Tom Harkin

Mr. HARKIN

Mr. HARKIN. I yield 15 minutes to the Senator.

Mr. HARKIN. I thank my friend from Minnesota. The Senator makes a good point. I am going to have some more data on how much money was raised in the last cycle and what this might mean, but in terms of time, let's be honest about it. How much time do we spend on the phone raising money and traveling on weekends, going here and there? This would help us because now we can spend more time in our States, meet with people, spend more time, as you say, around the coffee tables in the small cafes and restaurants rather than running all over the country trying to raise money all the time. I think the Senator makes a good point on that. It will bring us closer to representative democracy.

Mr. HARKIN. Mr. President, so far as I see, we have done a lot of good things in the McCain-Feingold bill. We rejected a lot of bad amendments. It looks good. But all in all, the way our campaigning financing system is today, it is still an incumbent protection system. It is still incumbent protection. For example, in the 2000 election, the average incumbent raised $4.5 million, while the average challenger raised $2.7 million. This helps to level that playing field a little bit. I also point out the statistics that in the 2000 election cycle, Senate candidates spent $434.4 million in hard money. If we had had this voluntary limit in existence in the 2000 election, Senate candidates would have spent $113.4 million, a difference of $321 million less than Senate candidates would have had to raise in the 2000 election. I think we would have had better campaigns, and we would have had better issue-oriented campaigns in the 2000 election cycle. That $321 million represents how many hours, how many days, and how many times Senators have to travel all over the country and have to get on the phone to raise the money, as Senator Wellstone said, when those Senators could be in their home State meeting with their constituents? I yield 10 minutes to my colleague from North Dakota.

Mr. HARKIN. I am happy to yield it.

Mr. HARKIN. No public financing.

Mr. HARKIN. That is true.

Mr. HARKIN. That is fine.

Mr. HARKIN. Mr. President, I want to respond and maybe get in a little colloquy with my friend from Kentucky. I appreciate the struggle he has had with the logic of his argument. But, quite frankly, I think the logic is somewhat unsound. My friend from Kentucky talks about a challenger out there, someone who wants to run for the Senate who has a message, such as Senator Dodd talked about, someone who has an idea, some convictions and issues they want to bring out. They want to run for the Senate. The Senator from Kentucky says, rightfully, that they need some money to get that message out and, by putting this limit on it, they would not be able to spend any more to get their message out than, say, an incumbent. Of course, we have access to the airwaves and the newspapers and all that kind of stuff. So a challenger might want to have more money. Well, again, to attack the logic of that is to look at the facts. In the 2000 election, the average incumbent raised $4.5 million--the incumbent--us--to get our message out. The average challenger raised $2.7 million. So under the present system, the challenger can't get that message out. He is swamped by what we can raise.

Mr. HARKIN. Yes, I will, in a second. Now in the amendment I am offering, they would be equal in terms of how much they could raise to spend. In fact, this amendment would help any of those challengers out there to get the message out.

Mr. HARKIN. Mr. President, again, the Senator's reasoning flies in the face of facts. That is why his reasoning is specious. Look at the data. In the last election cycle, incumbents had $4.5 million, challengers had $2.7 million. I will tell you what; I dare my friend from Kentucky to go out and ask any challenger who ran in the last race if they would have accepted this kind of a deal. They could spend as much money as the incumbent in the campaign. I will bet you, you would find very few who would turn that offer down, if they could keep the incumbent down, keep them at the same level. That is why I say I think the reason flies in the face of the facts.

Mr. HARKIN. Let's take this analogy of the football field. You are right. Both of us have been on the same side. I have been a challenger running against a sitting Senator, and so have you. And we have run as incumbents. We have seen both sides of this. Now, I suppose all things being equal, I would rather be an incumbent, obviously. But there are certain advantages to not being an incumbent. As I remember, when I ran, I had an open field. I am on the 5-yard line, the incumbent Senator is on the 30-yard line. But guess what. I am out there every day. I am in that State every day getting my message out from town to town, community to community, newspaper to newspaper, radio show to radio show. The person sitting here has to be in the Senate all year long. So I had a great advantage. The challenger has a great advantage. That field is open. The Senator starting on the 30-yard line goes from one side, to the other side, to the other side before he gets down to the end of the field. That challenger is open. So I have to tell you that even though the incumbent has some advantages of being an incumbent in the newspapers and elsewhere, a challenger has advantages from being out there all the time. You know that as well as I do. We have done that in the past.

Mr. HARKIN. Not only are you getting all of this free press and stuff from being a Senator, you are getting the money, too.

Mr. HARKIN. There is nothing I can do about you getting publicity. That comes with the territory of being a Senator. I am saying you should not have it both ways; you should not have the money and all of the protections that incumbents have. You can't do anything about all the stuff--the stuff a Senator gets. We can set voluntary limits. I say to my friend from Kentucky I know how strongly he feels about public financing. Perhaps my friend was right the other day when he said polls show that people don't want their tax dollars used for public spending for people such as Lyndon LaRouche. My friend is probably right there. That is why I think there is another hammer--and you are right, this is a hammer--because there is no public financing in my amendment unless and until someone exceeds the limits. It is that person who triggers, then, the financing that comes from a voluntary checkoff. Now, my friend says, well, there probably won't be enough money there because the people are not checking off as much money as they used to. Is that right? I think the Senator said that is what is happening. Well, the fact is, I have talked to a lot of people about the checkoff. Do you know why they don't want to give money to the checkoff? We just spend it. We buy more TV ads, we hire more ad agencies, and the price keeps going up and up. They say: Why should I check off money to give to a candidate and all I do is see more of these soap ads, selling them like soap to me? Under my amendment, a person checking off the money is putting money into a reserve fund to prevent that from happening. There is another hammer there because the person who exceeds the limits is the one who triggers the public financing. If my friend is right, that people do not like public financing, that is another reason why someone would not exceed the limits. That is another reason why I think people would be more prone to check off the money because the money would basically be used to prevent this unregulated, unlimited spending on ads. I say to my friend from Kentucky, I do not know if he listened to my argument on that, but this will get people to check off more money because then it would be used not to just add to the coffers of spending and buying more TV ads, but it would be put into a reserve fund as a hammer to keep us from spending more and more money.

Mr. HARKIN

Mr. HARKIN. Mr. President, I am pleased to join Senator Lugar, the chairman of the Committee on Agriculture, Nutrition and Forestry, to introduce this legislation to authorize a national effort to strengthen 4-H's youth development program. With the 4-H program set to observe its centennial year in 2002, this legislation is a fitting tribute to the tremendous contributions 4-H has made over the years to youth development in both rural and urban communities. The 4-H program is uniquely positioned to continue and expand upon its record of service to our youth all across America and across our many diverse communities, from farms to inner cities. 4-H is federally authorized, carried out through state land-grant universities and supported with public and private resources, including from the National 4-H Council. However, the key to 4-H's success is the multitude of volunteers who make the 4-H program work at the local community level. This legislation will authorize a new initiative for developing and carrying out strategies for strengthening 4-H youth development in its second century. Working through public-private partnerships, the National 4-H Council will start at the grassroots level with a program of discussions around the country involving meetings, seminars and listening sessions to address the future of 4-H youth development. Based on the information and ideas gathered, a report will be prepared that summarizes and analyzes the discussions, makes specific recommendations of strategies for youth development and proposes a plan of action for carrying out those strategies. The objective, of course, is to build on the tradition and success of 4-H to develop new approaches for youth development that are appropriate and effective in the 21st Century. Youth today face ever- growing pressures, demands and challenges far different from those of the past. 4-H has a great deal to offer them, but to be fully successful 4-H must adapt to the realities of an increasingly complex and rapidly changing world. 4-H must also be responsive to the widening diversity of the local communities where its contributions really make a difference. In short, 4-H can expand its fine record of service and accomplish even more in its second century by developing new strategies for youth development. That is exactly what this legislation is designed to help achieve. I urge my colleagues to support it.

Mr. HARKIN

Mr. HARKIN. Mr. President, I applaud today's release of the Surgeon General's report, ``Women and Smoking.'' It provides us with important information and recommendations to support our efforts to reduce smoking among women and prevent girls from starting the deadly habit. The results are disturbing and make it clear that we have a responsibility to combat the epidemic of smoking and tobacco-related diseases among women in the United States and around the world. What the report makes clear is that we have been witness to an unprecedented tobacco industry marketing campaign targeted towards young women and girls. The consequences of this marketing campaign are staggering. From 1991 to 1999, smoking among high school girls increased from 27 to 34.9 percent. Since 1968, when Philip Morris introduced Virginia Slims, the rate of lung cancer deaths in women has skyrocketed. In fact, lung cancer has surpassed breast cancer as the leading cause of cancer death in the United States, accounting for 25 percent of all cancer deaths among women. I am pleased that Secretary Thompson was able to join Dr. Satcher this morning to release the Surgeon General's report. I hope his presence signals the Bush administration's willingness to aggressively pursue policies and legislation to combat tobacco use among our children. In particular, the report demonstrates the need for meaningful regulation of tobacco products by the Food and Drug Administration. Today, tobacco companies are exempt from the most basic health and safety oversight of their products. Consumers know more about what is in their breakfast cereal that what is in their cigarettes. Tobacco companies are not required to test additives for safety or tell consumers what is in their products. Nothing prevents them from making misleading or inaccurate health claims about their products. This lack of regulation impacts women as tobacco companies aggressively target young girls through marketing campaigns linking smoking to weight loss and women's rights and progress. For example, one of the most famous ads directed at women was Lucky Strike's ``Reach for a Lucky Instead of a Sweet.'' A recent Virginia Slims' ad campaign told women that smoking could help them ``Find Your Voice.'' As the father of two daughters, I find it unacceptable that young girls are relentlessly barraged with slick marketing campaigns encouraging them to take up a deadly--and illegal--habit. Also, recognizing that many women are concerned about the long term health risks of smoking, tobacco companies have been promoting ``low tar'' or ``light'' cigarettes to women as a ``safer'' option. Big Tobacco is well aware that the health claims in their ads are either misleading or entirely false. But it works. Currently 60 percent of women smokers use light and ultra light cigarettes. These are just some of the reasons I, along with Senators Lincoln Chafee and Bob Graham, introduced the first bipartisan tobacco legislation in this Congress, the KIDS Deserve Freedom from Tobacco Act. Our bill would grant the FDA full authority to regulate the manufacture, distribution, marketing, and sale of tobacco products to protect our children from the dangers of tobacco use. The results of the Surgeon General's report demonstrate the need for FDA authority over tobacco products. Today, I call upon Secretary Thompson to make a commitment to the young girls and women of this country: that the Bush administration will make passing legislation giving the FDA strong, meaningful regulatory authority over tobacco products a top priority.

Mr. HARKIN

Mr. HARKIN. Mr. President, I congratulate Ed Hill, the new president of the International Brotherhood of Electrical Workers, IBEW, on his election, and thank the outgoing president, J.J. ``Jack'' Barry, for his years of dedicated service to IBEW. When I think about all the hard work and long hours presidents Hill and Barry have put in over the years, I am reminded of a story that one of my heroes, the great Hubert H. Humphrey liked to tell. It was Humphrey's 65th birthday, and he was celebrating with his grandchildren. One of the grandkids looked up and said, ``Grandpa, how long have you been a Democrat?'' Humphrey thought about that for a moment, and replied, ``Well, I've been a Democrat for 70 years.'' His grandson said, ``Grandpa, how could you have been a Democrat for 70 years when you're only 65 years old?'' ``Easy,'' Humphrey answered, ``I've put in a lot of overtime.'' Well, these men have put in a lot of overtime on behalf of the IBEW and on behalf of all Americans. You know, I like to tell people, you go to any town in America, rural or urban, big or small, and you'll see the IBEW's work on display. Whether it's lighting our homes, or heating our schools, or bringing the Internet to our libraries, it's clear that the IBEW's work is critical to our families and our economy. I welcome the new leadership and express my gratitude to the outgoing leadership. Ed Hill hails from Beaver County, PA, and he has a long history with the IBEW. Ed joined IBEW Local 712 in his hometown back in 1956 and worked his way up to business manager in 1970. He became part of the IBEW staff in 1982, and, by 1994, he was a Vice President in charge of operations in Pennsylvania, New York, New Jersey and Delaware. In 1997, Ed became the IBEW's second highest-ranking officer, and he worked hard to bring the latest technology to IBEW's operations. He also spent long hours building the membership of IBEW-COPE to record levels and making new strides in grassroots activism and communications. Ed is a talented leader, and he has a strong foundation to build on. IBEW's outgoing president, J.J. Barry, had a long, impressive tenure at the IBEW. Jack is from Syracuse, NY and joined Local 43 in Syracuse in 1943. He served on the executive board and became business manager in 1962. In 1968, he began serving as International Representative and then, in 1976, became International vice president of the third district which includes New York, New Jersey, Pennsylvania, and Delaware. Jack was a virtuoso organizer, and during his tenure, he began a number of important, new initiatives in education and training for IBEW members. He was widely respected and honored throughout this country and around the world for his outstanding work. While I will miss him in his position as president, I look forward to working with him in a new capacity in the coming years. I also recognize Jerry O'Connor who was appointed to take Ed's place as IBEW secretary-treasurer. Jerry has been on the IBEW staff since 1987 and has served as International vice president of the IBEW's sixth district covering Illinois, Indiana, Michigan, Minnesota and Wisconsin since 1995. He was initiated into IBEW Local 701 in Wheaton, IL in 1959, and he served his local as business manager-financial secretary from 1978 until he joined the IBEW staff. I look forward to working with him in his new position. For over 100 years, the IBEW has been a leader in the union movement in America. Whether they were providing energy to our war efforts during World War II, creating one of the best apprenticeship programs around, or providing workers with the cutting edge skills they need to keep up with current electricity needs, IBEW was always ahead of the times. I know that the newest generation of IBEW leadership will continue this proud tradition. I thank them for their dedication and commitment, and I look forward to working with them in the coming years.

Mr. HARKIN

Mr. HARKIN. Mr. President, you have heard the old saying that an ounce of prevention is worth a pound of cure. Today, I am introducing the Elementary and Secondary School Counseling Improvement Act of 2001 to provide that ounce of prevention. After the unspeakable act of violence at Columbine High in 1999, CNN and USA Today conducted a public opinion poll of Americans. They asked what would make a difference in preventing a future outbreak of violence in our Nation's schools. The leading response was to restrict access to firearms. The second most popular response, a response selected by 60 percent of those polled, was to increase the number of counselors in our nation's schools. Counseling programs, especially in our elementary schools are an ounce of prevention. However, too many children do not have access to a well-training counselor when they need one. Experts tell us that to be effective, there should be at least one counselor for every 250 students. Unfortunately, the current student: counselor ratio is more than double the recommended level: 551:1. That means counselors are stretched to the limit and cannot devote the kind of attention to children that is needed. Children today are subjected to unprecedented social stresses, including the fragmentation of the family, drug and alcohol abuse, violence, child abuse and poverty. The legislation I am introducing today reauthorizes the Elementary School Counseling Demonstration Act and expands services to secondary schools. The Elementary School Counseling Program is modeled on a successful program in the Des Moines school district. The counseling program, Smoother Sailing, operates on the simple premise that we must get to kids early to prevent problems rather than waiting for a crisis. The schools participating in Smoother Sailing have seen a dramatic reduction in the number of students referred to the office for disciplinary reasons. Teachers report fewer classroom disturbances and principals notice fewer fights in the cafeteria and on the playground. The schools and classrooms have become more disciplined learning environments. The legislation authorizes $100 million. However, since the counselor shortage is particularly acute in elementary schools, the legislation requires that the first $60 million appropriated would go to provide grants for elementary schools. Earlier this month, the Nation was shocked to learn about a school shooting in Santee, California. We have a desperate need to improve counseling services in our Nation's schools and this legislation will be an important step in addressing this critical issue. I urge my colleagues to support this legislation.

Mr. HARKIN

Mr. HARKIN. Mr. President, you have heard the old saying that an ounce of prevention is worth a pound of cure. Today, I am introducing the Elementary and Secondary School Counseling Improvement Act of 2001 to provide that ounce of prevention. After the unspeakable act of violence at Columbine High in 1999, CNN and USA Today conducted a public opinion poll of Americans. They asked what would make a difference in preventing a future outbreak of violence in our Nation's schools. The leading response was to restrict access to firearms. The second most popular response, a response selected by 60 percent of those polled, was to increase the number of counselors in our nation's schools. Counseling programs, especially in our elementary schools are an ounce of prevention. However, too many children do not have access to a well-training counselor when they need one. Experts tell us that to be effective, there should be at least one counselor for every 250 students. Unfortunately, the current student: counselor ratio is more than double the recommended level: 551:1. That means counselors are stretched to the limit and cannot devote the kind of attention to children that is needed. Children today are subjected to unprecedented social stresses, including the fragmentation of the family, drug and alcohol abuse, violence, child abuse and poverty. The legislation I am introducing today reauthorizes the Elementary School Counseling Demonstration Act and expands services to secondary schools. The Elementary School Counseling Program is modeled on a successful program in the Des Moines school district. The counseling program, Smoother Sailing, operates on the simple premise that we must get to kids early to prevent problems rather than waiting for a crisis. The schools participating in Smoother Sailing have seen a dramatic reduction in the number of students referred to the office for disciplinary reasons. Teachers report fewer classroom disturbances and principals notice fewer fights in the cafeteria and on the playground. The schools and classrooms have become more disciplined learning environments. The legislation authorizes $100 million. However, since the counselor shortage is particularly acute in elementary schools, the legislation requires that the first $60 million appropriated would go to provide grants for elementary schools. Earlier this month, the Nation was shocked to learn about a school shooting in Santee, California. We have a desperate need to improve counseling services in our Nation's schools and this legislation will be an important step in addressing this critical issue. I urge my colleagues to support this legislation.

Mr. HARKIN

Mr. HARKIN. Mr. President, I am pleased to be joined today by Senators Snowe, Mikulski, Murkowski, Murray, Schumer and Reid to introduce the ``Assure Access to Mammography Act of 2001.'' This important legislation will help improve access to life-saving breast screenings for millions of women. I lost both of my sisters to breast cancer. I strongly believe that if they had had access to regular mammography services and today's advanced treatments, they would still be alive today. Over the past several years, we've made a great deal of progress against breast cancer. In particular, we've been able to secure significant funding increases for research to understand the causes of and find treatments for breast cancer. Almost a decade ago, when I looked into the issue of breast cancer research, I discovered that barely $90 million was spent on breast cancer research. That's why, in 1992, I offered an amendment to dedicate $210 million in the Defense Department Budget for breast cancer research. This funding was in addition to the funding for breast cancer research conducted at the National Institutes of Health. My amendment passed and, overnight, it doubled Federal funding for breast cancer. Since then, funding for breast cancer research has been included in the Defense Department Budget every year. Today, I am proud to say, between the DoD and NIH, over $600 million is being spent on finding a cure for this disease. But our success in building our research enterprise will be pointless if breakthroughs in diagnosis, treatment and cures are not available for patients. That is why, a decade ago, as Chairman of the Senate Labor, Health and Human Services and Education Appropriations Subcommittee, I worked with Senator Mikulski to create a program, run by the Centers for Disease Control and Prevention, to provide breast and cervical cancer screening for low-income, uninsured women. And last year, I pushed a new law to provide Medicaid coverage to women diagnosed through this program so they can get the treatment they need. But we still have a long way to go. Breast cancer is the second-most common form of cancer in the United States, next to skin cancers. Approximately 3 million women are living with cancer today, 2 million who have been diagnosed, and an estimated 1 million who do not yet now they have the disease. If we are going to win the war against breast cancer, we've got to be able to detect it early enough to apply the latest treatments effectively. We can prolong and save the lives of millions of women if the cancer is detected when it is small and has not yet spread to other areas of the body. Although not the perfect solution, screening mammograms are the best known way to diagnose breast cancer and reduce mortality. For example, routine mammograms in clinical trials resulted in a 25-30 percent decrease in breast cancer mortality for women aged 50-70. In 1990, Congress acted to ensure access to screening by creating a Medicare mammography benefit and provided adequate payment for screening mammography by setting reimbursement for the procedure at $55, indexed to inflation. Today that amount is $69.23. Unfortunately, this payment has not kept pace with the costs of the procedure, and women's access to screening mammography is being curtailed. Hundreds of facilities across the country are losing money on screening mammography, and since September of 1999, 243 facilities have closed their doors; close to 100 of them in the last 5 months. At the same time, one million additional women each year need regular mammograms. To compound the problem, there is increasing evidence of a shortage of practicing radiologists and radiology residents willing to conduct mammography screening and receive the necessary specialty training. Radiologists report that mammography is under-reimbursed and has a comparatively higher workload, high malpractice costs and more on-the- job stress. In addition, this shortage of radiologic technologists appears to be worsening at the same time as the demand for medical imaging escalates. The number of RT trainees who take the certification exams has declined dramatically in the past several years, from 10,330 in 1995 to 7,149 in 2000. Facilities nationwide report an inability to find and keep qualified RTs. As a result, women in many different parts of the country are having to wait many weeks and months to get a mammogram. These kinds of delays put women at risk for more advanced and less treatable forms of breast cancer. Some of my colleagues may have read in TIME Magazine recently about Paula Sperling from New York. When she called her local mammography facility, they told her she'd have to wait 5 months for her annual mammogram, even though she has a history of breast cancer in her family. She told TIME, ``Three or four months could mean the difference between a tumor that's localized and one that's spread into the lymph nodes.'' In my home state of Iowa, the situation is less dire, but our mammography facilities are struggling because reimbursement doesn't come anywhere near the costs of providing the service. For example, Mercy Medical Center's Cedar Rapids mobile mammography unit serves thousands of women in 7 rural counties in the surrounding area. Many of these women would find it very difficult, if not impossible, to get their mammograms in any other way. But because of low reimbursements, this mobile unit lost $75,000 last year; losses that simply cannot be sustained. It is a day to day struggle to keep that mobile unit going. Congress has a responsibility to make sure our Medicare policy ensures that women have access to timely, quality mammography services. Our legislation would do the following: Increase the Medicare reimbursement for screening mammograms to $90 for 2002, based on currently available cost data. Increase Medicare graduate medical education funding for added radiology residency slots, some of whom will choose mammography as a specialty. Increase funding for allied health profession loan programs to increase the supply of qualified radiologic technicians (RTs) available to conduct mammograms. In addition, we have included two important studies in our bill. Recent research has suggested that the Medicare reimbursement structure for physician work undervalues services and procedures done primarily in women when compared to similar male-specific procedures. Our bill requires the General Accounting Office to further evaluate this research and make recommendations to Congress on how to make Medicare reimbursement more equitable. Also, there is evidence that screening services are undervalued in the physician fee schedule relative to other procedures. Given the importance of regular screening to prevent and catch disease in the early stages, from breast cancer to colorectal and prostate cancer, we include a provision in our bill requiring the Medicare Payment Advisory Commission, MedPAC, to study this issue and make recommendations to Congress. Our legislation has the support of the American Cancer Society, American College of Radiologists, Society of Breast Imaging and the American Society of Radiologic Technologists. I ask unanimous consent that their letters of endorsement be printed in the Congressional Record. And for the sake of women across America and their families and friends, I urge my colleagues to join us in cosponsoring this important bill. I ask unanimous consent that the text of the bill, be printed in the Record.

Mr. HARKIN

Mr. HARKIN. Mr. President, I am pleased to be joined today by Senators Snowe, Mikulski, Murkowski, Murray, Schumer and Reid to introduce the ``Assure Access to Mammography Act of 2001.'' This important legislation will help improve access to life-saving breast screenings for millions of women. I lost both of my sisters to breast cancer. I strongly believe that if they had had access to regular mammography services and today's advanced treatments, they would still be alive today. Over the past several years, we've made a great deal of progress against breast cancer. In particular, we've been able to secure significant funding increases for research to understand the causes of and find treatments for breast cancer. Almost a decade ago, when I looked into the issue of breast cancer research, I discovered that barely $90 million was spent on breast cancer research. That's why, in 1992, I offered an amendment to dedicate $210 million in the Defense Department Budget for breast cancer research. This funding was in addition to the funding for breast cancer research conducted at the National Institutes of Health. My amendment passed and, overnight, it doubled Federal funding for breast cancer. Since then, funding for breast cancer research has been included in the Defense Department Budget every year. Today, I am proud to say, between the DoD and NIH, over $600 million is being spent on finding a cure for this disease. But our success in building our research enterprise will be pointless if breakthroughs in diagnosis, treatment and cures are not available for patients. That is why, a decade ago, as Chairman of the Senate Labor, Health and Human Services and Education Appropriations Subcommittee, I worked with Senator Mikulski to create a program, run by the Centers for Disease Control and Prevention, to provide breast and cervical cancer screening for low-income, uninsured women. And last year, I pushed a new law to provide Medicaid coverage to women diagnosed through this program so they can get the treatment they need. But we still have a long way to go. Breast cancer is the second-most common form of cancer in the United States, next to skin cancers. Approximately 3 million women are living with cancer today, 2 million who have been diagnosed, and an estimated 1 million who do not yet now they have the disease. If we are going to win the war against breast cancer, we've got to be able to detect it early enough to apply the latest treatments effectively. We can prolong and save the lives of millions of women if the cancer is detected when it is small and has not yet spread to other areas of the body. Although not the perfect solution, screening mammograms are the best known way to diagnose breast cancer and reduce mortality. For example, routine mammograms in clinical trials resulted in a 25-30 percent decrease in breast cancer mortality for women aged 50-70. In 1990, Congress acted to ensure access to screening by creating a Medicare mammography benefit and provided adequate payment for screening mammography by setting reimbursement for the procedure at $55, indexed to inflation. Today that amount is $69.23. Unfortunately, this payment has not kept pace with the costs of the procedure, and women's access to screening mammography is being curtailed. Hundreds of facilities across the country are losing money on screening mammography, and since September of 1999, 243 facilities have closed their doors; close to 100 of them in the last 5 months. At the same time, one million additional women each year need regular mammograms. To compound the problem, there is increasing evidence of a shortage of practicing radiologists and radiology residents willing to conduct mammography screening and receive the necessary specialty training. Radiologists report that mammography is under-reimbursed and has a comparatively higher workload, high malpractice costs and more on-the- job stress. In addition, this shortage of radiologic technologists appears to be worsening at the same time as the demand for medical imaging escalates. The number of RT trainees who take the certification exams has declined dramatically in the past several years, from 10,330 in 1995 to 7,149 in 2000. Facilities nationwide report an inability to find and keep qualified RTs. As a result, women in many different parts of the country are having to wait many weeks and months to get a mammogram. These kinds of delays put women at risk for more advanced and less treatable forms of breast cancer. Some of my colleagues may have read in TIME Magazine recently about Paula Sperling from New York. When she called her local mammography facility, they told her she'd have to wait 5 months for her annual mammogram, even though she has a history of breast cancer in her family. She told TIME, ``Three or four months could mean the difference between a tumor that's localized and one that's spread into the lymph nodes.'' In my home state of Iowa, the situation is less dire, but our mammography facilities are struggling because reimbursement doesn't come anywhere near the costs of providing the service. For example, Mercy Medical Center's Cedar Rapids mobile mammography unit serves thousands of women in 7 rural counties in the surrounding area. Many of these women would find it very difficult, if not impossible, to get their mammograms in any other way. But because of low reimbursements, this mobile unit lost $75,000 last year; losses that simply cannot be sustained. It is a day to day struggle to keep that mobile unit going. Congress has a responsibility to make sure our Medicare policy ensures that women have access to timely, quality mammography services. Our legislation would do the following: Increase the Medicare reimbursement for screening mammograms to $90 for 2002, based on currently available cost data. Increase Medicare graduate medical education funding for added radiology residency slots, some of whom will choose mammography as a specialty. Increase funding for allied health profession loan programs to increase the supply of qualified radiologic technicians (RTs) available to conduct mammograms. In addition, we have included two important studies in our bill. Recent research has suggested that the Medicare reimbursement structure for physician work undervalues services and procedures done primarily in women when compared to similar male-specific procedures. Our bill requires the General Accounting Office to further evaluate this research and make recommendations to Congress on how to make Medicare reimbursement more equitable. Also, there is evidence that screening services are undervalued in the physician fee schedule relative to other procedures. Given the importance of regular screening to prevent and catch disease in the early stages, from breast cancer to colorectal and prostate cancer, we include a provision in our bill requiring the Medicare Payment Advisory Commission, MedPAC, to study this issue and make recommendations to Congress. Our legislation has the support of the American Cancer Society, American College of Radiologists, Society of Breast Imaging and the American Society of Radiologic Technologists. I ask unanimous consent that their letters of endorsement be printed in the Congressional Record. And for the sake of women across America and their families and friends, I urge my colleagues to join us in cosponsoring this important bill. I ask unanimous consent that the text of the bill, be printed in the Record.

Mr. HARKIN

Mr. HARKIN. I am delighted to yield to my chairman.

Mr. HARKIN. I think what the Senator has said is absolutely correct. That approach makes too much sense. For example, it does seem to me that if we are rational, reasonable, human beings, and that we do want to work in a bipartisan fashion, which is the only way we are really going to be able to accomplish anything this year--except something such as this, which is rammed through on account of a fast-track procedure--if we truly want to work in a bipartisan fashion, then we ought to be talking about, if there are problems some people have in the ergonomics rule, well, then, the logical, reasonable, responsible way would be, as Senator Kennedy has said, to let the administration propose some modifications that would be published in the Register. There would be a 60- or 90-day--I forget which it is--hearing period in which outside interests could come in and testify as to whether they thought that part of the rule was bad or good or should be modified. At the end of that hearing process, the administration could then propose changing that, modifying that, to meet the objections some people may have. That seems to me to be the responsible way to proceed, not this kind of fast-track Congressional Review Act that we have on the floor of the Senate today whereby we have 10 hours of debate with no chance of amendment. Maybe there are some reasonable modifications that might be made to the ergonomics rule. Maybe there are. I do not know every little item in the rule. I do not pretend to know every little item in the rule. Maybe there are some. But if there are, this is not the way to proceed--to just say: its all or nothing. Let's just throw it out the window--after more than 10 years of work. When these kinds of things happen on the Senate floor, and in the Congress, I can begin to understand more and more why the American people are losing faith in us, why they do not think we really pay attention to them and their needs, why they believe we may be out of touch with the common people of America. Because I think the average American would understand that there is a reasonable, responsible way of approaching this. And what we are doing here today is unreasonable, irresponsible, illogical, and harmful--harmful to perhaps some of the least powerful people in this country. Is this rule going to affect Members of the Senate or the House? No. It will not affect our staffs. It is not going to affect people of higher income. Let's face it, most of the people who suffer from these injuries are some of the lowest paid people in America. They are the people who are working in our meatpacking industries, our poultry plants, who are making low wages, working at tough jobs. They are our cashiers and our clerks and our keyboard operators, our cleaning women--the people who clean the buildings at night, our janitors. They are our nursing home people. These are some of the lowest paid and some of the hardest working people in America. This is who it affects. That is why we should not support this resolution to repeal the rule. That is why we should proceed in a responsible, reasoned manner. Let the President suggest some modifications, have the hearing process, and move ahead that way. What we are doing here today is unreasonable and should not be done. I yield the floor. Several Senators addressed the Chair.

Mr. HARKIN

Mr. HARKIN. Mr. President, today we will be introducing the Public School Repair and Renovation Act. This legislation will provide grants to local schools so they can make the repairs to ensure the safety of their students. I am pleased to be joined by Senators Bingaman, Kennedy, Wellsone, Dodd, and Clinton on this legislation. In 1998, the American Society of Civil Engineers issued a Report Card for America's Infrastructure which reported serious problems with the physical infrastructure in our nation. However, the most alarming finding is the failing grade to schools in the United States--the only area to receive a failing grade. It is a national disgrace that the nicest places our kids see are shopping malls, sports arenas, and movie theaters, and the most rundown place they see is their school. What signal are we sending them about the value we place on them, their education and future? Modernizing and repairing our nation's schools is something I've been advocating for over a decade now. I secured $100 million in the fiscal year 1995 appropriations bill as a down payment on a school modernization program and was disappointed when those funds were rescinded. But we made real progress last year with the passage of a $1.2 billion initiative to make emergency repairs. That was a bipartisan agreement hammered out by Senator Specter and me in negotiations on the fiscal year 2001 appropriations bill with Congressman Goodling and the White House. This was a 1 year authorization and the School Repair and Renovation Act will reauthorize this bipartisan plan for 5 years. This program provides grants to Local Education Agencies to help them make urgently needed repairs and to pay for special education and construction related technology expenses. Funds will be distributed to the States. States will then distribute 75 percent of the funds on a competitive basis to local school districts to make emergency repairs such as fixing fire code violation, repairing the roof or installing new plumbing. The remaining 25 percent will be distributed competitively to local school districts to use for technology activities related to school renovation or for activities authorized under Part B of the Individuals with Disabilities Education Act. The School Repair and Renovation Act is a key component in a two- prong strategy to modernize our nation's schools. In the near future I will join forces with Representatives Johnson and Rangel and introduce the America's Better Classrooms Act in the Senate to provide tax credits for school construction projects. This bipartisan legislation would leverage $1.7 billion in tax credits over 5 years to pay the interest on $25 billion in school modernization bonds. I know this approach will work because it mirrors a successful school construction demonstration program I started in Iowa in 1997. The Iowa demonstration is a two-prong response to our school modernization needs. First, we provide grants to local school districts to make urgent repairs to remedy fire code violations. Second, grants are made to local school districts to subsidize a portion of the cost for a new construction project. The program has been a big success. During the first 2 years of the demonstration, federal funds of $14.7 million supported projects totaling $142 million--each federal dollar leveraged $10.33. There is a legitimate federal role in helping fix our nation's crumbling schools, and we can do so without undermining local control of education. This federal role is recognized by President Bush who is recommending an expanded use of private activity bonds for school construction projects. Over the past few years we have had several partisan skirmishes related to school construction. This is a new year, a new Congress, and a new administration. I look forward to working with my colleagues to enact the School Repair and Renovation Act of 2001. I ask unanimous consent that a copy of the report card to which I referred be printed in the Record. There being no objection the material was ordered to be printed in

Mr. HARKIN

Mr. HARKIN. Mr. President, today we will be introducing the Public School Repair and Renovation Act. This legislation will provide grants to local schools so they can make the repairs to ensure the safety of their students. I am pleased to be joined by Senators Bingaman, Kennedy, Wellsone, Dodd, and Clinton on this legislation. In 1998, the American Society of Civil Engineers issued a Report Card for America's Infrastructure which reported serious problems with the physical infrastructure in our nation. However, the most alarming finding is the failing grade to schools in the United States--the only area to receive a failing grade. It is a national disgrace that the nicest places our kids see are shopping malls, sports arenas, and movie theaters, and the most rundown place they see is their school. What signal are we sending them about the value we place on them, their education and future? Modernizing and repairing our nation's schools is something I've been advocating for over a decade now. I secured $100 million in the fiscal year 1995 appropriations bill as a down payment on a school modernization program and was disappointed when those funds were rescinded. But we made real progress last year with the passage of a $1.2 billion initiative to make emergency repairs. That was a bipartisan agreement hammered out by Senator Specter and me in negotiations on the fiscal year 2001 appropriations bill with Congressman Goodling and the White House. This was a 1 year authorization and the School Repair and Renovation Act will reauthorize this bipartisan plan for 5 years. This program provides grants to Local Education Agencies to help them make urgently needed repairs and to pay for special education and construction related technology expenses. Funds will be distributed to the States. States will then distribute 75 percent of the funds on a competitive basis to local school districts to make emergency repairs such as fixing fire code violation, repairing the roof or installing new plumbing. The remaining 25 percent will be distributed competitively to local school districts to use for technology activities related to school renovation or for activities authorized under Part B of the Individuals with Disabilities Education Act. The School Repair and Renovation Act is a key component in a two- prong strategy to modernize our nation's schools. In the near future I will join forces with Representatives Johnson and Rangel and introduce the America's Better Classrooms Act in the Senate to provide tax credits for school construction projects. This bipartisan legislation would leverage $1.7 billion in tax credits over 5 years to pay the interest on $25 billion in school modernization bonds. I know this approach will work because it mirrors a successful school construction demonstration program I started in Iowa in 1997. The Iowa demonstration is a two-prong response to our school modernization needs. First, we provide grants to local school districts to make urgent repairs to remedy fire code violations. Second, grants are made to local school districts to subsidize a portion of the cost for a new construction project. The program has been a big success. During the first 2 years of the demonstration, federal funds of $14.7 million supported projects totaling $142 million--each federal dollar leveraged $10.33. There is a legitimate federal role in helping fix our nation's crumbling schools, and we can do so without undermining local control of education. This federal role is recognized by President Bush who is recommending an expanded use of private activity bonds for school construction projects. Over the past few years we have had several partisan skirmishes related to school construction. This is a new year, a new Congress, and a new administration. I look forward to working with my colleagues to enact the School Repair and Renovation Act of 2001. I ask unanimous consent that a copy of the report card to which I referred be printed in the Record. There being no objection the material was ordered to be printed in

Mr. HARKIN

Mr. HARKIN. Mr. President, I strongly support the ``Helping Children Success by Fully Funding the Individuals with Disabilities Education Act, IDEA, Act.'' This is a bi-partisan effort to help our states provide a free and appropriate public education to children with disabilities. As I've said time and again, disability is not a partisan issue. We all share an interest in ensuring that children with disabilities and their families get a fair shake in life. Currently, the State Grant program within IDEA receives $6.34 billion. Estimates by the Congressional Research Service suggest that the program needs to be funded at $17.1 billion for fiscal year 2002 to meet the targets established in 1975. Our amendment would obligate funding for IDEA annually in roughly $2.5 billion increments over the next six years and would put us on track to meet our goal of 40 percent funding. In the early seventies, two landmark federal district court cases, PARC v. Commonwealth of Pennsylvania and Mills v. Board of Education of the District Court of Columbia, established that children with disabilities have a constitutional right to a free appropriate public education. In 1975, in response to these cases, Congress enacted the Education of Handicapped Children Act, EHA, the precursor to IDEA, to help states meet their constitutional obligations. Congress enacted PL 94-142 for two reasons. First, to establish a consistent policy of what constitutes compliance with the equal protection clause of the 14th amendment with respect to the education of kids with disabilities. And, second, to help States meet their Constitutional obligations through federal funding. The Supreme Court reiterated this in Smith v. Robinson: ``EHA is a comprehensive scheme set up by Congress to aid the states in complying with their constitutional obligations to provide public education for handicapped children.'' It is Congress' responsibility to help States provide children with disabilities an education. That is why I strongly agree with the policy of this bill and the infusion of more money into IDEA. As Senator Jeffords has said before, this is a win-win for everyone. Students with disabilities will be more likely to get the public education they have a right to because school districts will have the capacity to provide such an education, without cutting into their general education budgets. The Supreme Court's decision regarding Garret Frey of Cedar Rapids, Iowa underscores the need for Congress to help school districts with the financial costs of educating children with disabilities. While the excess costs of educating some children with disabilities is minimal, the excess costs of educating other children with disabilities, like Garret, is great. Just last week, I heard from the Cedar Rapids/Iowa City Chamber of Commerce that more IDEA dollars will help them continue to deliver high quality educational services to children in their school districts. This bill would provide over $300 million additional dollars to Iowa over the next six years. I've heard from parents in Iowa that their kids need more qualified interpreters for deaf and hard of hearing children and they need better mental health services and better behavioral assessments. And the additional funds will help local and area education agencies build capacity in these areas. In 1975, IDEA authorized the maximum award per state as being the number of children served times 40 percent of the national average per pupil expenditure, known as the APPE. The formula does not guarantee 40 percent of national APPE per disabled child served; rather, it caps IDEA allotments at 40 percent of national APPE. In other words, the 40 percent figure was a goal, not a commitment. As the then ranking minority member on the House Ed and Labor Committee, Rep. Albert Quie, explained: ``I do not know in the subsequent years whether we will appropriate at those [authorized] levels or not. I think what we are doing here is laying out the goal. Ignoring other Federal priorities, we thought it acceptable if funding reaches that level.'' One of the important points in the Congressman's statement is that we cannot fund IDEA grant programs at the cost of other important federal programs. That is why historically the highest appropriation for special education funding was in FY79, when allocations represented 12.5 percent APPE. Over the last six years, however, as Ranking Member on the Labor-H Appropriations Subcommittee, I have worked with my colleagues across the aisle to almost triple the IDEA appropriation so that we're now up to almost 15 percent of the funding formula. This bill would help us push that number to 40 percent without cutting into general education programs. We must redouble our efforts to help school districts meet their constitutional obligations. And this increased funding will allow us to increase dollars to every program under IDEA through appropriations. Every program under IDEA must get adequate funds. As I said, we can all agree that states should receive more money under IDEA. I thank Senator Hagel, Senator Jeffords, Senator Kennedy and Senator Dodd for their leadership on this issue. I encourage my colleagues to join us in support of this bill.