Federal Food, Drug and Cosmetic Act as needed to make FDA law consistent with appropriate Medicare law.

Mr. GRASSLEY

Mr. GRASSLEY. Mr. President, I yield the floor.

Mr. GRASSLEY. Mr. President, the ethics bill has now been signed into law and, as my colleagues are aware, it contains new requirements about what we in the Senate call holds, meaning an individual Senator can hold up a bill all by himself from coming up. Senators may be wondering what exactly is required under these new requirements about holds and how it is going to work. As a coauthor of the original measure, I have to tell my colleagues that I don't know how it is going to work. The provisions have been rewritten from what we had originally adopted on the floor of the Senate by a very wide margin. I am not even sure by whom this has been rewritten because it was a closed process and Republicans were not invited to participate in that process. Now I am trying to understand how these provisions will work. Let me give a little background. I have been working for some time, along with Senator Wyden of Oregon, to end the practice of secret holds through a rules change or through what we call in the Senate a standing order. I do not believe there is any legitimate reason a single Senator should be able to anonymously--I emphasize anonymously--block a bill or nomination. I do not argue with an individual Senator blocking a bill. I do that myself. But I do not think it should be secret. We ought to know who is doing it because the public's business--and the Senate is all about the public's business; we are on television--the public's business ought to be public, and we ought to know who that person is. If a Senator has the guts to place a hold, they ought to have the guts to say who they are and why they think that bill ought to be held up. If there is a legitimate reason for a hold, then Senators should have no fear about it being public. I am not talking hypothetically; I am speaking from my experience. I have voluntarily practiced public holds for a decade or more, and I have had absolutely no cause to regret telling all my colleagues and the whole country why I am holding up a bill and who Chuck Grassley is so they can come and talk with me if they want to talk with me about it, know what the rationale is, and maybe we will want to work something out. Through the years, there have been several times when the leaders of the two parties have agreed to work with Senator Wyden and me to address this issue, albeit in a way different than what maybe we would have proposed. I have approached these opportunities with optimism, only later on to be disappointed. For instance, in 1999, at the start of the 106th Congress, Majority Leader Lott and Minority Leader Daschle sent a ``Dear Colleague'' letter to all Senators outlining a new policy that any Senators placing a hold must notify the sponsor of the legislation and the committee of jurisdiction. It went on to state that written notification of the holds should be provided to respective leaders, and staff holds--in other words, staff for the Senator placing holds--would not be honored unless accompanied by a written notification. All that sounds good if it worked out that way. But I want to tell my colleagues, this policy announced in 1999 was quickly forgotten or ignored by Senators, and the people who could enforce it actually did not enforce it. Then, recognizing that the previous ``Dear Colleague'' letter was not effective, Leaders Frist and Daschle sent another ``Dear Colleague'' letter in 2003 that purported to have some sort of enforcement mechanism. The new policy required notification of the legislation's sponsor if and only if a member was of their party, as well as notification of the senior party member on the committee of jurisdiction. In other words, this new policy required less disclosure than the previous policy since it only affected holds by members of the same party. Nonetheless, the leaders promised that if the disclosure was not made, they would disclose the hold. It also reiterated that staff holds would not be honored unless accompanied by written notification. That policy had more holes in it than Swiss cheese. I am not sure anyone understood the policy, and it had no effect that I can tell on improving transparency in a public body, the Senate, where we are on television and the public's business--all of the public's business-- ought to be public. No longer willing to settle for half measures such as we had been dealt in 1999 and 2003 that do not end secret holds once and for all, in the last Congress, Senator Wyden and I then took our own initiative, not waiting for leaders to act. We offered our standing order to require full public disclosure of all holds as an amendment to the lobbying reform bill. It was a well-thought-out measure that was drafted with the help of people who know about how this place operates--Senator Lott and Senator Byrd. Remember, Senator Byrd has been around here for a half century. We used their insights and their knowledge of Senate procedures as former majority leaders to write our legislation. Our standing order passed the Senate by a vote of 84 to 13. Now think of that, this Senate making a decision that holds should not be secret anymore by a vote of 84 to 13. But listen to what happened after that 84-to-13 vote. While that bill did not become law, it became a starting point for the ethics bill passed by the Senate last year. I thought the leaders had finally accepted that we would have full disclosure of holds. In fact, our secret holds provisions remained intact in the version of the ethics bill that originally passed the Senate earlier this year. Then, even though the secret holds provisions related only to the Senate--nothing to do with the other body, the House of Representatives--and had already been passed by the Senate, on a voice vote this time but reflecting the reality of the 84-to-13 vote before, they were rewritten behind closed doors by Members of the majority party. Once again, I feel like half measures have been substituted for real reform. In other words, the provisions that had passed one time by 84 to 13, only affecting us, went to conference--where they didn't have to go to conference because it only affected us, it didn't affect the other body--and we end up with no real reform. Under the rewritten provisions, a Senator will only have to disclose a hold ``following the objections to a unanimous consent to proceeding to, and, or passage of, a measure or matter on their behalf.'' Now, that is going to puzzle you like it puzzles me. Obviously, in this case, the hold would already have existed well before any objection. In fact, most holds never even get to this stage because the mere threat of a hold prevents unanimous consent requests from being made in the first place. This is particularly true if the Senator placing the hold is a member of the majority party. In that case, the majority leader would simply not ask unanimous consent, knowing that a member of his party has a hold. For instance, it is not clear to me what would happen if the minority leader asked unanimous consent to proceed to a bill and the majority leader objected on his own behalf to protect his prerogative to set the agenda but also having the effect of honoring the hold of another member of the majority leader's caucus. Or what if the majority leader asked unanimous consent to proceed to a bill and the minority leader objects but does not specify on whose behalf, even though a member of the minority party has a hold. Would the minority Senator with the hold then be required to disclose the hold? I don't know. It is not very clear. I asked the Office of the Parliamentarian for an opinion about how the new provision would work in such instances, but with no legislative history--because this was written behind closed doors there is no report to come out--with no legislative history for the changes that were made to the Wyden-Grassley measure, the intent of the rewritten provisions was not evident is what the Parliamentarian said. Therefore, what did I do? I wrote to the Senate Rules Committee to provide insight into the content of the rewritten provisions. The response referred me to a section-by-section analysis of the bill in the Congressional Record that essentially restates the provisions but once again sheds no light on the specific questions about how this works. Perhaps that is because the answer might be a little embarrassing. Depending upon how the new provisions are interpreted in the first instance I mentioned, it is possible that holds by members of the majority party will never be made public. In the second instance, a literal interpretation of the provision might indicate that either leader could choose to keep a hold by a member of their party secret so long as they do not specify publicly that their objection is on behalf of another Senator. The Rules Committee letter claims the changes were intended to make the provision ``workable.'' It seems to me it is quite obvious that, unless somebody can answer these questions--I have asked the Parliamentarian and the Rules Committee and no answers yet--I don't see how the new provisions are any more workable than the original. On the contrary, they are not only unworkable, they undermine transparency. They make it more difficult for this body that is on television every day, where everything we do is the public's business. We want the public to know about it or we wouldn't be on television. Don't you think if a Senator has a hold on a bill, we ought to know who that Senator is and why he has a hold? Under the changes, not only is the disclosure of holds only required after formal objection has been made to a unanimous consent request, but Senators then have a full 6 session days to make their disclosure public. What is more, a new provision was added specifying that holds lasting up to 6 days may remain secret--remain secret--forever. What is the justification for that? Six days is more than enough time to kill a bill at the end of the session. And we are saying it is okay for Senators to do that in secret? There are other changes that are puzzling to me. For instance, our original measure required holds to be submitted in writing in order to be honored, to prevent staff from placing holds without the knowledge of the Senator. However, in the rewrite of what Senator Wyden and I originally put in, Senators now must be given written notice to the respective leaders of their ``intent to object'' only after the leader has already objected on the Senator's behalf. This is not only unworkable, but I think you would agree it sounds very absurd. I have stated repeatedly and emphatically that as a matter relating to Senate procedure, it would be completely illegitimate to alter in any way the original Senate-passed measure requiring full disclosure of holds. The U.S. Constitution makes clear, ``Each House may determine the rules of its proceedings.'' The hold is a unique feature of the Senate arising out of its own rules and practices, with no equivalent in the House of Representatives. As such, there is no legitimate reason why this provision, having already passed the Senate, should have been altered in the first place and in any way. Nevertheless, it was altered in a very substantial way. In fact, it was altered in a way that I fear will allow secrecy to continue in this institution. Clearly, the so-called Honest Leadership and Open Government Act was handled by the majority party in a way that is anything but what the title of the bill implies. So as you can tell, I have been frustrated so far in my attempts to find answers about how the rewritten provisions will be applied, but we will find out soon enough. Because I can assure you I will not give up until I am satisfied the public's business in this Senate is being done in a public way. Mr. President, I ask unanimous consent to have printed in the Record the letter I wrote to the Rules Committee and the response I got back.

Mr. GRASSLEY

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

Mr. GRASSLEY

Mr. GRASSLEY. Madam President, I am here to follow through on a promise I made back on June 13. At that time, after several speeches on the alternative minimum tax, I said I was going to continue talking about the alternative minimum tax until Congress took action to protect the roughly 19 million families and individuals who will be hit by it in 2007 who did not have to pay it in 2006--19 million families now affected who weren't affected last year. I am also here to talk about a promise Congress needs to follow through on, which is to protect these 19 million families and individuals from the alternative minimum tax for the tax year we are in right now, 2007. In 2006, 4.2 million families and individuals were captured by the AMT. For taxable year 2006, the legislation that temporarily increased the amount of income exempt from the alternative minimum tax expired. So, right now, and for the last 9 months, under current law, we expect around 23 million families and individuals to fall victim to the alternative minimum tax if Congress doesn't act. This chart illustrates the current situation, using the figures I have already referred to: 4.2 million people were paying the alternative minimum tax last year. But what is submerged underneath the surface there is the 19 million people who are affected because Congress has not taken action yet. Tax year 2007, then, is represented by the boat and is rapidly approaching the AMT iceberg. Right now, most of the iceberg--the part that represents the 19 million additional taxpayers who will be caught by the alternative minimum tax this year-- is under water. The full magnitude of this imminent disaster will become apparent when those 19 million families and individuals start working on their 2007 tax returns starting January 2 of next year. Actually, the situation is worse than I implied--if you can imagine that it can be any worse than that. I wish to say that many families have already fallen victim to the alternative minimum tax. Of course, I am referring to those taxpayers who have to file quarterly returns, quarterly estimated returns. The last time I spoke to you here on the Senate floor was on the occasion of the estimated tax payments for the second quarter due. I wish to say I am also speaking to my fellow Senators, but I am not sure how many of them might be listening because between June, when I spoke last, and the 3 months since, estimated tax payments for the third quarter were due this past Monday, September 17. Before I go further, I want to specifically address the size of the population that makes estimated tax payments. In case anyone is thinking this is a very small group of people, the statistics of the income division of the IRS state that for tax year 2004, almost 11 million families and individuals made estimated tax payments. I am not saying each of those filers would be captured this year by the alternative minimum tax, but I surely want to remind everybody of the possibility that the number of people making estimated tax payments is very large, and that those among them hit by the AMT--we have already failed them by not taking care of this before the first payments were made in January. As I have said, I last addressed the AMT on the Senate floor 3 months ago. In that time, no progress has been made on taking care of the problem of the AMT. The next chart actually portrays what the Senate leadership has accomplished in the past 3 months in regard to this issue. It shows a giant goose egg. I have served the people in Iowa in Congress for many years. In that time, I have learned that generally things do not happen overnight. It takes time to formulate ideas, and it takes time to build enough support to take action. That is why I am particularly unhappy with this giant goose egg. The current leadership has indicated that they have much they wish to accomplish this year. Time is rapidly running out and a plan for dealing with the AMT has not been proposed, much less a specific solution. The prospects of the AMT swallowing huge swaths of taxpayers is not a new problem. But until now, we have been able to keep it in check and not be 3 months away from 19 million more taxpayers being hit by it. Since 2001, the Finance Committee has produced bipartisan packages--I emphasize bipartisan--that have continually increased the amount of income that is exempt from the alternative minimum tax. This was possible thanks to the help of Senator Baucus, currently chairman of the Finance Committee. Together, Senator Baucus and I were able to minimize the damage caused by the AMT. These increases in exemptions, designed to keep pace with inflation and slow the spread of the alternative minimum tax, were never what I envisioned as a permanent solution. Rather, I consider a permanent solution to be the policies represented in a bill with the number S. 55, called the Individual Alternative Minimum Tax Repeal Act. Once again, I have to credit Chairman Baucus for his advocacy on behalf of tax fairness, as he introduced this bill with me, with Senators Crapo, Kyl, and Schumer signing on as cosponsors, and Senators Lautenberg, Roberts, and Smith also signed on as cosponsors. In case any of our friends in the House of Representatives are paying attention, a companion bill exists in H.R. 1366, called the Individual AMT Repeal Act. It was introduced by Congressman Phil English of Pennsylvania. What these bills--the ones I introduced in the Senate and Phil English's bill--accomplish is to completely repeal the AMT without offsetting it. That is, these bills do not replace taxes no longer collected from the AMT by raising taxes someplace else. I think it is very important to ensure that revenues that the Federal Government does not collect as a result of the alternative minimum tax reform are not collected someplace else. The alternative minimum tax was never meant to raise revenue from the middle class of America and was certainly not meant to bring in the amount of money under existing budget law and, oddly, that the Congressional Budget Office has to count. In other words, it should not be counted in the first place if you weren't intended to tax these middle-income taxpayers, but it happens because the AMT was not indexed. The AMT, then, was conceived as a way to promote basic tax fairness in response to concern about a very small number of wealthy taxpayers who were able to eliminate their entire income tax liability through legal means. The tax created to deal with this--the AMT--was originally, back in 1969, created with the impact at that time of affecting about 1 person out of 500,000. Now, over the course of 38 years, this small salute to tax fairness has grown into a monstrosity of a revenue raiser. The next chart is taken from the Long-Term Budget Outlook, a Congressional Budget Office publication. It was last published in December 2005. These are the latest figures I have. This illustrates how the alternative minimum tax will swallow more taxpayers as revenue is collected from the alternative minimum tax, being the green line on the chart, over a period of the next 45 years almost, or any time between now and the next 45 years. You can see how it continually grows. That is what the CBO, through the present budget laws, has to count. But they count it from people--remember, the middle-income people who were never supposed to pay it as opposed to the superrich, a very small number of people, who would take advantage of every legal loophole--I emphasize ``legal'' loophole--and not pay a regular income tax but pay the AMT. I suppose that is out of the theory that everybody living in this country, particularly the wealthy, ought to pay a little bit of tax as a matter of fairness. You can argue whether that is a good rationale, but that was the rationale back in 1969. So you can see that there is a massive amount of revenue projected to come in from people who were never supposed to pay it that somehow you are supposed to offset, so that that revenue that was never supposed to come in is not lost. I know that doesn't sound reasonable to the average commonsense American listening to me out there, but that is the way our budget laws are, and that is the way Congress has to respond to it, whether it makes sense or not. Left alone, the Congressional Budget Office calculates that more than 60 percent of the families and individuals in America will fall prey to the alternative minimum tax as it absorbs more than 15 percent of the total tax liability by the year 2050. This next chart, which is taken from the same congressional office publication, illustrates how under current law revenues collected by the Government are projected to push above their historical average and keep growing as the AMT brings in more and more money. We can see the historical average into the future for 40 years, but it follows a historical average going back 40 years before now, and because of the alternative minimum tax mostly but also for other law changes, current law, we are going to see the revenue coming in to the Federal Government growing to almost 25 percent of gross national product. From a philosophical point of view and economic point of view, what is wrong with that? Philosophically, there is less freedom for the Americans. As we spend more of their money, they have less economic freedom. But more importantly, the economic harm that comes from 535 Members of Congress spending 25 percent of the gross national product instead of using the historical average of about 18 percent, that 7 percent difference means we are going to make decisions on how to spend it instead of the 137 million taxpayers in this country deciding how to spend it, where it will turn over the economy more times than if we spend it and do more economic good and create more jobs and have more economic freedom. That is what is at stake in this whole debate if we do not do anything about the alternative minimum tax and it continues to grow to 15 percent of the total tax liability by the year 2050. This chart points out the increasing power of Congress through taking more money from the taxpayers without even changing the law if we do not do something about this alternative minimum tax. Anyone who maintains that the alternative minimum tax reform or repeal needs to be offset is not actually doing anything about the problem these charts illustrate. The problems the alternative minimum tax is responsible for are the ballooning Federal revenues above historical levels and a burden on middle-class taxpayers that keeps increasing over time. Offsetting the alternative minimum tax revenue does absolutely nothing to address these issues, and it seems to me to be an attempt to pretend to solve a real problem by actually trying to hide that problem. Aside from the long-term problems with the alternative minimum tax that we can solve by repealing it, the alternative minimum tax poses a short-term problem to the taxpayers who will fall into its clutches this year if Congress does not act. Putting aside the legitimacy of keeping this tax, it is not doing what it was intended to do. Putting aside the long-term solution, we are going to end up right now with 19 million more families and individuals being caught by the AMT this year. That 19 million will probably include many taxpayers making estimated tax payments. Some of these families and individuals may not be taking the AMT into account as they make their quarterly payments simply because they do not realize they ought to take this into consideration. Additionally, there may be some taxpayers who are required to make estimated tax payments when subject to the alternative minimum tax but are not required to make the estimated payments under the regular income tax system. At the end of this tax year, not only could those well-meaning filers find themselves subject to the alternative minimum tax, but they could also face the increased insult of being fined by the IRS for unintentionally miscalculating their estimated tax payments. I do not believe these well-intentioned taxpayers ought to be penalized because Congress has not come through on its promise to at least keep the AMT from running wild--in other words, going beyond those 4.5 million taxpayers who are already hit by it and not including the 19 million who are otherwise being hit because of inaction so far. That is why, on July 23, I dealt with this penalty issue by introducing S. 1855, called the AMT Penalty Protection Act. This legislation protects individuals from a penalty for failing to pay estimated taxes on amounts attributable to the AMT in cases where the taxpayers were not subject to the AMT last year. This is not a giveaway meant to compensate for the AMT, as it does not protect taxpayers who paid the AMT last year. Rather, this bill protects the families and individuals who do not yet appreciate the horrible impact our failure to act is going to have on them. I am not the only one who thinks this legislation is a good idea. We have these Senators--Senators Allard, Brownback, Collins, Hutchison, Smith, and Snowe--agreeing to cosponsor the legislation. In addition, I have received letters from the Committee on Personal Income Taxation, the New York City Bar, as well as the National Association of Enrolled Agents in support of the provisions of this safe harbor bill so that the IRS cannot apply interest and penalties resulting from the failure to pay estimated taxes on amounts resulting from the AMT in cases where the taxpayers were not liable for the AMT last year. I ask unanimous consent to have printed in the Record these letters to which I just referred.

Mr. GRASSLEY. Mr. President, I would like to believe this legislation is not necessary because we are going to prevent the AMT from swallowing 19 million taxpayers in 2000, but I am not optimistic considering the fact we have not acted yet. In closing, I encourage--and it is meant to encourage--the Democratic leadership to keep our promise with the American taxpayers and at least modify the exemption amounts for 2007. Of course, the best option is to completely repeal the AMT, and I am going to raise this issue with the Finance Committee members, and I am going to raise the issue with Members outside the committee. We ought to just get rid of it. It is stupid to be saying we are going to collect revenue from people who were never intended to pay, but we are counting that revenue. It is a big shell game. So I will be talking with my colleagues about the sensibility of just getting rid of something. I will tell my colleagues another reason for getting rid of the AMT. It is supposed to hit the super-rich. We are told by the IRS right now that there are about 2,500 of these super-rich who ought to be paying the alternative minimum tax--we would expect them to pay the alternative minimum tax--but they have found ways legally of even avoiding the alternative minimum tax. So we ought to just get rid of it. But for the time being, the only thing the taxpayers can rely on is the same goose egg we have been sitting on all year.

Mr. GRASSLEY. Mr. President, I also wish to use my time to address another issue. I would like to continue, Mr. President.

Mr. GRASSLEY

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

Mr. GRASSLEY. Mr. President, is the Senate in morning business?

Mr. GRASSLEY. I ask to speak--it will not be for a very long time but longer than the usual 10 minutes allotted.

Mr. GRASSLEY. I thank the Chair. (The remarks of Mr. Grassley pertaining to the introduction of S. 2041 are printed in today's Record under ``Statements on Introduced Bills and Joint Resolutions.'')

Mr. GRASSLEY. Mr. President, I yield the floor, and I suggest the absence of a quorum.

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

Mr. GRASSLEY

Mr. GRASSLEY. Mr. President, I wish to speak for a short period of time on another issue that I have been working on. Yesterday, the Journal of the American Medical Association published a study on the diabetes drug Avandia. This study concluded Avandia significantly increases the risk of heart attacks, a subject that Senator Baucus and I have been investigating for some months. You will remember that it was back in May that a study in the New England Journal of Medicine first alerted the public of an increased risk of heart attacks from Avandia. When that study was published, Senator Baucus, chairman of the Senate Finance Committee, and I raised concerns that the drugmaker had sought to silence a critic who voiced apprehension about Avandia back in 1999. Remember, this is 8 years ago. At the time, SmithKline Beecham manufactured Avandia. The company later merged with Glaxo Wellcome to form today's GlaxoSmithKline. According to the Wall Street Journal, GlaxoSmithKline said the allegations that the company silenced critics of Avandia were ``absolutely false.'' Today I would like to discuss some internal company communications that suggest otherwise. The person who first blew the whistle about cardiovascular problems with Avandia was Dr. John Buse. He was a professor at the University of North Carolina. Shortly after Avandia came on the market, back in 1999, Dr. Buse began warning his colleagues at medical meetings that the drug might be dangerous. How did this company respond when this professor brought up these issues? In an e-mail dated June 25, 1999, two company executives discussed ways to silence Dr. Buse. I would like to read parts of the e-mail. One executive wrote of a plan to ``write him a firm letter that would warn him about doing this again . . . with the punishment being that we will complain up his academic line and to the CME granting bodies that accredit his activities.'' CME stands for continuing medical education. I will come back to that in just a second. In response, another company executive e-mailed back, proposing to sue Dr. Buse and launched a media offensive promoting Avandia. Based on this e-mail exchange, it seems to me that at least two drug company officials did attempt to silence a critic. In fact, Dr. Buse stopped making any critical statements about Avandia shortly after this e-mail exchange. Scientists should be able to raise issues related to public health and safety in a free and uncensored manner, not the way they do things in China. And when these scientists are suppressed, we ought to consider that a very serious problem. The reason why is because the scientific process will take care of itself. If scientist Grassley has a suggestion and you think it is crazy, you are a scientist, my work can be reviewed by you and it has to stand the test of peer review. So I think it is a very good process, and if we just let it go on, it will show whether this scientist or that scientist is right or wrong. The scientific process, if suppressed, I say, is a very serious problem. But more important in this whole process, the American public loses. Instead of Avandia being more critically examined for safety, it was heavily marketed and became what experts have called the best selling diabetes drug in America. It has been reported to me that this huge volume of sales may have resulted in 60,000 to 100,000 heart attacks from 1999 until the year 2006--that is about 20 a day--from the users of Avandia. What happened to the company executives who sought to attack Dr. Buse for voicing his scientific opinion? Based on the information I have received to date, nothing has happened to these corporate executives. Let me return to the issue of continuing medical education. In the e- mail exchange I quoted, the two company officials discussed complaining about Dr. Buse to the accrediting bodies of continuing medical education. Every year, medical professionals must get continuing medical education credits to stay current in their profession. The continuing medical education companies and the doctors who teach the classes are supposed to be independent of drug companies that fund the courses. But I think we now know what we have often suspected: Continuing medical education courses often are not independent at all. In fact, the drug companies have a lot to say about what goes on in these courses and who gets paid to teach them. In April, the Finance Committee staff released a report on pharmaceutical company support of continuing medical education. Drug companies pour about $1 billion every year into continuing medical education, and the report noted that some educational courses have become veiled forms of advertising. Of course, this also ties in to last week's introduction of the bill I submitted called the Physicians Payments Sunshine Act. I introduced that bill with Senator Kohl, who is chairman of the Aging Committee, because Americans have a right to know how the drug companies are using money to try to shape the medical field. The bill requires drug and device companies to report payments and other gifts they give to doctors, bringing a little transparency to the practice of companies such as GlaxoSmithKline. I hope to see more of my colleagues sign on to this legislation. I cannot spotlight every instance where a drug company goes after an independent scientist with a stick, as they did with Dr. Buse, but together we can splash some sunlight on the financial carrots drug companies use to try to shape doctors' behavior. Before I yield the floor, I ask unanimous consent to have the e-mails I referred to printed in the Record.

Mr. GRASSLEY. I yield the floor, and I suggest the absence of a quorum.

Mr. GRASSLEY

Mr. GRASSLEY. Mr. President, for 27 years, I have come to the Senate floor to discuss legislation that will help the Government run efficiently and effectively. I have been an outspoken advocate for whistleblowers, which whistleblowers in good faith bring forth information about waste, fraud, and abuse of taxpayers' dollars. I have championed oversight efforts, and I have spent my time in the Senate asking the tough questions of Government bureaucrats in order to expose these problems, particularly problems that have been brought to my attention by patriotic whistleblowers. One thing I learned from oversight is that no matter how engaged Congress may be, there are not enough hands to find all the waste, fraud, and abuse in Government programs. Instead, we have to rely then, as I have indicated, on those courageous and patriotic individuals who speak out and blow the whistle, to go to court to collect Government money that was lost to unscrupulous contractors who are selling false or fraudulent goods, in the case of 100 years ago, to Union troops because that is why the False Claims Act came about, and to make sure that we protect whistleblowers when a program is not working and taxpayers' dollars are being lost. These whistleblowers, by sticking their necks out, are individuals often at risk. They risk everything to fix problems within our Government because they believe in doing their job the way it was intended to be done, and they probably do not get the attention of higher-ups in the bureaucracy. That is why they become whistleblowers and come to Congress to bring these faults out. Somehow they end up being as welcome in the bureaucracy as a skunk is at a picnic. However, pointing out fraud is one thing; getting results, fixing the problem, and recouping taxpayers' money lost to fraud, waste, and abuse is quite another thing. The key to recouping these lost funds is ensuring that we have effective laws on the books. One such law is the Federal False Claims Act. I have come to the floor today to remind people about the history of the False Claims Act, but also to suggest some improvements in that act so it can be an even more useful tool in the fight against waste, fraud, abuse, and the protection of whistleblowers. I have referred to the False Claims Act. This is known as the Lincoln law because it has some history going back to the Civil War. The Lincoln law was originally passed by Congress to combat war profiteering by Government contractors during the Civil War. The False Claims Act allowed individual citizen whistleblowers to go to court to collect Government money that was lost to unscrupulous contractors who were selling false or fraudulent goods to Union troops. This legal mechanism, known as qui tam, a Latin term, is the key component to the False Claims Act allowing individual citizens to act as private attorneys general to help stop fraud and recover lost money. However, following World War II, the False Claims Act was weakened by an act of Congress which lowered the penalties limiting the money the Government could recover from fraud. This remained the state and the language of the False Claims Act until 1986 when I authored amendments to the act which restored teeth and breathed new air and new life into a law that was designed to protect all American taxpayers. I am happy to report that in the 20 years since I introduced and Congress passed the 1986 amendment, the Federal Government has used the False Claims Act to recover over $20 billion from those who defraud Government. That is $20 billion that would otherwise be lost and gone forever. More importantly, this $20 billion serves as a deterrent reminder to those who wish to steal from the Government. We cannot measure the deterrent value of this legislation, but I personally feel, and I have had students of Government tell me, the deterrent value of the False Claims Act is much greater than even the $20 billion that we can quantify that has come back to the Federal Treasury. Today, the False Claims Act faces a situation where it may not be as effective as intended. Recent decisions by Federal courts have limited the False Claims Act in a way that was not envisioned when I authored the 1986 amendments. These court decisions threaten to undermine both the spirit and intent of the 1986 amendments. The first case, U.S. Totten v. Bombardier Corporation, held that false claims presented to Government grantees, in this case employees at Amtrak, were not actually presented to the Federal Government. As a result, the Government was precluded from recovering money lost to fraud and abuse perpetuated against Amtrak. The second case, Rockwell International Corporation, et al, v. U.S., was decided earlier this year by the U.S. Supreme Court. In this case, the Court interpreted an area of the False Claims Act, known as the public disclosure bar, which prohibits a false claims case from moving forward if the case is based upon publicly disclosed information, such as a government report, unless the whistleblower filing the case was the ``original source'' of the information. Now here, the Supreme Court held that a qui tam whistleblower was barred from receiving a share of any money recovered unless that whistleblower was the original source of all claims ultimately settled. Now, I say to my colleagues that this may not sound like a very troublesome decision. However, it is, and the impact is that oftentimes a case is brought by a whistleblower on a certain set of facts and then expanded by the Department of Justice, which ultimately settles on other grounds. As a result, this case creates a disincentive for a whistleblower to bring forth information about fraud, as they may not get to share in any part of the recovery. You see, one of the incentives for the whistleblowers is if they bring a case that brings back money into the Federal Treasury, they get part of that settlement as an incentive to do this. Quite frankly, a whistleblower sticks their neck out. By doing the right thing, they are probably ruining themselves professionally. Let us say that they get part of the recovery. Well, the Federal Government gets billions of dollars that we would not have even gotten if we had not had the information from the whistleblower. That is why the whistleblower is very important. Now, there is another case that gives us problems. This third case that challenges the intent of the False Claims Act is United States DRC v. Custer Battles, decided a year ago. In that case, a jury found that a defense contractor in Iraq had defrauded the Government of $10 million. However, the judge overturned the jury verdict, finding that the money lost was not U.S. taxpayer money but was instead Iraqi money under the control of the U.S. Government. As a result of this case, the U.S. Government may not recover for any fraud committed against the U.S. Government if the funds are not American funds, even if the U.S. Government has been entrusted with the management of those funds. These decisions, I can tell you as author of this legislation, are contrary to the spirit and the intent of the 1986 amendments. Today, I am joined by Senator Durbin as the lead cosponsor, along with Senator Leahy and Senator Specter--and in those two individuals I will say that Senator Leahy is chairman of the Judiciary Committee which has jurisdiction, and Senator Specter is the former chairman of the committee and now the Ranking Republican--so I feel by having Senator Durbin, Senator Leahy, and Senator Specter as cosponsors of this False Claims Act Correction Act, as powers within the Senate to bring attention to what the courts have done, this injustice to the False Claims Act and gutting of the False Claims Act, this act will bring it back to its original intent. This legislation will correct judicial interpretations damaging the False Claims Act. This bill is narrowly tailored to ensure that the intent of Congress in the 1986 amendments is upheld and nothing more. The False Claims Act Correction Act will correct these three judicial interpretations in addition to also making technical and correcting amendments. First, the bill will address the Totten decision by removing the requirement that false claims be directly presented to a government official, instead tying the liability directly to Government money and property. Next, the bill will address the Rockwell decision by requiring the Attorney General to file a timely motion to dismiss claims that violate the public disclosure bar. By allowing the Attorney General to present to the court information about public disclosures upfront in a case, the bill would eliminate procedural uncertainties that exist now by allowing public disclosures to be addressed at any time in the case. The False Claims Act Correction Act also clarifies that nontaxpayer funds under the trust and administration of the U.S. Government subject to fraud are actionable under the False Claims Act. Thus, money directly under the control of the U.S. Government subject to fraud that are currently outside the scope of the False Claims Act would now be covered. This will correct the problems that have arisen following the decision in the Custer Battles case. Additionally, the bill clarifies a split between the Federal Circuit Courts of Appeal that currently exists regarding whether a government employee may file a False Claims Act case. More specifically, the bill provides that a government employee would be able to bring a False Claims Act case based upon information learned in the course of their employment, only when the employee: No. 1, discloses the fraud to their supervisors; No. 2, discloses the fraud to the inspector general of that agency; and, No. 3, discloses the fraud to the Attorney General and then waits 12 months without the Government acting. After these conditions are met, then, and only then, may a government employee act as a qui tam whistleblower. Finally, the bill makes two technical corrections to the False Claims Act. The first is a technical-correcting amendment that clarifies the statute of limitations. The second is a technical amendment to the civil investigative demands that the Department of Justice is already authorized to issue. These technical corrections will streamline the procedures for filing as well as prosecuting False Claims Act cases by both qui tam whistleblowers as well as cases instituted originally by the Department of Justice. The False Claims Act Correction Act is a narrowly tailored bill that seeks to ensure the legislative intent of the 1986 amendments is truly understood. This is not a Democratic or Republican issue. It is an American taxpayer issue. I am proud to say this bill has strong bipartisan support, as I am joined by Senator Durbin as the lead Democratic cosponsor, and I wish to emphasize Senator Leahy's and Senator Specter's cosponsorship of this legislation. I am glad we have a bipartisan coalition ready to work to fix the False Claims Act with these narrowly tailored corrections, but I encourage my colleagues not to bow to special interest groups who have worked to weaken the No. 1 tool for recovering Government dollars lost to fraud. I will say at this point that yesterday I had a private discussion with a Senator who will go unnamed. He said, even as corrective as this legislation is, and it is only meant to be correcting, that already we have the pharmaceutical companies out working against this legislation. So this may not be easy to get through, even though it is sticking with the original intent. So I don't want to get into a situation such as I did in 1986, when we wrote a bill that was bipartisan, and it took about a year to get the various holds off that were put on this. In those days, we had secret holds. Under the new rules of the Senate, we are not supposed to have any secret holds anymore. So if people have complaints about this legislation, I wish to work it out, but I don't know how anybody can hold up legislation where the underlying legislation has brought $20 billion that would have otherwise been lost to fraud back to the Federal Treasury. The American taxpayers deserve a law that detects, prevents, and recovers money lost to fraud. The False Claims Act works and has recovered this $20 billion, and that law is 20 years old. But let me say this money didn't start rolling in until about 6 or 7 years after that 1986 law was passed. The False Claims Act Correction Act will provide necessary and narrowly tailored corrections to ensure that the False Claims Act works to protect the taxpayers into the future, as I visualized it would in 1986 in spirit as well as in letter. I urge my colleagues to support this important legislation. I have had the pleasure of having the Presiding Officer ask to be a cosponsor of the bill, so I ask unanimous consent that Senator Whitehouse be added as a cosponsor at this point.

Mr. GRASSLEY

Mr. GRASSLEY. Mr. President, for 27 years, I have come to the Senate floor to discuss legislation that will help the Government run efficiently and effectively. I have been an outspoken advocate for whistleblowers, which whistleblowers in good faith bring forth information about waste, fraud, and abuse of taxpayers' dollars. I have championed oversight efforts, and I have spent my time in the Senate asking the tough questions of Government bureaucrats in order to expose these problems, particularly problems that have been brought to my attention by patriotic whistleblowers. One thing I learned from oversight is that no matter how engaged Congress may be, there are not enough hands to find all the waste, fraud, and abuse in Government programs. Instead, we have to rely then, as I have indicated, on those courageous and patriotic individuals who speak out and blow the whistle, to go to court to collect Government money that was lost to unscrupulous contractors who are selling false or fraudulent goods, in the case of 100 years ago, to Union troops because that is why the False Claims Act came about, and to make sure that we protect whistleblowers when a program is not working and taxpayers' dollars are being lost. These whistleblowers, by sticking their necks out, are individuals often at risk. They risk everything to fix problems within our Government because they believe in doing their job the way it was intended to be done, and they probably do not get the attention of higher-ups in the bureaucracy. That is why they become whistleblowers and come to Congress to bring these faults out. Somehow they end up being as welcome in the bureaucracy as a skunk is at a picnic. However, pointing out fraud is one thing; getting results, fixing the problem, and recouping taxpayers' money lost to fraud, waste, and abuse is quite another thing. The key to recouping these lost funds is ensuring that we have effective laws on the books. One such law is the Federal False Claims Act. I have come to the floor today to remind people about the history of the False Claims Act, but also to suggest some improvements in that act so it can be an even more useful tool in the fight against waste, fraud, abuse, and the protection of whistleblowers. I have referred to the False Claims Act. This is known as the Lincoln law because it has some history going back to the Civil War. The Lincoln law was originally passed by Congress to combat war profiteering by Government contractors during the Civil War. The False Claims Act allowed individual citizen whistleblowers to go to court to collect Government money that was lost to unscrupulous contractors who were selling false or fraudulent goods to Union troops. This legal mechanism, known as qui tam, a Latin term, is the key component to the False Claims Act allowing individual citizens to act as private attorneys general to help stop fraud and recover lost money. However, following World War II, the False Claims Act was weakened by an act of Congress which lowered the penalties limiting the money the Government could recover from fraud. This remained the state and the language of the False Claims Act until 1986 when I authored amendments to the act which restored teeth and breathed new air and new life into a law that was designed to protect all American taxpayers. I am happy to report that in the 20 years since I introduced and Congress passed the 1986 amendment, the Federal Government has used the False Claims Act to recover over $20 billion from those who defraud Government. That is $20 billion that would otherwise be lost and gone forever. More importantly, this $20 billion serves as a deterrent reminder to those who wish to steal from the Government. We cannot measure the deterrent value of this legislation, but I personally feel, and I have had students of Government tell me, the deterrent value of the False Claims Act is much greater than even the $20 billion that we can quantify that has come back to the Federal Treasury. Today, the False Claims Act faces a situation where it may not be as effective as intended. Recent decisions by Federal courts have limited the False Claims Act in a way that was not envisioned when I authored the 1986 amendments. These court decisions threaten to undermine both the spirit and intent of the 1986 amendments. The first case, U.S. Totten v. Bombardier Corporation, held that false claims presented to Government grantees, in this case employees at Amtrak, were not actually presented to the Federal Government. As a result, the Government was precluded from recovering money lost to fraud and abuse perpetuated against Amtrak. The second case, Rockwell International Corporation, et al, v. U.S., was decided earlier this year by the U.S. Supreme Court. In this case, the Court interpreted an area of the False Claims Act, known as the public disclosure bar, which prohibits a false claims case from moving forward if the case is based upon publicly disclosed information, such as a government report, unless the whistleblower filing the case was the ``original source'' of the information. Now here, the Supreme Court held that a qui tam whistleblower was barred from receiving a share of any money recovered unless that whistleblower was the original source of all claims ultimately settled. Now, I say to my colleagues that this may not sound like a very troublesome decision. However, it is, and the impact is that oftentimes a case is brought by a whistleblower on a certain set of facts and then expanded by the Department of Justice, which ultimately settles on other grounds. As a result, this case creates a disincentive for a whistleblower to bring forth information about fraud, as they may not get to share in any part of the recovery. You see, one of the incentives for the whistleblowers is if they bring a case that brings back money into the Federal Treasury, they get part of that settlement as an incentive to do this. Quite frankly, a whistleblower sticks their neck out. By doing the right thing, they are probably ruining themselves professionally. Let us say that they get part of the recovery. Well, the Federal Government gets billions of dollars that we would not have even gotten if we had not had the information from the whistleblower. That is why the whistleblower is very important. Now, there is another case that gives us problems. This third case that challenges the intent of the False Claims Act is United States DRC v. Custer Battles, decided a year ago. In that case, a jury found that a defense contractor in Iraq had defrauded the Government of $10 million. However, the judge overturned the jury verdict, finding that the money lost was not U.S. taxpayer money but was instead Iraqi money under the control of the U.S. Government. As a result of this case, the U.S. Government may not recover for any fraud committed against the U.S. Government if the funds are not American funds, even if the U.S. Government has been entrusted with the management of those funds. These decisions, I can tell you as author of this legislation, are contrary to the spirit and the intent of the 1986 amendments. Today, I am joined by Senator Durbin as the lead cosponsor, along with Senator Leahy and Senator Specter--and in those two individuals I will say that Senator Leahy is chairman of the Judiciary Committee which has jurisdiction, and Senator Specter is the former chairman of the committee and now the Ranking Republican--so I feel by having Senator Durbin, Senator Leahy, and Senator Specter as cosponsors of this False Claims Act Correction Act, as powers within the Senate to bring attention to what the courts have done, this injustice to the False Claims Act and gutting of the False Claims Act, this act will bring it back to its original intent. This legislation will correct judicial interpretations damaging the False Claims Act. This bill is narrowly tailored to ensure that the intent of Congress in the 1986 amendments is upheld and nothing more. The False Claims Act Correction Act will correct these three judicial interpretations in addition to also making technical and correcting amendments. First, the bill will address the Totten decision by removing the requirement that false claims be directly presented to a government official, instead tying the liability directly to Government money and property. Next, the bill will address the Rockwell decision by requiring the Attorney General to file a timely motion to dismiss claims that violate the public disclosure bar. By allowing the Attorney General to present to the court information about public disclosures upfront in a case, the bill would eliminate procedural uncertainties that exist now by allowing public disclosures to be addressed at any time in the case. The False Claims Act Correction Act also clarifies that nontaxpayer funds under the trust and administration of the U.S. Government subject to fraud are actionable under the False Claims Act. Thus, money directly under the control of the U.S. Government subject to fraud that are currently outside the scope of the False Claims Act would now be covered. This will correct the problems that have arisen following the decision in the Custer Battles case. Additionally, the bill clarifies a split between the Federal Circuit Courts of Appeal that currently exists regarding whether a government employee may file a False Claims Act case. More specifically, the bill provides that a government employee would be able to bring a False Claims Act case based upon information learned in the course of their employment, only when the employee: No. 1, discloses the fraud to their supervisors; No. 2, discloses the fraud to the inspector general of that agency; and, No. 3, discloses the fraud to the Attorney General and then waits 12 months without the Government acting. After these conditions are met, then, and only then, may a government employee act as a qui tam whistleblower. Finally, the bill makes two technical corrections to the False Claims Act. The first is a technical-correcting amendment that clarifies the statute of limitations. The second is a technical amendment to the civil investigative demands that the Department of Justice is already authorized to issue. These technical corrections will streamline the procedures for filing as well as prosecuting False Claims Act cases by both qui tam whistleblowers as well as cases instituted originally by the Department of Justice. The False Claims Act Correction Act is a narrowly tailored bill that seeks to ensure the legislative intent of the 1986 amendments is truly understood. This is not a Democratic or Republican issue. It is an American taxpayer issue. I am proud to say this bill has strong bipartisan support, as I am joined by Senator Durbin as the lead Democratic cosponsor, and I wish to emphasize Senator Leahy's and Senator Specter's cosponsorship of this legislation. I am glad we have a bipartisan coalition ready to work to fix the False Claims Act with these narrowly tailored corrections, but I encourage my colleagues not to bow to special interest groups who have worked to weaken the No. 1 tool for recovering Government dollars lost to fraud. I will say at this point that yesterday I had a private discussion with a Senator who will go unnamed. He said, even as corrective as this legislation is, and it is only meant to be correcting, that already we have the pharmaceutical companies out working against this legislation. So this may not be easy to get through, even though it is sticking with the original intent. So I don't want to get into a situation such as I did in 1986, when we wrote a bill that was bipartisan, and it took about a year to get the various holds off that were put on this. In those days, we had secret holds. Under the new rules of the Senate, we are not supposed to have any secret holds anymore. So if people have complaints about this legislation, I wish to work it out, but I don't know how anybody can hold up legislation where the underlying legislation has brought $20 billion that would have otherwise been lost to fraud back to the Federal Treasury. The American taxpayers deserve a law that detects, prevents, and recovers money lost to fraud. The False Claims Act works and has recovered this $20 billion, and that law is 20 years old. But let me say this money didn't start rolling in until about 6 or 7 years after that 1986 law was passed. The False Claims Act Correction Act will provide necessary and narrowly tailored corrections to ensure that the False Claims Act works to protect the taxpayers into the future, as I visualized it would in 1986 in spirit as well as in letter. I urge my colleagues to support this important legislation. I have had the pleasure of having the Presiding Officer ask to be a cosponsor of the bill, so I ask unanimous consent that Senator Whitehouse be added as a cosponsor at this point.

Mr. GRASSLEY

Mr. GRASSLEY. Mr. President, it is with great sorrow, on this day of the 6th Anniversary of the September 11th attacks, that I speak in honor of a fallen American hero. Army Sgt. Kevin Gilbertson died August 31st at the Landstuhl Medical Center in Landstuhl, Germany, after losing a 2-day battle with injuries suffered after insurgents attacked his unit in Ramadi, Iraq. His courage and patriotism will be remembered. My thoughts and prayers go out to his friends and family, especially his parents, Keeley Peters and Don Gilbertson, as well as his wife, Nina, and sons, Timothy and Nickolas. Sergeant Gilbertson was an independent, complex, and highly involved individual. He loved his family, he loved his country, and he loved being a U.S. Army soldier. Kevin Gilbertson's service to this country is greatly appreciated, and he will be sorely missed. Kevin was a native of Cedar Rapids, IA. His father, Don Gilbertson, remembers him as ``the greatest kid in the world'' who ``joined the Army right out of high school to get a college education when he got out . . . His dream was getting a degree and supporting his family.'' Kevin Gilbertson will always be remembered as someone who gave everything he had for his country and who thought more about others than himself. For that we are eternally grateful.

Mr. GRASSLEY

Mr. GRASSLEY. Mr. President, on Tuesday Iowa gymnast Shawn Johnson and her USA teammates won the gold at the Gymnastics World Championships in Germany. Shawn is a native of West Des Moines, IA, where she has trained in gymnastics with Coach Liang Chow since the age of six. How did this young girl from Iowa become a world champion gymnast? I think it may have been said best by her coach in an interview with the Des Moines Register earlier this week. Coach Chow said Shawn, ``loved gymnastics. She loved to work out. She wanted to learn, and to get better.'' It is that love for what she does that carried Shawn to be crowned National Champion in San Jose, CA, two weeks ago, and carried her even higher to win the World Championship this week. I hope that Shawn's dedication to this sport will inspire many others to achieve greatness within their respective fields as well. It is with great Iowa pride that I offer my sincere congratulations to Shawn Johnson for her accomplishments.

Mr. GRASSLEY

Mr. GRASSLEY. Mr. President, a month ago I outlined an important issue affecting all Americans who take prescription drugs or use medical devices--the need for greater transparency in the money that drug and device companies hand out to doctors. Today, I am pleased to introduce the Physician Payments Sunshine Act, along with Senator Kohl, chairman of the Special Committee on Aging. This legislation will bring much needed transparency to the financial relationships that exist between the drug and device industries and doctors. There is no question that the drug and device industries have an intricate network of financial ties with practicing physicians. These financial relationships can take many forms. They can include speaking honoraria, consulting fees, free travel to exotic locations for conferences, or funding for research. Drug and device companies spend billions and billions of dollars every year marketing their products. A good amount of this money goes directly to doctors in the form of these payments. This practice, and the lack of transparency around it, can obscure the most important question that exists between doctor and patient: What is best for the patient? As the editorial board of the Des Moines Register wrote recently, and I quote, ``Your doctor's hands may be in the till of a drug company. So how can you know whether the prescription he or she writes is in your best interest, or the best interest of a drug company?'' That is an excellent question. Currently, the public has no way of knowing whether their doctor has taken payments from the drug and device industries, and I intend to change that--not just for Iowans but for all Americans. Payments to a doctor can be big or small. They can be a simple dinner after work or they can add up to tens of thousands and even hundreds of thousands of dollars each year. That is right--hundreds of thousands of dollars for one doctor. It is really pretty shocking. Companies wouldn't be paying this money unless it had a direct effect on the prescriptions doctors write, and the medical devices they use. Patients, of course, are in the dark about whether their doctor is receiving this money. The Physician Payments Sunshine Act sheds light on these hidden payments and obscured interests through the best disinfectant of all: sunshine. This is a short bill, and a simple one. This bill requires drug and device manufacturers to disclose to the Secretary of Health and Human Services, on a quarterly basis, anything of value given to doctors, such as payments, gifts, honoraria, or travel. Along with the money, these companies will have to report the name of the physician, the value and the date of the payment or gift, its purpose, and what, if anything, was received in exchange. This bill then requires the Department of Health and Human Services to make the information available to the public through a searchable web site. And this bill has some teeth, too. If a company fails to report, the Physician Payments Sunshine Act imposes a penalty ranging from $10,000 to $100,000 for each violation. Many States are ahead of the curve on this and have passed, or are currently considering, similar measures. In 1993, Minnesota required the Nation's first public disclosure of gifts and payments from wholesale drug distributors. Vermont passed a similar law in 2003, although much of the information is not publicly available. More recently, the District of Columbia, Maine, and West Virginia have followed suit in requiring disclosure, though not all make the information available to the public through a web site. The General Assembly in my home State of Iowa may soon be requiring disclosure as well. But this kind of information shouldn't be available only to Americans who happen to be lucky enough to live in a State already addressing this problem. On the contrary, this information should be accessible to all Americans across the country and it should be updated in a timely manner. I propose to my colleagues that now is the time to act. I realize that some critics, including many of the drug and device companies, are going to say that creating this sort of national database is too time consuming and too expensive. I can hear the complaints already. But let me remind you again--the drug companies are already reporting their payments to doctors in Minnesota and other States. Companies already have this information available. We aren't requiring them to go out and obtain it--we are just asking them to share it with the American people. Perhaps even more telling is that at least one industry leader has taken the goal of increased transparency into its own hands. Although it is not making its payments to doctors publicly available, Eli Lilly has taken important steps to meet the public's demand for increased sunshine. In response to my investigation of drug company payments for continuing medical education, Eli v Lilly voluntarily created a web site that details payments they make to organizations like patient groups and hospitals. I commend Eli Lilly for taking the lead on that issue, and I look forward to working with them on my latest effort. This bill is careful not to burden small businesses--it applies only to companies with annual revenues over $100 million. It is the largest companies who are driving this practice, and for whom disclosure would be least burdensome. Further, during a meeting on a separate matter with officials from Glaxo Smith Kline in early August, my staff brought up the idea of drug companies reporting payments to physicians. I am happy to say that Dr. Moncef Slaoui, the chairman of research and evelopment for Glaxo Smith Kline, said that he was also interested in a little sunshine. In fact, here are his exact words: ``We're happy for transparency.'' I would like to commend Dr. Slaoui for his comments and I look forward to working with him and leaders at other companies on this bill. It is not only industry leaders who are leading the way on the issue of increased transparency--some of America's best medical schools are taking steps to prevent conflicts of interest among their physicians. In fact, the Yale University School of Medicine, the University of Pennsylvania, and the Stanford University Medical School have gone so far as to prohibit certain gifts and payments altogether. So let me be clear. This bill does not regulate the business of the drug and device industries. I say, let the people in the industry do their business. After all, they have the training and the skill to get that job done. Just keep the American people apprised of the business you are doing and how you are doing it. Let a little bit of sunshine in to this world of financial relationships--it is, after all, the best disinfectant.

Mr. GRASSLEY

Mr. GRASSLEY. Mr. President, a month ago I outlined an important issue affecting all Americans who take prescription drugs or use medical devices--the need for greater transparency in the money that drug and device companies hand out to doctors. Today, I am pleased to introduce the Physician Payments Sunshine Act, along with Senator Kohl, chairman of the Special Committee on Aging. This legislation will bring much needed transparency to the financial relationships that exist between the drug and device industries and doctors. There is no question that the drug and device industries have an intricate network of financial ties with practicing physicians. These financial relationships can take many forms. They can include speaking honoraria, consulting fees, free travel to exotic locations for conferences, or funding for research. Drug and device companies spend billions and billions of dollars every year marketing their products. A good amount of this money goes directly to doctors in the form of these payments. This practice, and the lack of transparency around it, can obscure the most important question that exists between doctor and patient: What is best for the patient? As the editorial board of the Des Moines Register wrote recently, and I quote, ``Your doctor's hands may be in the till of a drug company. So how can you know whether the prescription he or she writes is in your best interest, or the best interest of a drug company?'' That is an excellent question. Currently, the public has no way of knowing whether their doctor has taken payments from the drug and device industries, and I intend to change that--not just for Iowans but for all Americans. Payments to a doctor can be big or small. They can be a simple dinner after work or they can add up to tens of thousands and even hundreds of thousands of dollars each year. That is right--hundreds of thousands of dollars for one doctor. It is really pretty shocking. Companies wouldn't be paying this money unless it had a direct effect on the prescriptions doctors write, and the medical devices they use. Patients, of course, are in the dark about whether their doctor is receiving this money. The Physician Payments Sunshine Act sheds light on these hidden payments and obscured interests through the best disinfectant of all: sunshine. This is a short bill, and a simple one. This bill requires drug and device manufacturers to disclose to the Secretary of Health and Human Services, on a quarterly basis, anything of value given to doctors, such as payments, gifts, honoraria, or travel. Along with the money, these companies will have to report the name of the physician, the value and the date of the payment or gift, its purpose, and what, if anything, was received in exchange. This bill then requires the Department of Health and Human Services to make the information available to the public through a searchable web site. And this bill has some teeth, too. If a company fails to report, the Physician Payments Sunshine Act imposes a penalty ranging from $10,000 to $100,000 for each violation. Many States are ahead of the curve on this and have passed, or are currently considering, similar measures. In 1993, Minnesota required the Nation's first public disclosure of gifts and payments from wholesale drug distributors. Vermont passed a similar law in 2003, although much of the information is not publicly available. More recently, the District of Columbia, Maine, and West Virginia have followed suit in requiring disclosure, though not all make the information available to the public through a web site. The General Assembly in my home State of Iowa may soon be requiring disclosure as well. But this kind of information shouldn't be available only to Americans who happen to be lucky enough to live in a State already addressing this problem. On the contrary, this information should be accessible to all Americans across the country and it should be updated in a timely manner. I propose to my colleagues that now is the time to act. I realize that some critics, including many of the drug and device companies, are going to say that creating this sort of national database is too time consuming and too expensive. I can hear the complaints already. But let me remind you again--the drug companies are already reporting their payments to doctors in Minnesota and other States. Companies already have this information available. We aren't requiring them to go out and obtain it--we are just asking them to share it with the American people. Perhaps even more telling is that at least one industry leader has taken the goal of increased transparency into its own hands. Although it is not making its payments to doctors publicly available, Eli Lilly has taken important steps to meet the public's demand for increased sunshine. In response to my investigation of drug company payments for continuing medical education, Eli v Lilly voluntarily created a web site that details payments they make to organizations like patient groups and hospitals. I commend Eli Lilly for taking the lead on that issue, and I look forward to working with them on my latest effort. This bill is careful not to burden small businesses--it applies only to companies with annual revenues over $100 million. It is the largest companies who are driving this practice, and for whom disclosure would be least burdensome. Further, during a meeting on a separate matter with officials from Glaxo Smith Kline in early August, my staff brought up the idea of drug companies reporting payments to physicians. I am happy to say that Dr. Moncef Slaoui, the chairman of research and evelopment for Glaxo Smith Kline, said that he was also interested in a little sunshine. In fact, here are his exact words: ``We're happy for transparency.'' I would like to commend Dr. Slaoui for his comments and I look forward to working with him and leaders at other companies on this bill. It is not only industry leaders who are leading the way on the issue of increased transparency--some of America's best medical schools are taking steps to prevent conflicts of interest among their physicians. In fact, the Yale University School of Medicine, the University of Pennsylvania, and the Stanford University Medical School have gone so far as to prohibit certain gifts and payments altogether. So let me be clear. This bill does not regulate the business of the drug and device industries. I say, let the people in the industry do their business. After all, they have the training and the skill to get that job done. Just keep the American people apprised of the business you are doing and how you are doing it. Let a little bit of sunshine in to this world of financial relationships--it is, after all, the best disinfectant.

Mr. GRASSLEY

Mr. GRASSLEY. Mr. President, it is with great sorrow that I speak today in honor of a fallen soldier. American hero MSG Scott M. Carney was killed in military operations on August 24, 2007. My deepest sympathy and prayers go out to Scott's wife Jeni and twin sons Jacob and Justin. I also express sincere sympathy and gratitude to his parents Geneva and John Carney and his brothers and sister. An Ankeny, IA, resident, Scott was killed during a humvee rollover near Herat, Afghanistan. Scott was a member of the Iowa National Guard's 2nd Brigade Combat Team, 34th Division out of Boone, IA. Scott enlisted in the U.S. Army in 1989 and had been a member of the 2nd Brigade Combat Team since 2004. Scott will be fondly remembered and missed dearly. His wife described Scott by saying he ``died doing what he loved, serving his country and protecting the freedom that we enjoy and providing the people of Afghanistan with the opportunity for freedom.'' I know I speak on behalf of all Iowans when I express gratitude for Scott's 18 years of military service. While I speak today with great sorrow, I also speak with great pride; pride in having soldiers like Scott, willing to make the ultimate sacrifice. A fellow soldier lent an apt description of Scott when he said ``the Army was his life. He loved his family dearly and was a great family member. He was also part of the team.'' I ask all Americans to spend a moment today in prayerful gratitude for the family of a true American patriot, fallen hero MSG Scott M. Carney.

Mr. GRASSLEY

Mr. GRASSLEY. Mr. President, I speak today with great sorrow as we have lost a great American. A Fort Dodge native, Marine Sergeant Jon ``J.J.'' Bonnell died while serving his country in Iraq on August 7, 2007. Sergeant Bonnell stepped on a roadside bomb while on duty between Baghdad and Fallujah. He was part of the 1st Battalion, 11th Marine Regiment, based in Camp Pendleton CA. My prayers and deepest sympathy go out to J.J.'s parents, Jon Bonnell, Sr., and Denise Roark, as well as to his three sisters and all his family and friends. I also wish to express my sympathy to the community of Fort Dodge, who not only lost a fine young man, but an exemplary soldier. J.J. will be remembered fondly and missed dearly. Only 22 years old, multiple students at Fort Dodge Senior High School referred to J.J. as a ``hero,'' a label he greatly deserves. Making the ultimate sacrifice, J.J. deserves the gratitude of every American. An uncle described J.J. by saying ``He loved doing what he did, and he gave the ultimate sacrifice. He said he was ready for the ultimate sacrifice.'' This speaks volumes for J.J.'s character, and we as Iowans and Americans are fortunate and honored to have a man with J.J.'s devotion and dedication serving our Nation. J.J. enlisted in the Marine Corps as a senior in high school in 2003. He assisted victims of the 2004 tsunami in Southeast Asia after his first tour in Iraq. A deeply dedicated marine, his grandmother recounted that J.J. ``thought all the marines were heroes.'' On behalf of all Iowans, I offer my most sincere appreciation for J.J.'s service to our Nation. I ask my colleagues in the Senate, and every American, to take a moment and remember with honor and gratitude the ultimate sacrifice of a true patriot, Sgt. Jon Bonnell, Jr.

Mr. GRASSLEY

Mr. GRASSLEY. Mr. President, I express my deep concern about the developing trends in drug abuse among our kids. As cochairman of the Senate Caucus on International Narcotics Control, I am often confronted with reports about the latest drug trends, but recently I have become more alarmed with what these reports contain. Drug dealers are beginning to market their deadly substances to an increasingly younger crowd so they can become hooked at a younger age. Young people are the most at-risk populations we have in drug abuse, which is why it is disturbing to see highly addictive drugs such as meth, heroin, even prescription pain killers, antidepressants, and steroids marketed and distributed in new ways--with an emphasis upon new ways--to get a greater number of very young people, particularly elementary children, addicted. I want Congress and the American people to know what is going on with our kids and what we need to do to stop these very dangerous trends. We have things such as candy-flavored methamphetamine. It is one of the biggest and latest gimmicks that drug dealers use to lure our kids into addiction. Flavors such as strawberry, known as ``Strawberry Quick,'' and chocolate are clearly being used to make methamphetamine seem less harmful and more appealing. This type of meth is also being marketed in smaller amounts, making it cheaper--because money is an issue--and, hence, more accessible to children. At least eight States have reported cases of candy-flavored meth, and many law enforcement officials are expecting Strawberry Quick to infiltrate their States in the near future. What is even more disturbing is that many kids may not realize they are using a deadly substance. In fact, that is the motivation behind the drug dealers and distributors. According to my colleague Senator Feinstein, some kids reported that they thought Strawberry Quick was an energy drink and were misled by drug dealers into trying meth for the first time. Methamphetamine abuse has reached epidemic proportions, and the fact that drug dealers are trying to get children addicted at such a young age underscores the importance of taking quick action to eliminate this danger. That is why I joined my colleague Senator Feinstein in introducing the Saving Kids From Dangerous Drugs Act. This legislation will double the Federal criminal penalties for drug dealers who flavor or disguise illegal drugs to make them more appealing to people under age 21, and it will triple the penalties for repeat offenders. I hope my colleagues will take a look at this piece of legislation and join Senator Feinstein and me in passing this legislation soon, because we have to end the practice of purposefully altering illegal drugs to make them more appealing to young people in order to get more people hooked at a very early age. The ongoing revelations of widespread steroid abuse in professional sports, along with the recent suicide of World Wrestling Entertainment superstar Chris Benoit, highlight a disturbing trend in sports and the entertainment world, and it has a lasting impact upon our kids. It is alleged that Benoit killed his wife and 7-year-old son in what is commonly called a ``roid rage,'' which is caused by a chemical imbalance in the brain brought on by steroid abuse. If this is proven true, it will be yet another tragic tale of the destructive nature of steroids. What is even more tragic is the fact that steroid abuse among high schoolers has been rising. The 2006 Monitoring the Future Survey, a study done annually to monitor drug abuse among middle and senior high school students, shows that the percentage of 12th graders who have admitted trying steroids has increased dramatically. Kids look up to these athletes and performers as role models. We know that. When they see their heroes using these terrible substances, they get the impression that it is okay to use steroids. Steroids are also marketed to kids. Students who participate in sports are facing enormous pressure to perform at high levels, and we are seeing more and more teens turn to steroids to gain an athletic advantage. You can find Web sites encouraging teens to buy substances called DHEA, which has been declared a steroid by the U.S. Anti-Doping Agency, as a new way to bulk up. The major sports leagues, with the exception of Major League Baseball, have banned DHEA, even though it remains legal in this country. Though DHEA is used as a legitimate supplement for thousands of people, teens are using it as an alternative to illegal steroids. I introduced a bill earlier this year that would reinstate the ban that was imposed on DHEA in the 1980s, but I think we can find a way to keep minors from obtaining this substance while allowing adults to use the drug legitimately. GNC, the world's leading dietary supplement provider, has a policy not to sell DHEA to anyone under 18, and for good reason. We need to pass that legislation as soon as we can. We should also take note of one of the fastest emerging drug trends among kids today--the abuse of prescription drugs. Most people don't even realize that their medicine cabinets can contain drugs just as powerful, just as addictive as meth and heroin. Because they are prescribed by a doctor, and millions of people use them, kids think anti-anxiety drugs such as Xanax and pain killers such as Vicodin and OxyContin are harmless. Several examples of abuse occur every day when kids come home from school and take a pill to relax. But eventually one pill is not enough to make them feel better. Soon these kids take more pills and try different mixtures until they can obtain a sufficient high, and that is often with deadly results. What is so troubling about this is a significant number of teens are experimenting with prescription drugs. According to a 2005 study conducted by the Partnership for a Drug-Free America, one in five teens has admitted using pain killers to get high, and the organization reports it is even getting worse. The 2006 Monitoring the Future Survey shows that the abuse of prescription drugs has doubled since 2002. Access to these drugs is widespread. Not only can teens obtain these drugs from home or in school, they can also get them on line and through ``pharm parties.'' Law enforcement officials have increasingly broken up pharm parties where teens grab prescription drugs from home and pass them around to friends. These drugs are often pooled in large bowls and young people take a pill or two, but they have no idea what pill they are taking. There are hundreds of Internet video clips where teens appear strung out on pills and alcohol as a result of pharm parties. We need to do a better job as parents and legislators to educate and prevent these fast-growing trends from reaching epidemic proportions. We have to educate the public about the proper ways to dispose of old medicines, and we need to help law enforcement deal with the large amount of illegal purchases at online pharmacies. Another sad trend is taking hold in Dallas, TX, where earlier this summer a 17-year-old high school student became the 23rd victim of a drug called ``cheese.'' ``Cheese heroin'' is a mixture of black tar heroin and Tylenol PM that is usually smoked or snorted and often very deadly. Because it resembles actual cheese and can be purchased for as little as $2 a hit, more kids in the Dallas area have been trying the new drug with terrible results. Though cheese heroin has only been seen in the Dallas area, don't think for a second it is going to stay in the Dallas area. Cheese heroin is cheap and being marketed solely to children. Law enforcement officials will be the first to tell you that the new drugs tend to emerge in the larger cities and then move out to the suburbs. We should all be concerned about the drug trend in Dallas, because the sooner we can stem it, the better we can prevent it from spreading across the country. The good news is that the people in the Dallas community are not taking this new drug lightly. We have school officials and police who have been holding assemblies, lectures, PTA meetings, and classroom discussions to get the word out about cheese heroin. A public service announcement, made in Dallas by local students, is currently airing throughout the area, and a hotline number has been taking a large number of calls for those seeking assistance to keep their loved ones from succumbing to this cheese heroin. Hopefully, their efforts will stop cheese in its tracks and maybe protect the rest of us around the country. The Greater Dallas Council on Alcohol and Drug Abuse established a task force that is responsible for this effort. The key to this task force's success is that it incorporates all sectors of the Dallas community. Engaging and involving all sectors of our local communities is one of the best solutions to keeping our children from abusing drugs. That is why I formed, about 10 years ago, an organization called the Face It Together Coalition--we call it FIT for short--in my effort to combat drug abuse in my own State of Iowa. My goal with Face It Together is to bring to the same table parents, educators, businesses, religious leaders, law enforcement officials, health care providers, youth groups, and members of the media to promote new ways of thinking about how to reach and educate Iowans about the dangers of drug abuse. With everyone working together, we will make a difference in our communities. Moreover, together we can build healthy children, healthy families, healthy communities, and a healthy future. In closing, I believe we have a moral obligation to ensure that our young people have a chance to grow up without being accosted by drug dealers at every turn, and particularly when they are in elementary school. We need as a country to create a strong moral context to help our kids know how to make the right choices. Research has shown time and again that if you can keep a child drug free until the age of 20, chances are very slim that they will ever try or become addicted. That is the task we face. We owe it to ourselves and the future of our country to protect our kids from drugs. Mr. President, I yield the floor

Mr. GRASSLEY

Mr. GRASSLEY. Mr. President, I want to take a few minutes to explain the action I am taking related to S. 1693, the Wired for Health Care Quality Act. Today, with great reluctance, I have asked Republican Leader McConnell to consult with us prior to any action regarding the consideration of this bill, which the Health, Education, Labor, and Pensions Committee reported on August 1, 2007. The Wired for Health Care Quality Act would encourage the development of interoperable standards for health information technology, IT, offer incentives for providers to acquire qualified health IT systems to improve the quality and efficiency of health care, and facilitate the secure exchange of electronic health information. The bill also includes provisions to require all federal agencies to comply with standards and specifications adopted by the Federal Government for purposes determined appropriate by the Secretary of Health and Human Services, HHS, and to ensure quality measurement and reporting of provider performance under the Public Health Service Act. I fully support fostering the adoption of health information technology to assist providers in making quality improvements in our health care system. In 2005, Senator Baucus and I introduced the Medicare Value Purchasing Act, S. 1356, in conjunction with Senators Enzi and Kennedy's legislation known as the Better Healthcare Through Information Technology Act, S. 1355. Although the Medicare Value Purchasing Act did not pass in its entirety, provisions based on our bill have been enacted in other legislation. Medicare is the single largest purchaser of health care in the Nation, so adopting quality payments in Medicare influences the level of quality in all of health care. We have seen time and time again how when Medicare leads, the other public and private purchasers follow. Medicare can drive quality improvement through payment incentives. The adoption of information technology is also desirable, both to facilitate the reporting of quality measures and to increase the efficiency and quality of our health care system. These two concepts should work together. A number of legislative initiatives have been enacted in Medicare in recent years to promote the development and reporting of quality measures. The Medicare Prescription Drug, Improvement, and Modernization Act of 2003, MMA, included provisions that required the reporting of quality measures for inpatient hospitals. The Deficit Reduction Act of 2005 expanded the reporting of quality measures for inpatient hospital services and extended quality measures to home health settings. Last year, the Tax Relief and Health Care Act of 2006, TRHCA, extended quality measure reporting to hospital outpatient services and ambulatory service centers. TRHCA also authorized the 2007 Physician Quality Reporting Initiative, PQRI, a voluntary quality reporting system in Medicare for physicians and other eligible health care professionals. Beginning July 1, 2007, the new PQRI program provides Medicare incentive payments for the successful reporting of quality measures that have been adopted or endorsed by a consensus organization. The Centers for Medicare and Medicaid Services, CMS, has worked diligently with the American Medical Association Physician Consortium for Performance Improvement, the Ambulatory Quality Alliance, and the National Quality Forum in the development, adoption, endorsement, and selection of quality measures for this program. Considerable time and effort have been devoted to the development and reporting of quality measures for various providers in Medicare under the Social Security Act. Many of these programs have now been up and running for some time. This is why I am greatly troubled that, as currently drafted, the Wired for Health Care Quality Act would require the development and reporting of quality measures under the Public Health Service Act. It is hard to comprehend how the quality measurement system created by S. 1693 would interact with the various quality measurement programs that have already been enacted by Congress under the Social Security Act and implemented by CMS. Creating two different quality measurement systems would have the potential to create differing or even duplicative quality measurement systems which could drastically interfere with our common goal of improving the quality of health care in this country. Under the bill, the Secretary also would establish Federal standards and implementation specifications for data collection. Within three years of their adoption, all Federal agencies would have to implement these standards according to the specifications. While this sounds appealing, I am concerned about the reality of implementing such standards--across the myriad programs at the Departments of Health and Human Services, Veterans Affairs, Defense, and all the other Federal agencies that may have health care data. It would be an enormous challenge. Agencies collect data for many different purposes, using many different data systems. Six years ago, when Secretary Thompson first arrived at the Department of Health and Human Services, the department had eight different computer systems. Presumably other agencies similarly have multiple systems. All will be expensive and difficult to retrofit to meet new federal standards. The bill also would require the HHS Secretary to provide federal health data, including the Medicare claims databases, to at least three ``Quality Reporting Organizations'' that agreed to provide public reports based on the data. The Quality Reporting Organizations would be required to release regular reports on quality performance that are provider- and supplier- specific. Any organization, including those with commercial interests, could request that the Quality Reporting Organizations compile specific reports based on the requester's methodology. So, for example, drug companies could request data on physician prescribing patterns to determine which physicians their salespeople should target. In overseeing Medicare, Congress is working to bring more quality reporting into the program. As I mentioned before, just this past December Congress enacted the Tax Relief and Health Care Act of 2006, which implemented a physician pay-for-reporting program in Medicare. The Finance Committee has been working for some time now to phase-in the use of quality measures with various providers. Eventually, I hope that Medicare can compensate providers appropriately for providing high-quality care. I am, however, concerned about public disclosure of provider-specific information without appropriate safeguards. If not used properly, the data could be misinterpreted. For example, hospitals that specialize in very difficult cases might seem to provide lower quality of care than those treating less severe cases. This would set up the wrong incentives for hospitals and other health care providers. I agree that it would be helpful to standardize data reporting throughout the federal government, and to use that data appropriately to assess the quality of care provided by clinicians, hospitals, and other health care organizations. At the same time, I have serious concerns about how this bill is structured with respect to the disclosure and use of the data from federal health entitlement programs which are within the sole jurisdiction of the Finance Committee. I welcome the opportunity to work with the sponsors of S. 1693, Senators Kennedy, Enzi, Clinton, and Hatch, along with members of the Health, Education, Labor, and Pensions Committee on this matter. I had hoped we could work out an agreement on legislative language that was acceptable to both the Finance Committee and the HELP Committee before the bill was on the floor. I appreciate the efforts that my colleagues, Senators Enzi and Kennedy, have undertaken with us over the last month to resolve the concerns of the Finance Committee. However, I remain deeply troubled that, as currently drafted, the Wired for Health Care Quality Act could end up unintentionally delaying or frustrating the goal we all share of improving the quality of health care for all Americans.