Jesse Helms

Mr. HELMS

Mr. HELMS. Mr. President, more than 3 years ago I began these daily reports to the Senate to make a matter of record the exact Federal debt as of close of business the previous day. As of the close of business yesterday, Wednesday, October 18, the Federal debt stood at exactly $4,970,326,555,499.77. On a per capita basis, every man, woman, and child in America owes $18,867.44 as his or her share of the Federal debt. It is important to recall, Mr. President, that the Senate this year missed an opportunity to implement a balanced budget amendment to the U.S. Constitution. Regrettably, the Senate failed by one vote in that first attempt to bring the Federal debt under control. There will be another opportunity in the months ahead to approve such a constitutional amendment.

Mr. HELMS

Mr. HELMS. Mr. President, three summers ago I had a close but fortunate encounter with some remarkable medical doctors in my home town of Raleigh. My heart surgery and the very effective subsequent rehabilitation made it clear that I had been cared for by some of the most capable people in the medical profession. I was free to choose the surgeon who performed the operation. Senior citizens enrolled in Medicare should have the same choice, and the bill I'm introducing today will enable senior citizens who join HMO's to preserve their right to choose their doctor. Mr. President most Americans, whether their health is insured by private firms or by Medicare, enjoy their freedom to decide which medical professional will provide their care and treatment. In reforming Medicare, Congress must make sure that senior citizens can choose their doctors and other medical providers. One of the many reasons for my having opposed the Clinton health plan was the well founded fear that the American people would have been denied their right to chose their medical care. The enormous bureaucracy of the Clinton plan made that apprehension a certainty-- which is why the American people rejected it. Now, Mr. President, the Senate is considering major reforms to save Medicare, and prevent its being pushed over the cliff. Medicare must be reformed before it goes bankrupt--otherwise the Medicare trust fund will be flat broke when the 21st century rolls around a few years hence. Americas's senior citizens depend on the health care coverage provided by the Medicare system, and those of us in Congress have a duty to make sure they will not be forced to give up their right to choose their doctors. It is vital to their future security that our senior citizens retain this right to choose. The power to choose will place citizens firmly in control of their health care. Their right to choose will encourage efficiency and cut costs without sacrificing quality care and treatment. Mr. President, all of us know full well that reform of the present Medicare System is imperative. The provisions of the legislation allowing senior citizens to join health maintenance organizations, and other types of managed care plans, will surely lower the costs of operating the vast Medicare System. And citizens who belong to a Medicare-supported HMO may gain coverage for prescription drugs, eyeglasses and hearing aids--coverages not presently provided by Medicare. Without some moderating legislation, however, senior citizens could very well find themselves locked into coverage that limits them to services provided by HMO-affiliated doctors, other professionals and hospitals. No longer would senior citizens have the freedom to choose their own doctor. So, Mr. President, these are the reasons why I am today introducing the Senior Citizens' Health Freedom Act to guarantee all Medicare- eligible Americans who choose to enroll in an HMO the same freedom to choose their doctors that every member of Congress enjoys. As much as I support the Republican Medicare plan now under discussion, I cannot dismiss my reservations about the absence of doctor choice in the plan as it presently stands. Mr. President, consider if you will the predicament of a patient who requires heart surgery, and whose HMO will not approve the cardiologist with whom the senior has built up a longstanding relationship. Should the patient be required to wait for a year's time to change to a plan that will cover the cardiologist that the patient knows and trusts? My bill will enable women being treated for breast cancer to rest assured that they can continue to see the specialists familiar with them and their conditions. For this reason, more than a hundred patient advocacy groups have voiced their support for this bill. We must provide a safety valve to protect seniors who find themselves in that position. A point of service option would enable patients to see physicians and specialists inside and outside the managed care network. If senior citizens are satisfied with the care they receive within the network, they will feel no need to choose outside doctors and specialists. Without such options, however, these senior citizens will be locked into a rigid system which may or may not give them the health care they need from people they most trust to provide it. Mr. President, we heard from the CBO last February that a built-in point of service feature would not increase the cost of Medicare. In testimony before the Senate Budget Committee, CBO stated that ``the point of service option would permit Medicare enrollees to go to providers outside the HMO's panel when they wanted to, and yet it need not increase the benefit cost to HMO's or to * * * '' The fastest growing health insurance product is a managed care plan that includes the point of service feature. The marketplace has responded to patient's demand. Requiring HMO's to include point of service is not intrusive, but rather advances a developing trend. In fact, in 1993, 61 percent of all HMO's offered a point of service option. Building a point of service option into all health plans under Medicare will not interfere with the plan's ability to contain cost, nor will it limit their efforts to encourage providers and patients to use their health care resources wisely. It simply will ensure that health plans put the patient's interest first. Moreover, the actuarial firm of Milliman and Robertson concluded that depending on the terms of the plan and a reasonable cost sharing schedule, there would be no increase in cost to the HMO. In fact, there could actually be a savings. Mr. President, according to polls I have seen, patients are willing to pay a little more for the ability to go out of network to be assured of seeing the doctors of their choice. As many as 70 percent of Americans over 50 years old declared in one poll that they would be unwilling to join a Medicare managed plan that denied them the freedom to choose their own physicians. So the best incentive to get senior citizens to join HMO's is to make sure they can choose their own doctors. As we prepare to enact this historic revision of the Medicare Program, let us not overlook the steps that are necessary to protect the security of our senior citizens. Let us never deny them the right to take an active part in their health care and treatment. [[Page S 15346]] We can save Medicare. We can extend its benefits while lowering the towering costs that beset us today. And with the legislation I introduce today, we can also preserve a basic American freedom to choose. Mr. President, I ask unanimous consent that the list of patient advocacy groups supporting this bill be printed in the Record.

Mr. HELMS

Mr. HELMS. Mr. President, I ask unanimous consent that the Committee on Agriculture, Nutrition, and Forestry be allowed to meet during the session of the Senate on Thursday, October 19, 15 9:00 a.m., in SR-332, to consider the nomination of Mr. Michael V. Dunn to be assistant secretary for marketing and regulatory programs and to be a member of the board of directors for the Commodity Credit Corporation, and Mr. John David Carlin to be assistant secretary for congressional relations.

Mr. HELMS. Mr. President, I ask unanimous consent that the full Committee on Environment and Public Works be granted permission to conduct a hearing Thursday, October 19, 1995, at 9:00 a.m. on S. 1316, the Safe Drinking Water Act Amendment of 1995.

Mr. HELMS. Mr. President, I ask unanimous consent that the Subcommittee on Oversight and Investigations of the Committee on Energy and Natural Resources be granted permission to meet during the session of the Senate on Thursday, October 19, 1995, for purpose of conducting a subcommittee hearing which is scheduled to begin at 9:30 a.m. The purpose of this hearing is to examine the role of the council on environmental quality in the decisionmaking and management processes of agencies under the committee's jurisdiction--Department of the Interior, Department of Energy, and U.S. Forest Service.

Mr. HELMS. Mr. President, I ask unanimous consent that the Subcommittee on Terrorism, Technology and Government Information of the Senate Committee on the Judiciary, be authorized to meet during a session of the Senate on Thursday, October 19, 1995, at 10:00 a.m., in Senate Hart room 216, on Ruby Ridge incident.

Mr. HELMS. Mr. President, I ask unanimous consent that the Committee on Small Business be authorized to meet during the session of the Senate on Thursday, October 19, 1995, at 9:30 a.m., in room 428A Russell Senate Office Building, to conduct a hearing focusing on revitalizing America's rural and urban communities.

Mr. HELMS

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

Mr. HELMS. Yes.

Mr. HELMS. Mr. President, I am perfectly willing to have the two amendments voted en bloc. And I would further ask the distinguished Senator from Connecticut if he would be willing to enter into a time agreement?

Mr. HELMS. There is a time agreement.

Mr. HELMS

Mr. HELMS. And I yield back the remainder of my time. I see the distinguished majority leader. I am glad to yield to the majority leader. Mr. DOLE addressed the Chair.

Mr. HELMS. Mr. President, that is certainly a fair and reasonable request. I ask unanimous consent that 4 minutes equally divided be provided at 4 o'clock on the Simon amendment.

Mr. HELMS. Yes.

Mr. HELMS. I thank the Chair. Mr. President, what I am about to say may indicate the widest legislative wing span in history, but the State Department and Jesse Helms agree on something. Both the State Department and Jesse Helms oppose the Simon amendment. I do so respectfully--and Paul Simon is my friend. We do not agree on everything, but that does not matter. He operates in good faith, and I try to. Let me say very briefly that during the tenure or parts thereof of eight American Presidents, the United States has pursued a bipartisan policy of isolating Fidel Castro, including restrictions on travel to Cuba. Obviously, the Simon amendment would enthusiastically do away with that restriction. I mentioned yesterday, and I guess I shall reiterate today, that there are good intentions behind anything that Paul Simon does. He is a gentleman. I regret the fact on a personal basis that he has announced that he will not seek reelection next year. But having said that, I just cannot support his amendment. And I cannot fail to urge Senators to vote against it because the result of the Simon amendment will not be the free exchange of ideas that they talk about. The result will be to give Fidel Castro access to new and desperately needed hard currency. On this, the State Department and I absolutely agree. What Castro has to offer is Cuban beaches. That is it. And allowing Americans to sit on Cuban beach does not do anything for the Cuban people who are oppressed and from whom we hear daily pleas to enact the Libertad bill. The Cuban people inside of Cuba--and also the Cuban people in exile in the United States and elsewhere--unanimously, as far as I know, favor the pending bill. Tourism, of course, is one of Fidel Castro's most important sources of hard currency, and for years and years Castro has lured foreigners to Cuba. This has not resulted in any liberalizing of his regime. It has instead resulted in less freedom and worse living circumstances for the Cuban people. Old Fidel, he is ugly, and he is blunt, and he is rough, and he is cruel, but he is not dumb. He knows the value of tourism for his regime. As a matter of fact, if he does not get hard cash from tourism and other aspects of operations, down he goes. And that is the point. We want him to go down. We want to be rid of him. We want the Cuban people to be rid of him so that they can establish a democratic government there that they have not had in a long, long time. Now, back in June, Castro began imposing a 100 percent tariff on all new articles brought into Cuba with a value between $100 and $1,000. And that means, Mr. President, if Castro officials, his cronies, determine that an item being brought into Cuba by a tourist is new, or if it is something that will be left behind when the tourist departs, then Cuba can charge 100 percent of the cost of that item. The tax on tourists benefits nobody but Fidel Castro and his cronies. Critics of the travel restrictions argue that we should remove them since they are not fully enforced. I recognize that the Treasury Department has encountered some problems in enforcing travel regulations. They probably encounter some problems in enforcing a lot of regulations. The reason for any problem they have in this regard is that currently only criminal penalties can be imposed for violations. [[Page S 15322]] The administration supports the enactment of civil penalties as the best means of enforcing existing restrictions, and that is exactly what we do in the Libertad bill. So there goes that wide wingspread again from left to right. Mr. President, I am going to reserve the remainder of my time because I have one or two other points that I may want to make, but I want there to be enough time for Senator Simon to make whatever rebuttal he wishes to make.

Mr. HELMS. Mr. President, would the Chair state the time situation?

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

Mr. HELMS. Mr. President, I again suggest the absence of a quorum on the same basis as the first request was made.

Mr. HELMS. Mr. President, I ask unanimous consent that the Senate stand in recess at 12 noon today until 4 p.m. and that at 4 p.m. the Senate proceed to the votes under the previous order.

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

Mr. HELMS. Mr. President, I suggest the absence of a quorum, and I suggest that the time be charged equally.

Mr. HELMS

Mr. HELMS. Mr. President, three summers ago I had a close but fortunate encounter with some remarkable medical doctors in my home town of Raleigh. My heart surgery and the very effective subsequent rehabilitation made it clear that I had been cared for by some of the most capable people in the medical profession. I was free to choose the surgeon who performed the operation. Senior citizens enrolled in Medicare should have the same choice, and the bill I'm introducing today will enable senior citizens who join HMO's to preserve their right to choose their doctor. Mr. President most Americans, whether their health is insured by private firms or by Medicare, enjoy their freedom to decide which medical professional will provide their care and treatment. In reforming Medicare, Congress must make sure that senior citizens can choose their doctors and other medical providers. One of the many reasons for my having opposed the Clinton health plan was the well founded fear that the American people would have been denied their right to chose their medical care. The enormous bureaucracy of the Clinton plan made that apprehension a certainty-- which is why the American people rejected it. Now, Mr. President, the Senate is considering major reforms to save Medicare, and prevent its being pushed over the cliff. Medicare must be reformed before it goes bankrupt--otherwise the Medicare trust fund will be flat broke when the 21st century rolls around a few years hence. Americas's senior citizens depend on the health care coverage provided by the Medicare system, and those of us in Congress have a duty to make sure they will not be forced to give up their right to choose their doctors. It is vital to their future security that our senior citizens retain this right to choose. The power to choose will place citizens firmly in control of their health care. Their right to choose will encourage efficiency and cut costs without sacrificing quality care and treatment. Mr. President, all of us know full well that reform of the present Medicare System is imperative. The provisions of the legislation allowing senior citizens to join health maintenance organizations, and other types of managed care plans, will surely lower the costs of operating the vast Medicare System. And citizens who belong to a Medicare-supported HMO may gain coverage for prescription drugs, eyeglasses and hearing aids--coverages not presently provided by Medicare. Without some moderating legislation, however, senior citizens could very well find themselves locked into coverage that limits them to services provided by HMO-affiliated doctors, other professionals and hospitals. No longer would senior citizens have the freedom to choose their own doctor. So, Mr. President, these are the reasons why I am today introducing the Senior Citizens' Health Freedom Act to guarantee all Medicare- eligible Americans who choose to enroll in an HMO the same freedom to choose their doctors that every member of Congress enjoys. As much as I support the Republican Medicare plan now under discussion, I cannot dismiss my reservations about the absence of doctor choice in the plan as it presently stands. Mr. President, consider if you will the predicament of a patient who requires heart surgery, and whose HMO will not approve the cardiologist with whom the senior has built up a longstanding relationship. Should the patient be required to wait for a year's time to change to a plan that will cover the cardiologist that the patient knows and trusts? My bill will enable women being treated for breast cancer to rest assured that they can continue to see the specialists familiar with them and their conditions. For this reason, more than a hundred patient advocacy groups have voiced their support for this bill. We must provide a safety valve to protect seniors who find themselves in that position. A point of service option would enable patients to see physicians and specialists inside and outside the managed care network. If senior citizens are satisfied with the care they receive within the network, they will feel no need to choose outside doctors and specialists. Without such options, however, these senior citizens will be locked into a rigid system which may or may not give them the health care they need from people they most trust to provide it. Mr. President, we heard from the CBO last February that a built-in point of service feature would not increase the cost of Medicare. In testimony before the Senate Budget Committee, CBO stated that ``the point of service option would permit Medicare enrollees to go to providers outside the HMO's panel when they wanted to, and yet it need not increase the benefit cost to HMO's or to * * * '' The fastest growing health insurance product is a managed care plan that includes the point of service feature. The marketplace has responded to patient's demand. Requiring HMO's to include point of service is not intrusive, but rather advances a developing trend. In fact, in 1993, 61 percent of all HMO's offered a point of service option. Building a point of service option into all health plans under Medicare will not interfere with the plan's ability to contain cost, nor will it limit their efforts to encourage providers and patients to use their health care resources wisely. It simply will ensure that health plans put the patient's interest first. Moreover, the actuarial firm of Milliman and Robertson concluded that depending on the terms of the plan and a reasonable cost sharing schedule, there would be no increase in cost to the HMO. In fact, there could actually be a savings. Mr. President, according to polls I have seen, patients are willing to pay a little more for the ability to go out of network to be assured of seeing the doctors of their choice. As many as 70 percent of Americans over 50 years old declared in one poll that they would be unwilling to join a Medicare managed plan that denied them the freedom to choose their own physicians. So the best incentive to get senior citizens to join HMO's is to make sure they can choose their own doctors. As we prepare to enact this historic revision of the Medicare Program, let us not overlook the steps that are necessary to protect the security of our senior citizens. Let us never deny them the right to take an active part in their health care and treatment. [[Page S 15346]] We can save Medicare. We can extend its benefits while lowering the towering costs that beset us today. And with the legislation I introduce today, we can also preserve a basic American freedom to choose. Mr. President, I ask unanimous consent that the list of patient advocacy groups supporting this bill be printed in the Record.

Mr. HELMS

Mr. HELMS. Mr. President, again, every time I get into a debate with Paul Simon it is like a fraternity meeting. We are such close personal friends even though we frequently disagree. I say to the Senator that the policy against Cuba is working. Castro is on the ropes. And he wants the hard currency that tourism brings in because that will give him a few more days, and a few more weeks, or whatever. As far as a heart attack that he may have, I will not say that I want anybody to have a heart attack. But I want him to get off the backs of the Cuban people as quickly as possible, and I know the Senator from Illinois does, too. The infusion of hard currency is the only thing that is going to save Castro [[Page S 15287]] now. He needs that money, and that is the reason he is selling off real estate which does not belong to Castro's government any more than that table does. But he is selling this property off nevertheless. He is frantic to get hard currency. That is the reason he wants very much to have the tourism. And the proximity of Cuba--how many times have we said this Communist country is 90 miles off our shore? That is precisely the point. You cannot make a case about China and North Korea because they are so far away that the number of United States tourists are relatively minimal because many Americans cannot afford to travel there. I say to the Senator with all due respect that I just cannot agree with the amendment. That is my last word.

Mr. HELMS. Mr. President, the distinguished Senator from Illinois, my friend and my neighbor in the Dirksen Building, is always cooperative. If I say anything to excite him about his amendment, he will be entitled to take as much time as he needs to reply to me. I do not agree with the amendment, and I hope it will not be accepted. But let me say this, Mr. President, I never have any question about the good intent of the Senator from Illinois on any issue, including this one. He sincerely believes the flow of American citizens to Cuba will promote positive change in Cuban society. But, in the context of Fidel Castro's regime, in my judgment, the belief that tourism will change Castro's tyranny cannot be supported by the facts. Here is why. I say, with all friendliness, the loudest advocate of the Senator's amendment would be Fidel Castro, because he is trying to lure tourists into Cuba so they will bring hard cash which he could use to buy a little bit more time for his regime. As a matter of fact, for years Mr. Castro has lured Europeans, Canadians, Mexicans, and others to Cuba. But from the beginning, Castro typically set up a structure to isolate foreign tourists and tourist facilities from the larger Cuban population. As a matter of fact, some of the major newspapers in this country and elsewhere refer to this system of Mr. Castro's as ``tourist apartheid.'' What has been Mr. Castro's purpose in promoting tourism? It has not been to improve the lives or freedoms of the Cuban people. Tourists visiting Cuba have access to food, shelter, and recreation not available to the poor Cuban people themselves. But this does not bother Fidel Castro and his cronies. Mr. Castro tolerates the tourist trade because he needs, as I said earlier, the hard cash--the hard currency generated by tourism to subsidize his corrupt regime. Even the employment generated by tourism supports the regime. Here is how that works. The Cuban Government, that is to say Castro's officials, decide who will work in the tourist resorts. Nobody else need apply. With the Cuban State economic sector collapsing, jobs are becoming more and more scarce in Cuba and working in a tourist area becomes leverage that Castro uses as people struggle to find work in order to feed and care for their families. There is another tragic phenomenon that has emerged from Castro's efforts to attract foreign tourists. It is called sex tourism. More and more, Cuban women, some little girls as young as 14 years of age, are prostituting themselves because they cannot find any other way to feed themselves and their families. An Italian travel magazine recently identified Cuba as the ``paradise of sexual tourism,'' ranking it above Thailand and Brazil as the place to go for what the magazine called ``erotic tourism.'' This is just one of the perverted legacies of the Castro revolution. The free flow of American citizens to Cuba would be no more effective in reforming Castro's regime than has been the flow of Canadian, European, and Latin American tourists up to now. And lifting the travel restrictions, I say to my friend with all due respect, will not--will not--expedite Castro's departure. Rather, it will help keep Castro in power by giving him badly need hard currency. The Treasury Department rules now allow for travel by journalists and by [[Page S 15286]] people engaged in educational or religious activities, as well as travel for humanitarian reasons, including permission to travel for those accompanying humanitarian donations to the Cuban people and individuals traveling in connection with recognized human rights organizations. Restrictions on the right to travel are within the bounds of the Constitution. Twice the United States Supreme Court has heard challenges to the rules governing travel to Cuba. Every time, the Court has upheld the regulations, holding that the right to international travel is not without limitations when the restrictions are connected with the national security interests of the United States. In the case of Cuba, it is in our national interest to deny Fidel Castro the hard currency that would be brought in by tourism. If the amendment of my friend is approved, the result would be to limit the President's ability to restrict travel. There are, in my judgment--and I say this with respect to my friend--there are valid national security reasons why travel to Cuba should be regulated. Approval of this amendment will serve to give hope to Castro, and that is why I must oppose it. Mr. President, I ask unanimous consent that two articles from the Miami Herald, one on April 24, 1995, and one on February 28, 1995, be printed in the Record.

Mr. HELMS

Mr. HELMS. Mr. President, before the Senate proceeds to vote on the cloture motion on the substitute to H.R. 927, the Cuban Liberty and Democratic Solidarity Act, I state for the record that if cloture is invoked, it is my intention to seek recognition and to lay before the Senate amendment No. 2936, the Libertad Act, with titles I and II only. I thank the Chair.