Nancy Kassebaum

Mrs. KASSEBAUM

Mrs. KASSEBAUM. Mr. President, the language that I am cosponsoring with my colleague from Vermont is, as he has said, identical language that was included in the Foreign Operations appropriations bill, which passed the Senate in September by a vote of 91-9. It is also language similar to that which passed the Senate in 1984 and in 1989. At this time, as Senator Leahy pointed out, House and Senate conferees were able to reconcile every other aspect of the legislation, except this issue. The House insisted upon their language, we insisted upon ours and, thus, the bill was reported out of conference with this language in disagreement. I think that if the House passed the language they passed and if we pass the language offered in this amendment, it is my understanding that a continuing resolution would continue for the bill with everything passed--the language of everything passed in a continuing resolution, except current language reporting the issue at stake in disagreement here. The language that has been introduced does not change the current U.S. policy that prohibits funding for abortion activities. It simply ensures that foreign governments and nongovernmental organizations will be treated in the same way with respect to establishing eligibility for U.S. population assistance. If abortion is legal in a country and if a foreign government is engaged in population assistance programs, why should we tell a nongovernmental agency or organization working in that country that they cannot use U.S. funds? It seems to me they should be able to use them for population assistance, Mr. President. That is what this issue is about. It is not about abortion. As I think all colleagues know, this issue first came about in 1984 at the International Conference on Population in Mexico City. The Reagan administration announced that any nongovernmental organization which used private or non-U.S. funds to contract abortion-related activities would be prohibited from receiving U.S. population assistance. If they use their own private, or if their own non-U.S. funds in any way are involved, as the Senator from Vermont pointed out, then they could not receive any U.S. funds for population assistance. I just feel that it is far too limiting, Mr. President. It really cripples us in our ability to help other nations deal with population assistance initiatives. Since 1973, the United States has prohibited the use of U.S. dollars by any recipient of U.S. population assistance to pay for abortions abroad. I support this. However, Mr. President, this amendment, as I said before, is not about an abortion. As the Senator from Vermont pointed out, it would prohibit funds going to China. It would also prohibit funds which could be used for lobbying for or against abortion. So I think it is important to keep in mind exactly what it is about. It is about supporting nongovernmental organizations in creating safe, effective, comprehensive family planning programs--programs that are designed to prevent the need for abortion. Mr. President, some of my colleagues have argued that the United States should not have a role in international population assistance programs. But while some contend that there is no relationship between world population and our national security, a closer look, I think, at all the factors involved make it clear that population stabilization is in our best interest. Without such an effort, the world's political, economic, and environmental forces balance precariously on the verge of chaos. I think I came to realize this most clearly as I have spent a number of years on the Africa Subcommittee in the Foreign Relations Committee. It has shown me that arguments to the contrary are misinformed. The population assistance initiatives are important. There is no doubt in my mind, for example, that overpopulation played a major role in compounding famine in Africa. I do not think I need to point out to anyone here the tragedies that have resulted from that, or could result from that, and the importance of doing thoughtful, constructive population assistance initiatives. It is not easy. We have to be very sensitive to cultural differences as we work in other countries and support work in other countries. But, clearly, it seems to me that it does have merit and it is important. I realize that many of my colleagues here are tired of this fight. But I continue to believe strongly in preventing the need for abortion by working to establish effective family planning programs. I hope my colleagues will similarly recognize the need to prevent what has been called the international gag rule from ever emerging as an obstacle to creating effective policy. I urge my colleagues to vote in favor of this amendment. I suggest, Mr. President, it is not really an issue of the President vetoing this bill. In my mind, it is an issue of the merit or demerit of this amendment. I feel strongly that this amendment really says that we do care about working together with nongovernmental organizations, with other countries, being sensitive and constructive with family planning initiatives.

Mrs. KASSEBAUM

Mrs. KASSEBAUM. Mr. President, I urge my colleagues to support striking this provision from the bill before us, because I believe it is bad pension policy. We are making some assumptions here which we do not really know the consequences of, and I feel that it is absolutely essential that we not begin to make inroads into pension plans in which retirees have counted on without knowing the consequences. I urge all to support the amendment.

Mrs. KASSEBAUM

Mrs. KASSEBAUM. Mr. President, I send an amendment to the desk on behalf of myself, Ms. Snowe, Mr. Jeffords, Mr. Coats, Mr. Gregg, Mr. Frist, Mr. DeWine, Mr. Ashcroft, Mr. Abraham, and Mr. Gorton, and ask for its immediate consideration.

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

Mrs. KASSEBAUM. Mr. President, the purpose of this amendment is to strike the provisions relating to loan payments from institutions, the elimination of the grace period interest subsidy, and the PLUS loan interest rate and rebate. I will just briefly speak to this, Mr. President, because this has been something the Labor and Human Resources Committee has worked long and hard on. We passed the budget resolution earlier this year in the U.S. Senate. The Labor Committee, as a whole, expressed reservations at that time about the magnitude of the cuts that the resolution directed us to make in the Federal student loan programs. However, we agreed to try and meet the reconciliation instruction, and we did so. As chairman of the Committee on Labor and Human Resources, on behalf of the majority members of this committee, we worked to get a package that met the reconciliation instruction and had the least impact on students. Much has been said on the Senate floor about the impact on students. We consciously directed the effort so that it would not impact strongly on students. This amendment would reduce savings by about $6 billion from the original $10.8 billion that was requested from and produced by the committee. Those costs will be offset by excess savings from the entire budget package. Mr. President, this amendment would eliminate the provision of the bill that would require students to pay for the interest on their subsidized Stafford loans in the 6 months after they leave school. This would have only applied to new borrowers, but we now eliminate that provision. It would eliminate a raise in interest rate and the interest rate cap on the PLUS parent loans and would also repeal the assessment of a participation fee on institutions of higher education. The main difference between this amendment and the amendment offered by Senator Kennedy, is that we leave intact provisions in the budget bill that would decrease the size of the direct loan program to a more appropriate demonstration size, until we can fully assess the merits and feasibility of direct lending. Direct lending does not affect student eligibility for Federal student loans, nor does it affect the amount of funds available for loans or the rates and fees charged to students. They do not make financial aid more affordable or more accessible. Mr. President, I just add that there are two members--one, a member of the committee, Senator Jeffords from Vermont, and the other is Senator Snowe from Maine--who have felt strongly from the very beginning that we simply should not cut into the education funds as much as the reconciliation request required. They have fought long and hard. I will yield what time I have remaining to Senator Jeffords and Senator Snowe but I want to point out that a majority of the committee is cosponsoring this amendment. We are all united behind this amendment, and it has been a dedicated effort on the part of the committee majority members. I yield the floor to the Senator from Vermont.

Mrs. KASSEBAUM. Mr. President, I yield the time remaining to the Senator from Maine [Ms. Snowe].

Mrs. KASSEBAUM. Mr. President, I want to take a few moments this afternoon to discuss a provision in the reconciliation package that has attracted relatively little attention to this point. As many of my colleagues know, the House reconciliation bill includes a measure designed to generate approximately $10 billion in tax revenue by doing away with penalties Congress imposed in 1990 on pension fund withdrawals. The House proposal generally allows companies to take money from pension plans that are more than 125 percent funded and use those funds for any purpose, without informing their workers. In response to a wave of corporate takeovers and pension raids in the 1980's, Congress in 1990 imposed an 50-percent excise tax on pension fund reversions, except in limited circumstances. The idea was to make it costly for companies to take assets from their pension plans. And, in fact, the raids on assets ceased almost entirely. Before this change, however, about $20 billion was siphoned from pension funds in just a few years, many pension plans were terminated, and thousands of workers saw their pensions replaced by risky annuities that provided lower benefits. The reconciliation package before us includes a pension reversion measure that is similar to the House proposal. Under the Senate bill, excess pension assets could be wihdrawn--with little or no penalty--to fund active and retiree health benefits, underfunded pension plans, disability benefits, child care, and educational assistance plans. Mr. President, this represents a significant change in pension policy. I understand that there are approximately 22,000 pension plans covering 11 million workers and 2 million retirees that have assets in excess of 125 percent of current liability, and that the Joint Committee on Taxation estimates that the pension reversion provisions contained in both the House and Senate bills could result in the removal of tens of billions of dollars in assets from these plans. Therefore, while the Senate proposal clearly is more limited than the House proposal, I nevertheless must oppose it. I understand there will be an amendment to strike this provision that will be offered by the ranking member of the Senate Labor and Human Resources Committee, Senator Kennedy. I want to make clear to my colleagues that I intend to support that amendment. The Senate Committee on Labor and Human Resources, which I chair, shares jurisdiction over the Employee Retirement Income Security Act [ERISA] with the Committee on Finance. In the past, the Labor Committee has taken an active role in pension security and pension reversion issues. In fact, the provision reported by the Finance Committee contains modification to title I of ERISA, which clearly fall within the Labor Committee's jurisdiction. Yet the Labor Committee did not consider the pension provisions contained in the legislation before us. And neither the Finance Committee nor the Labor Committee has held hearings to consider modifications of this nature in the pension reversion area. Mr. President, as I said, the Senate proposal clearly is more limited than the House proposal. I also believe that there may be valid reasons to revisit the pension reversion penalties that were imposed in 1990. However, given the actions that led to the imposition of the excise tax, I strongly believe that any modifications in this area should be given full consideration by the committees of jurisdiction and that we should weigh heavily the genuine possibility of adverse consequences to plan participants, the Federal pension insurance program, and the national savings rate that may result from a change in pension policy of this magnitude. Therefore, I intend to support the Kennedy amendment and I urge my colleagues to do the same.

Mrs. KASSEBAUM

Mrs. KASSEBAUM. Mr. President, I rise today to join Senator Bennett, the distinguished majority leader, Senators Hatch, Kennedy, Frist, Leahy, Simon, and others in introducing the Medical Records Confidentiality Act of 1995. We have spent a great deal of time and energy these last several months--and will spend even more time during the coming weeks--debating changes to the Medicare and Medicaid programs. As we debate these changes, the private health care system continues to literally transform itself overnight. While health providers still wrestle with multiple paper forms and bulky files, increasingly health information and data is digitally transmitted to multiple databases by high-speed computers over fiber- optic networks. Many Americans believe their private medical records are safely stored in doctors' offices and hospitals. Yet, the evolving health care delivery system and the technological infrastructure necessary to support it has left gaping holes in the patchwork of current State privacy laws and threatened the confidentiality of private medical information. Let me give just one example that highlights both the promise and the peril of medical information. Recent advances have allowed researchers to identify a growing number of genetic characteristics that place individuals at higher-than-average risk for developing disease. While genetic research provides tremendous opportunities to help us better treat and manage illness, disclosure of genetic information also may place individuals at a greater risk of discrimination in obtaining health coverage for themselves and their families. The Medical Records Confidentiality Act takes a balanced approach to encouraging the continued development of a world-class health information infrastructure while, at the same time, assuring Americans that their sensitive medical records are protected. The legislation is designed to provide all patients with Federal safeguards for their medical records, whether in paper or electronic form, and to provide doctors, hospitals, insurance companies, managed care companies, and other entities that have access to medical records with clear Federal rules governing when and to whom they may disclose health information. Mr. President, I applaud Senator Bennett for taking on such a complex and important issue. I look forward to working with him, and with my colleagues on the Senate Committee on Labor and Human Resources, to see [[Page S 15578]] that this very important piece of legislation is enacted during the 104th Congress.

Mrs. KASSEBAUM

Mrs. KASSEBAUM. Mr. President, I rise today to join Senator Bennett, the distinguished majority leader, Senators Hatch, Kennedy, Frist, Leahy, Simon, and others in introducing the Medical Records Confidentiality Act of 1995. We have spent a great deal of time and energy these last several months--and will spend even more time during the coming weeks--debating changes to the Medicare and Medicaid programs. As we debate these changes, the private health care system continues to literally transform itself overnight. While health providers still wrestle with multiple paper forms and bulky files, increasingly health information and data is digitally transmitted to multiple databases by high-speed computers over fiber- optic networks. Many Americans believe their private medical records are safely stored in doctors' offices and hospitals. Yet, the evolving health care delivery system and the technological infrastructure necessary to support it has left gaping holes in the patchwork of current State privacy laws and threatened the confidentiality of private medical information. Let me give just one example that highlights both the promise and the peril of medical information. Recent advances have allowed researchers to identify a growing number of genetic characteristics that place individuals at higher-than-average risk for developing disease. While genetic research provides tremendous opportunities to help us better treat and manage illness, disclosure of genetic information also may place individuals at a greater risk of discrimination in obtaining health coverage for themselves and their families. The Medical Records Confidentiality Act takes a balanced approach to encouraging the continued development of a world-class health information infrastructure while, at the same time, assuring Americans that their sensitive medical records are protected. The legislation is designed to provide all patients with Federal safeguards for their medical records, whether in paper or electronic form, and to provide doctors, hospitals, insurance companies, managed care companies, and other entities that have access to medical records with clear Federal rules governing when and to whom they may disclose health information. Mr. President, I applaud Senator Bennett for taking on such a complex and important issue. I look forward to working with him, and with my colleagues on the Senate Committee on Labor and Human Resources, to see [[Page S 15578]] that this very important piece of legislation is enacted during the 104th Congress.

Mrs. KASSEBAUM

Mrs. KASSEBAUM. Mr. President, I ask unanimous consent that the Senate proceed to the immediate consideration of Calendar 204, S. 1048.

Mrs. KASSEBAUM. Mr. President, I send an amendment to the desk on behalf of Senator Pressler.

Mrs. KASSEBAUM. Mr. President, I ask unanimous consent reading of the amendment be dispensed with.

Mrs. KASSEBAUM. Mr. President, I ask unanimous consent that the amendment be agreed to, the committee substitute, as amended, be agreed to, the bill be deemed to have been read a third time and passed, and the motion to reconsider be laid upon the table, and that any statements relating to the bill be placed in the appropriate place in the Record.

Mrs. KASSEBAUM

Mrs. KASSEBAUM. I wonder if the Senator from Minnesota would yield for a few moments for some unanimous-consent requests.

Mrs. KASSEBAUM. Mr. President, the other evening, the majority leader, Senator Dole, spoke about the opportunities which the GI bill provided to thousands of Americans following World War II. Enactment of the GI bill in 1944 marked the beginning of Federal efforts to open the door to postsecondary education for individuals who would otherwise be unable to attend. Over the past 50 years, the scope and variety of Federal student aid programs have expanded considerably. Today, any student in need of financial help can obtain it. My reason for addressing the Senate now is to dispel the notion that, somehow, all this will change if Congress enacts student loan changes as part of the budget reconciliation bill. Unfortunately, misconceptions about this legislation are widespread, and I believe it is important to set the record straight. A few weeks ago, the Senate Committee on Labor and Human Resources reported its portion of this legislation, providing Federal student loan savings of $10.85 billion over 7 years. Because the Federal student loan program is one of the few mandatory spending programs under the jurisdiction of the Labor and Human Resources Committee, it was the only place we had to turn in order to comply with our instruction. Granted, $10.85 billion is a substantial sum over 7 years. However, to hear some describe our package, one would assume that it spells the end of higher education as we know it. Mr. President, that is simply not the case. Federal student loan programs were established to assist students and their parents in financing postsecondary education. These programs have been successful in achieving that goal. Approximately $26 billion in loan funds have been made available this year. The figure will grow next year. Even if the Labor Committee package is approved intact, that volume will grow. The reason is that the savings in this package were achieved without restricting a student's ability to borrow. In short, there is nothing in the package which limits the amount of loan funds available. Loans will continue to be available to all who qualify. There is nothing in the package which limits the ability of a student to qualify for a [[Page S 15298]] Federal loan. The rules are exactly the same as they have been. There is nothing in the package which increases the cost of the loan to a student who is in school. The only direct cost to students included in the package applies to new borrowers after they leave school. At that point, they will continue to be able to defer loan payments for 6 months--the so-called grace period--but the Federal Government will no longer subsidize interest payments during that period of time. That, I believe, Mr. President, is reasonable. This package was developed with the clear intention of minimizing costs to students. I believe that purpose was accomplished. It is, therefore, particularly disturbing to me that students and their families are being intentionally misled about the impact of the proposed changes. I fear that this misinformation will discourage some students from even exploring postsecondary education, and that, I believe, would be a real tragedy. I would like to explain briefly how the $10.85 billion in savings is achieved. First of all, about $4 billion of the savings comes from reductions to entities involved in the guaranteed loan program, such as banks and guaranty agencies. The elimination for new borrowers of the interest subsidy during the 6-month grace period achieves about $2.7 billion in savings over that 7-year period. This change would mean an extra $1.89 a month for an undergraduate who borrows $5,500 in 1 year. At most, it would mean an additional $22.50 a month for a graduate student who has borrowed the $65,000 maximum through his or her college career. Capping the direct loan program at 20 percent of loan volume produces about $1.5 billion in savings. Additional savings are achieved through the elimination of fees paid to schools and alternative originators for direct loan administration. Whatever one may believe about the merits or demerits of direct lending, the fact remains that the way a loan is delivered has absolutely nothing to do with the ability of students to borrow or with the amounts they may borrow. The terms and conditions of direct loans are identical to those of guaranteed loans. There is no difference to the students at that juncture. To suggest that paring back the direct loan program will deprive students of loan funds or make those funds more expensive is plainly inaccurate. The one advantage, at this point, of direct loans and direct lending is that it makes a loan available immediately. It does expedite the process of obtaining a loan by a student. As far as any difference in the loans being more expensive, that is certainly not the case. The package also calls upon postsecondary education institutions to participate in achieving savings by imposing a fee equal to 0.85 percent of the amount of Federal loans made available to their students. This proposal produces about $1.9 billion over 7 years. Some have argued that these costs will be passed directly on to the students rather than being absorbed through the efficiencies in other school operations. Perhaps that will be the case. Even if the entire cost is passed on to the student, it would amount to an average of $20 to $25 per student per year. That is at the high end. Others would be about $11 to $12 to $13 per year. Finally, approximately $700 million in savings is achieved by increasing the interest rate and the interest rate cap on parent loans. When one looks beyond the hype to see the facts, Mr. President, it is clear that this reconciliation package does not spell disaster for secondary education in this country. Blaming a Republican Congress for reducing access to postsecondary education by increasing its costs may be convenient, but it does not explain away the fact that college tuitions have been growing at a rate surpassing inflation for well over a decade. That is what has caused such enormous problems for students and their families, is the escalating cost of college education due to increased tuition. Figures recently released by the college board show an average tuition increase this year of 6 percent, more than double the inflation rate. Average tuition in fees at a 4-year public institution are $2,860. For a 4-year private institution, these costs average $12,432. Mr. President, another 6-percent increase in those amounts next year would mean an additional per-student cost ranging from $171 to $745, presenting far more serious problems for students and their families than anything in this reconciliation package. Federal student aid is simply not going to be able to pick up the slack in such an environment, nor is that a role for which it was intended. That is what I think we need to understand, Mr. President. There is not anything in the reconciliation package regarding student loans that I suppose we would be comfortable with. On the other hand, it is not the tragedy that is being portrayed. I think it is very important that students and their families understand that. No one relishes the task of cutting back. It is much easier to build upon the expensive policies that have brought us to our current budget problems in the first place. However, one can prune the branches without killing the tree. It is a disservice to the American taxpayers to suggest otherwise. Mr. President, I yield the floor.

Mrs. KASSEBAUM

Mrs. KASSEBAUM. Mr. President, today, there will be a period for morning business until the hour of 10:30 a.m. At 10:30, the Senate will resume consideration of H.R. 927, the Cuba sanctions bill, with Senator Dodd to be recognized to offer his two amendments. The only remaining amendment in order to the bill is the Simon amendment No. 2934, which has a 20-minute time limitation. Therefore, it is expected that the Senate will complete action on the bill early this afternoon.

Mrs. KASSEBAUM

Mrs. KASSEBAUM. Yes.

Mrs. KASSEBAUM

Mrs. KASSEBAUM. Mr. President, I ask unanimous consent that the Senate proceed to the immediate consideration of Senate Resolution 177, reported today by the Judiciary Committee.

Mrs. KASSEBAUM

Mrs. KASSEBAUM. Mr. President, I ask unanimous consent that Calendar 206, S. 1318, the Amtrak and Local Rail [[Page S 15313]] Revitalization Act of 1995, be referred to the Finance Committee solely for the consideration of title 10 of the bill, for not to exceed 15 calendar days; and further, that if the bill has not been reported from the committee after the 15 days, it automatically be discharged and placed on the calendar.

Mrs. KASSEBAUM

Mrs. KASSEBAUM. Mr. President, I ask unanimous consent that the resolution be agreed to, the preamble be agreed to, and the motion to reconsider be laid upon the table, and that any statements relating to the resolution appear in the appropriate place in the Record.

Mrs. KASSEBAUM

Mrs. KASSEBAUM. Mr. President, on behalf of Senator Kennedy, Senator Frist, and myself, I introduce legislation which will further improve the quality and equity of solid organ and marrow transplantation. We can all be proud of the solid foundation that private initiatives, supported by Federal funding, have created. However, now that this infrastructure is in place, I believe that it is time for Congress to reexamine the Federal role in the oversight and the financing of solid organ and bone marrow transplantation. The partnership between the Government, the solid-organ transplant community, and the public has worked well. However, the recent experience with the heart transplant program in my own State of Kansas, or the public distrust voiced when Mickey Mantle received his liver transplant, reminds us that improvements need to be made. In 1994, more than 18,000 solid organ transplants were performed. Yet, more than 41,000 other Americans still await an organ for transplantation. This disparity between the supply and the demand for organs to transplant confirms that continued Federal oversight is necessary to provide the public with a sense of fairness and trust. Even though Federal oversight is still required, we must consider alternatives to fund the vital functions of the organ transplant network. The legislation we are introducing today stresses equity for all beneficiaries and proposes a balanced approach. Governmental oversight is maintained but clarified. The Organ Transplant Network remains responsible for the development of transplant policies, and the program remains grounded in the expertise of the transplant community. The importance of transplant candidates, patients, and their families as the real consumers of transplant services is reconfirmed, and this legislation increases their voice in the process. In addition, the phase-in of a new ``data management fee'' will guarantee that future transplant services will continue uninterrupted. Mr. President, the shortage of organs for transplantation is a problem which we, as a nation, have not yet solved. Recent medical studies have shown a continued reluctance by the American public to consent to organ donation when faced with the impending death of a family member. New and innovative approaches must be developed to increase the public's acceptance of organ donation. This legislation authorizes funding--obtained through a partnership among the government, the Nation's transplant centers, and the organ procurement organizations--to address the continued shortage of organs for transplantation. A single piece of legislation cannot be expected to correct the problem of insufficient organs for transplantation, but we believe that this proposal moves the transplant program in the right direction. Unrelated-donor bone marrow transplantation poses a different challenge. The National Bone Marrow Donor Registry was developed to facilitate and to maximize the number of bone marrow transplants for patients who do not have a matched relative. The success of this program to recruit potential marrow donors has been admirable, but as noted in the recent past by the General Accounting Office, the number of resulting transplants has been quite modest. Increasing the number of unrelated-donor bone marrow transplantations will likely require more than just expanding the potential marrow donor pool. Improvements in technology and scientific understanding of transplantation will need to be made. Because of these biologic limitations, I question continued Federal funding and the merits of a government-funded national bone marrow registry. Therefore, Mr. President, this legislation reauthorizes the National Bone Marrow Donor Registry, it reconfirms the goal to increase unrelated-donor bone marrow transplants, and it provides advocacy services for patients and donors. This legislation also requests the Institute of Medicine to evaluate the future role of a government- funded marrow transplant program as a means to maximize the number of unrelated-donor bone marrow transplants. I recognize that the present Federal budget constraints and the proposed reevaluation of the Federal role in transplantation have caused some concern. However, I believe this situation provides both the transplant communities and the Congress with a unique opportunity. This legislation is a carefully crafted plan for the future. It strives for equity for all beneficiaries, an appropriate degree of Government oversight, an evaluation of the future governmental role, an appropriate level of fiscal responsibility, and the development of a system to respond to the present and future transplantation needs. As discussion of these issues develops, I would welcome any suggestions my colleagues or others may have for improving this legislation. Mr. President, I ask unanimous consent that the text of the bill and a summary be printed in the Record.

Mrs. KASSEBAUM

Mrs. KASSEBAUM. Mr. President, on behalf of Senator Kennedy, Senator Frist, and myself, I introduce legislation which will further improve the quality and equity of solid organ and marrow transplantation. We can all be proud of the solid foundation that private initiatives, supported by Federal funding, have created. However, now that this infrastructure is in place, I believe that it is time for Congress to reexamine the Federal role in the oversight and the financing of solid organ and bone marrow transplantation. The partnership between the Government, the solid-organ transplant community, and the public has worked well. However, the recent experience with the heart transplant program in my own State of Kansas, or the public distrust voiced when Mickey Mantle received his liver transplant, reminds us that improvements need to be made. In 1994, more than 18,000 solid organ transplants were performed. Yet, more than 41,000 other Americans still await an organ for transplantation. This disparity between the supply and the demand for organs to transplant confirms that continued Federal oversight is necessary to provide the public with a sense of fairness and trust. Even though Federal oversight is still required, we must consider alternatives to fund the vital functions of the organ transplant network. The legislation we are introducing today stresses equity for all beneficiaries and proposes a balanced approach. Governmental oversight is maintained but clarified. The Organ Transplant Network remains responsible for the development of transplant policies, and the program remains grounded in the expertise of the transplant community. The importance of transplant candidates, patients, and their families as the real consumers of transplant services is reconfirmed, and this legislation increases their voice in the process. In addition, the phase-in of a new ``data management fee'' will guarantee that future transplant services will continue uninterrupted. Mr. President, the shortage of organs for transplantation is a problem which we, as a nation, have not yet solved. Recent medical studies have shown a continued reluctance by the American public to consent to organ donation when faced with the impending death of a family member. New and innovative approaches must be developed to increase the public's acceptance of organ donation. This legislation authorizes funding--obtained through a partnership among the government, the Nation's transplant centers, and the organ procurement organizations--to address the continued shortage of organs for transplantation. A single piece of legislation cannot be expected to correct the problem of insufficient organs for transplantation, but we believe that this proposal moves the transplant program in the right direction. Unrelated-donor bone marrow transplantation poses a different challenge. The National Bone Marrow Donor Registry was developed to facilitate and to maximize the number of bone marrow transplants for patients who do not have a matched relative. The success of this program to recruit potential marrow donors has been admirable, but as noted in the recent past by the General Accounting Office, the number of resulting transplants has been quite modest. Increasing the number of unrelated-donor bone marrow transplantations will likely require more than just expanding the potential marrow donor pool. Improvements in technology and scientific understanding of transplantation will need to be made. Because of these biologic limitations, I question continued Federal funding and the merits of a government-funded national bone marrow registry. Therefore, Mr. President, this legislation reauthorizes the National Bone Marrow Donor Registry, it reconfirms the goal to increase unrelated-donor bone marrow transplants, and it provides advocacy services for patients and donors. This legislation also requests the Institute of Medicine to evaluate the future role of a government- funded marrow transplant program as a means to maximize the number of unrelated-donor bone marrow transplants. I recognize that the present Federal budget constraints and the proposed reevaluation of the Federal role in transplantation have caused some concern. However, I believe this situation provides both the transplant communities and the Congress with a unique opportunity. This legislation is a carefully crafted plan for the future. It strives for equity for all beneficiaries, an appropriate degree of Government oversight, an evaluation of the future governmental role, an appropriate level of fiscal responsibility, and the development of a system to respond to the present and future transplantation needs. As discussion of these issues develops, I would welcome any suggestions my colleagues or others may have for improving this legislation. Mr. President, I ask unanimous consent that the text of the bill and a summary be printed in the Record.

Mrs. KASSEBAUM

Mrs. KASSEBAUM. Mr. President, I appreciate the Senator from North Dakota limiting his remarks. It is a subject, and an important subject that he cares a great deal about.

Mrs. KASSEBAUM

Mrs. KASSEBAUM. Mr. President, that is fine. I will be happy to wait.

Mrs. KASSEBAUM

Mrs. KASSEBAUM. Mr. President, I would like to speak on the subject of the legislation before us at this time, which is the Cuban Liberty and Democratic Solidarity Act, and to say that all of us on both sides of the aisle share I believe the same objective--to craft a United States policy toward Cuba that will most effectively encourage a democratic transition in that last stronghold of authoritarian rule in our hemisphere. The question before us today is whether this legislation is the best means of advancing that goal. If I may speak for just a moment about some of the concerns that I have, in the past, I have argued for a policy of strengthened engagement with the Cuban people. I believe we should take steps to encourage the free exchange of ideas within Cuba and increase news coverage of the island, to support dissident organizations and humanitarian groups in Cuba, and to help lay the groundwork for support of a post Castro government. These objectives are widely shared. Some of the initiatives announced last week by President Clinton would move us in that direction. Similarly, chapters I and II of the legislation before us take a similar approach. I want to commend the chairman of the Foreign Relations Committee, Senator Helms, the majority leader, Senator Dole, and other colleagues on both sides of the aisle--this is not a partisan issue on this legislation--for their hard work on these sections of the bill. But to my mind, Mr. President, this legislation still raises very difficult issues, primarily in chapter III of the act before us. That section establishes a cause of action in United States Federal courts against any person or organization, foreign or domestic, who acquires property in Cuba against which a United States national has an expropriation claim. In part, this approach is designed to help United States nationals to recover damages for the expropriation of their property in Cuba, and that is certainly understandable. Since they cannot recover from the Castro regime, this legislation would let them go after deep-pocket companies that have acquired property that Castro expropriated. At the same time, this approach has, in my judgment, a broader foreign-policy consequence--to discourage foreign investment in Cuba. It seeks to do so by discouraging companies from acquiring certain expropriated property because of the uncertainty of what litigation may be involved. It is interesting that this legislation would allow any United States citizen who meets its criteria to seek relief through our Federal courts--even if the person is recently naturalized and was a Cuban citizen at the time the Cuban Government expropriated his property or her property. I believe many questions about this approach remain unanswered, and perhaps they can be answered. But I want to raise them now with issues that are troubling to me, and I have been very appreciative of Senator Helms and Senator Helms' staff who have offered to try to help me understand the questions that I have. What precedent are we setting for use of our Federal courts? I am not convinced that Congress would be wise to decide that our Federal courts should be used as a tool to advance our foreign policy interests. If we use courts to advance our policy objectives in Cuba [[Page S 15089]] today, will we be tempted tomorrow to use the courts to advance our interests in China? In Eastern Europe? In Africa? And what if policy objectives that are current today change tomorrow, as they often do in the fluid field of diplomacy and international politics? Will we then change the cause of action we have established in our legal system? What effect will that have on the certainty of the law and the distinction between law and diplomacy? What will be the practical effect on our court system? Estimates of the number of lawsuits that would be filed under this legislation vary widely, from less than a dozen to tens of thousands. It is protective, not retrospective. And I understand that. But it could go from less than a dozen to perhaps thousands of cases. We really do not know. At a time when our courts already are overburdened, it seems to me we should conduct a thorough and thoughtful assessment of what would be required if this legislation were to become law. Will this approach make us, rather than Castro, the focus of the international Cuban debate? In this bill, we are considering extending the reach of our courts for political purposes, and many of our friends--countries that have businesses that could find themselves hauled into U.S. court under this legislation--have serious concerns about this approach. At a time when we want to marshall our friends to our side in opposition to the Castro regime, we may discover that we have instead driven a wedge between us. Will this approach spawn a backlash against our companies abroad? Many U.S. companies worry that if we choose to use U.S. courts as a channel to pressure foreign companies to advance political objectives, other countries will do the same. We may well find our companies operating abroad dragged into foreign courts as part of broader policy disputes that do not even involve the United States. I believe we should think very carefully about the precedent we may be setting. Mr. President, I commend the majority leader and the chairman of the Foreign Relations Committee for their leadership in bringing this important debate before the Senate. But I do think there are serious questions that relate both to our foreign policy and to our judicial system about which we must think very carefully. I know these matters have been discussed at length--certainly people on both sides have made strong arguments to me about their position. The Foreign Relations Committee did conduct a hearing on some of the issues related to this subject. But I am troubled that neither the Foreign Relations Committee nor the Judiciary Committee has given this complex legislation the careful review that it deserves, regarding the judicial structure as laid out in the legislation before us. Perhaps I am too conservative in my approach to this matter. But it seems to me that we should be hesitant to take steps that may potentially politicize our courts, may put at risk our businesses abroad, and may detract from our efforts to marshall international support for ending the Castro regime, which is what we are all dedicated to addressing here in the U.S. Senate. The Senate should think and act very carefully before taking this precedent-setting step in my judgment. Mr. President, I yield the floor. Mr. THOMPSON addressed the Chair.