Nancy Kassebaum

Mrs. KASSEBAUM

Mrs. KASSEBAUM. I would ask unanimous consent that the interpretive memorandum be printed in the Record immediately preceding the disposition of the amendment, and I thank the Senator from Illinois.

Mrs. KASSEBAUM. We have drafted a sponsors' memorandum to accompany the amendment to assist with the interpretation of this legislation. Would the Senator agree that this interpretative memorandum embodies what the sponsors intend to accomplish with this legislative change to ERISA?

Mrs. KASSEBAUM. Mr. President, I rise for the purpose of entering into a colloquy with the Senator from Illinois regarding his limited scope audit amendment.

Mrs. KASSEBAUM

Mrs. KASSEBAUM. Mr. President, I have no objection to setting aside the underlying committee amendment, if that is the wish of the Senator. I thought, actually, we could voice vote the sense of the Senate. There are many other amendments that will require lengthy debate. If we want to set aside the entire amendment, that is fine. I am happy to do so, so the debate can proceed on other amendments.

Mrs. KASSEBAUM. Mr. President, I suggest that we have been in the 104th Congress for 2 years. This legislation was introduced in the House some time ago. It would have been useful to us here in the U.S. Senate if this legislation had been before us prior to July 31. We would then have had time to hold committee hearings, which I think would have enabled us to make some corrections or additions or changes and to understand better the consequences of all the steps toward the goals we do support. I think it is not fair to say all of a sudden that, because a bill introduced right before the August recess has not yet been considered, that means it is something we do not care about. There was time in which the process could have moved forward, had the bill been introduced earlier.

Mrs. KASSEBAUM. Mr. President, no, this is not another study. It is a sense-of-the-Senate resolution. So it does not have statutory authority as the language of the Senator from Oregon would have had. However, it does not call for another study. It simply says that the Senate should take into account any relevant findings of the National Commission on Health Care Quality which President Clinton has said he would appoint and other public and private entities with expertise in this issue and in the quality of health care service delivery. We would consider the views of those entities at a hearing before the Labor and Human Resources Committee, the committee of jurisdiction over this legislation. I do not think another study is important so much as gaining understanding through a hearing about what facts are known and what points of view would be expressed from different aspects of the health care service delivery industry, and then acting expeditiously. So I assume the bill of the Senator from Oregon would be the vehicle in the next Congress. Hopefully, the bill would be introduced right at the beginning of the Congress, so that there would be time to look at it. I think that the interest in this issue is indicative of the fact there is going to be a great deal of interest in legislation regarding this subject. So I am not calling for a study. My amendment says we should act expeditiously, but we should review all of the pertinent information that is available.

Mrs. KASSEBAUM. Mr. President, this amendment is very brief, if I may just explain it. It expresses the sense of the Senate regarding communications between physicians and their patients. It addresses the same issue that we have just been debating. I think we have had a good and extensive debate. My concern with the amendment on which we just voted was that its provisions had not been fully considered and had not been the subject of any hearings in the Senate. We needed to approach the issue, I thought, in a more cautious way--even though there was strong support for the concept behind that amendment. My amendment is just saying that: It is the sense of the Senate that the Committee on Labor and Human Resources of the Senate, taking into account any relevant findings of the National Commission on Health Care Quality and other public and private entities with expertise and quality health care service delivery, should act expeditiously in the first session of the 105th Congress to schedule hearings and executive session consideration of legislation designed to ensure that patients be given access to all relevant information concerning their health care so as to permit such patients, in consultation with their physicians, to make appropriate decisions regarding their health care, and that the Senate should promptly consider that legislation. This amendment is consistent with the intent of the legislation offered by the Senator from Oregon and the Senator from Massachusetts, but puts the Senate on record as supporting the use of the standard and proper procedures that I think are needed to give this issue the full and careful consideration it deserves. Since we have had, I think, a full debate, I ask for the yeas and nays and for the immediate consideration of this measure.

Mrs. KASSEBAUM. Mr. President, no. As I stated, I am happy to lay aside the underlying amendment. Otherwise, my sense of the Senate is open to being amended. I feel that would not be a good position in which to be placed at this point. I am happy to do so and proceed with other amendments to the bill and see what we can work out. That is the position I take.

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

Mrs. KASSEBAUM. Mr. President, I send to the desk an amendment to the committee amendment and ask that it be considered.

Mrs. KASSEBAUM. Mr. President, I wish to speak briefly in order to mention to the Senator from Oregon that he has talked a couple of times about the language of the Senator from North Carolina, Senator Helms. I just visited with Senator Helms to ask him what he thought of the provision before us. He pointed out that his language is much more narrowly drawn. It applies only to the Federal Employees Health Benefits Plan and includes some specific criteria. He has some difficulty believing that we should expand it further without understanding more of the ramifications. I, like everyone else, have great sympathy for what Senator Wyden has been wanting to accomplish, and what Congressman Ganske wants to do in the House. I just have to say, however, it may not be as easily done as we would like to believe that it could be. That is all the more reason, I think, that we ought to at least have a hearing in the Senate and take the legislation through the committee. As I said, and as Senator Kennedy pointed out, we have considered some major legislation which has not gone through the full committee process. But, in general, those have been instances in which we have had some fairly extensive debate. This proposal came to us without advance warning and without benefit of prior discussion in the committee or in the Senate. We are simply not prepared to look at language regarding contractual arrangements in the private sector and make wise decisions about it overnight. I yield the floor. Mr. SHELBY addressed the Chair.

Mrs. KASSEBAUM. Mr. President, I say, first, this is not an effort to hide behind a technical point of order. I care just as much as the Senator from Massachusetts or the Senator from Oregon about the quality of health care. We all do in this Chamber. There is a process, unfortunately--or fortunately--under which we operate around. That process requires us to do some things to assure that issues are considered with some thoroughness, and I believe that is appropriate. I agree in many ways, in all ways, actually, on the principle to which the Senator from Oregon and the Senator from Massachusetts are speaking. Patients should have access to complete and accurate information regarding their health care. None of us here in this Chamber disagree with that concept, or with the concept that doctors should be allowed to share that information with their patients. Patients' communications with their doctor should be protected. I think we would all feel this is a prime concern. It is a vital part of the health care process. I have a great deal of sympathy for the motivations behind the amendment that is offered by Senators Wyden and Kennedy. However, I believe it would simply be irresponsible to approve it in the absence of any review or discussion of its provisions at any level in the U.S. Senate. The legislation upon which the amendment is based was introduced barely a month ago on July 31 and no committee hearings have been held. I have visited with Senator Wyden because, as chairman of the Labor and Human Resources Committee, I have wanted to hold hearings on this legislation since we came back from the August recess. It has not been possible to find a time that we were able to put a hearing together. That does not mean that it is not going to happen, and certainly it should be a priority of the next Congress. However, just as so often happens here when we begin to run out of time, we want to add everything that we can to the appropriations bills that are moving. In this instance, as has been pointed out, a similar proposal was approved by the Commerce Committee in the House of Representatives. It is a bipartisan measure. There is nothing partisan about this. It passed unanimously in committee. It has not been considered by the full House of Representatives. I believe that, when we are looking at aspects of a very important and yet complex piece of legislation, we do have to go through the procedures and processes that are part of our operation here, whether we want to or not. It certainly is not unprecedented to have extraneous amendments offered at the last minute. However, the Senate's being asked to decide a highly complex issue without the benefit of any review at all is, I suggest, Mr. President, a mistake. It is a mistake. Our procedures may delay consideration of legislation we support, but it protects us from legislation that we do not support as well. We need to be able to understand what a piece of legislation is all about. For example, we are not sure what CBO's scoring of this amendment is. It might not be important, but it is a requirement we have scoring around here. We have that requirement so we can better understand the budgetary consequences of our actions, and--generally--we are required to provide offsets for spending increases. As I mentioned earlier and as Senator Wyden pointed out, the House Commerce Committee has considered this issue and has held extensive hearings. I have visited with Congressman Ganske myself, and I have high regard for the dedication that he has given to this issue and for the time that he has spent with it. His being a doctor, I have high regard for his understanding of the issue. I have great interest in his work and feel that he is to be commended for moving forward the discussion to the point that it has progressed. However, I point out that even the authors of the amendment before the Senate acknowledge that the work of the House committee is not the final word, as several provisions of the amendment depart from the language approved by the House committee. The reason that we have committees in the Senate and the reason that each one of us spends, or should spend, so many hours in committee work is to lend some degree of thought and expertise to public policy issues. It can be very frustrating when legislation does not move forward at the pace we would like to see. Nevertheless, the committee system is one of the processes, and perhaps breaks, that we have here, Mr. President. That system enables us to turn out, one would hope, a finished product where we understand what the language means and which avoids the unintended consequences of the initial language proposed. In the course of this work, I think we find that very little is as simple as it may seem at first glance. We also find our initial solutions can spawn problems just as serious as those we set out to address. Such solutions are inevitably refined and improved as additional information is gathered. In an area as complex and dynamic as managed care, we need to give serious thought and deliberation before launching the Federal Government into the middle of private contractual arrangements. The amendment is intended to address an important issue regarding quality health care, and it is an important issue. But good intentions are not sufficient; we need to understand the consequences of the language we use and the actions we take. In fact, President Clinton himself has acknowledged the need for a closer examination of managed care issues with his recent announcement of his plans to establish the National Commission on Health Care Quality. As I stated when I began speaking, I am not arguing that this issue should be ignored. In fact, I think it is a very important issue for us to look at and one of the next important steps in any of our health care debates. It is a legitimate concern. It is for this reason I intend to propose an amendment calling for action in this area early next year after there has been an opportunity to review the full ramifications of the solution proposed by the Senator from Oregon. A vote ``no'' on this motion, Mr. President, does not mean that we do not care. A vote ``no'' is not hiding behind some procedural arrangement. A vote ``no'' is simply saying we have a process that we should make work as intended in order to give us the best end result on an issue that we all care deeply about and that I believe should be of prime concern. I yield the floor.

Mrs. KASSEBAUM

Mrs. KASSEBAUM. I would like to reiterate my opposition to the legislation before us. Last Friday, we had a thorough debate on the Employment Nondiscrimination Act during the course of which important arguments were made why it should not become law. First, Senator Hatch pointed out the relationship between this bill and title VII and how the use of statistics in certain cases will also be available under this bill. The net result is that under this bill, as under title VII, statistics may be used by the EEOC as evidence of discrimination. Employers, as a defensive measure, may feel compelled to keep track of the sexual preferences of their employees. This is an example of the unintended consequences that may flow from this bill. Second, Senator Ashcroft pointed out that the bill itself acknowledges that there are legitimate reasons why in certain situations the law should not apply. For example, the bill exempts the military as well as religious organizations and their not-for-profit activities. His question, which I think is a good one, is: If there are reasons for exempting these employers, may not these same reasons apply to other employers in the private sector? Finally, Mr. President, I want to repeat my own principal objection to this bill. I do not believe that relying on more lawsuits and litigation, as this bill would do, will promote greater tolerance in the workplace. I believe prejudice and discrimination can be fought in other ways, and I hope that it would be done--leading by way of example. The Senator from Massachusetts [Mr. Kennedy], who is the author of the legislation, pointed out numerous examples of employers who adopted their own nondiscrimination policies, and I applaud those efforts, but I do not believe we need to create another legal cause of action with compensatory and punitive damages that will only lead to more division in the workplace, not less. Mr. President, I urge my colleagues to vote against this bill, and I yield the floor.

Mrs. KASSEBAUM

Mrs. KASSEBAUM. Mr. President, I would like to speak for just a few moments on the Defense of Marriage Act. I will speak in support of it. But it is an issue relating to marriage that I think is one that is an example of where divorce and related domestic matters have traditionally been subject to State law. I believe they should remain so. Same-sex marriage is a concept with which few Americans are comfortable, and I do not believe that the judgment of one court in a single State should hold sway over the rest of the Nation. States should have the ability to disregard same-sex marriages if they so choose, and this legislation would permit them to do that. Many aspects of this debate are troubling, as it touches not only on questions of law and the Constitution, but also on deeply held personal views about values, cultural traditions, and religion. As legislators, we are not always adept at debating matters such as this, and we find ourselves on far less comfortable ground in debating Federal legislative approaches to highly personal matters. We are more adept at debating matters of law and policy. But here I think we are on uncertain territory, and we have had already differing views expressed during the course of this debate. Unfortunately, such debate sometimes occurs in an atmosphere of rigidity and intolerance. They are not dialogs aimed at reaching any sort of understanding but, rather, become shouting matches, which can happen in the public arena in our own States, not aimed at reaching any sort of understanding, in which each side becomes securely stationed behind its line in the sand. The terms of engagement are set by extremists at both ends. I have been picketed by both sides, out in my own State, in Kansas. The debate over this legislation has been no exception. Nothing will make the issues any easier, but no purpose is served by abandoning civility and a respect for differing viewpoints in the process. Nor should we forget that at the heart of the debate over homosexuality are individual Americans. An abstract subject takes on different dimensions when given the face of a friend, a family member, a coworker. The things we all hold dear--family, friendships, a job, a home--present a unique set of challenges for the gay community. It should come as little surprise that, like anyone else, gay men and women would like to live their lives without being defined only by their sexual orientation. Shortly after the August recess, I visited with a young man from Kansas who made a strong plea in opposition to the Defense of Marriage Act, arguing that fear was the driving force behind the measure. Although I was not persuaded to change my position on the legislation, I was deeply moved by his very genuine desire to move the debate beyond stereotypes and unchallenged assumptions. Congress is not the ideal forum for the resolution of these issues, nor will any piece of legislation settle them. However, the tone we set in our deliberations is one which will be echoed around kitchen tables and worksites throughout the Nation. Let that tone be one which honors our democratic traditions of reasoned debate, responsible decisionmaking, and respect for all individuals. I yield the floor.

Mrs. KASSEBAUM

Mrs. KASSEBAUM. Mr. President, I yield myself 5 minutes. Mr. President, I have spoken earlier about concerns I had with this legislation. I agree with the Senator from Missouri. I think one can oppose this legislation and not be thought of as being bigoted or, I suggest, creating stereotypes, because I think there are some very troubling aspects of this bill. The subject of this bill is, in many ways, not easy to define. Let me suggest that there are several points that have been raised here today in the course of the debate. One, I do believe it will lead to prolonged litigation where there are punitive and compensatory damages involved that could further divide the workplace. I do not believe it furthers what we would most like to occur--a tolerant and understanding workplace. Second, there is a question about how this law would impact affirmative action requirements. And third, how it will impact on the strongly held views of employers or employees? I guess what we are really trying to decide here is how far we can go by legislating what employers should or should not do when it comes to firing and hiring. I do not think we can answer that easily by legislation. I frankly believe, as I said before, that I think every single one of us deplores discrimination. We should not stereotype anyone. I do not think that we are. However, I do believe that there are legitimate concerns about the consequences of this bill that lead me to oppose the legislation before the Senate. I think there are better ways to promote tolerance. I suggest, also, Mr. President, that I think it is very important for us to respect differing viewpoints in the process and to continue to hold respect for all individuals. I believe we can hold these views. I believe we can be respectful of differences and still oppose this legislation. As we consider the aspects of the debate that we have heard here this morning, when we vote on Tuesday, I urge those who are uncertain about how to vote, even though there have been arguments that have been made on the other side that have shown where States have had this legislation in place, very few cases have been brought. As the Senator from New York, Senator Moynihan pointed out, and Senator Kennedy as well, to have legislation imposing requirements in order to open doors--indeed, this is a different type of situation and we need to think carefully about what it may lead to in the future. I would suggest there may be some different and better paths as we look at the consequences of litigation on firing and hiring practices. For these reasons and the concerns I believe that exist, I urge all Senators who have some doubts about this to oppose this legislation. I yield back any time remaining, and I suggest the absence of a quorum.

Mrs. KASSEBAUM. I have no problem extending the time.

Mrs. KASSEBAUM. I yield the Senator from Georgia 5 minutes.

Mrs. KASSEBAUM. I yield 10 minutes to the Senator from Oklahoma.

Mrs. KASSEBAUM. Mr. President, I yield as much time as the Senator from Oklahoma would like to use.

Mrs. KASSEBAUM. I am happy to yield 10 minutes.

Mrs. KASSEBAUM. Mr. President, I yield 3 minutes to the Senator from Missouri.

Mrs. KASSEBAUM. Mr. President, I yield 10 minutes to the Senator from Oklahoma.

Mrs. KASSEBAUM. Whatever time.

Mrs. KASSEBAUM. I would be happy to yield 5 more minutes.

Mrs. KASSEBAUM

Mrs. KASSEBAUM. Mr. President, I have been speaking a number of times on why Africa matters to the United States. I spoke before the recess on infectious disease and environmental concerns and how what is happening in Africa can affect the rest of the world, and the United States as well. Today, I would like to address a broader point about environmental issues--what happens to the natural world in Africa holds consequences for Americans. Even as we struggle to find reasonable, responsible solutions to domestic environmental problems, we must remember that our future is closely intertwined with the preservation and sound management of the environment around the world--particularly in Africa. Today much of Africa today is caught in a cycle of environmental degradation, poverty and humanitarian crises. Battles over scarce resources can lead to political conflict, which in turn results in forced migration, and further environmental destruction. As a result, the international community feels the effects of not only global environmental changes, but also refugee flows, instability, and sagging trade revenues. Mr. President, the evidence of environmental degradation on the African continent is overwhelming. From deforestation to land degradation, the shrinking diversity of African plant life to the increasing number of endangered species, the African environment affects the United States. deforestation Let me begin with the most shocking of all the environmental problems sweeping the continent--deforestation. Consider the following: In 1900, forests accounted for 40 percent of the highlands in the Horn of Africa. By 1990, only 4.4 percent of these forested highlands remained. In 1961, as much as 60 percent of the west African nation of Sierra Leone was covered by primary rainforest. Today, that figure has dropped to 6 percent. These are but two examples of what is an all-too-familiar pattern on the continent. And because Africa's population is projected to increase by over 50 percent as early as 2010, the pressures on remaining forest lands are likely to grow as people seek new land to live on, new fields to cultivate, and new sources of firewood for cooking and heating. The immediate consequences of deforestation are soil erosion and flooding. Combined with other forms of land degradation, these trends lead to food shortages and massive displaced populations. Some experts believe that severe desertification will affect more than 100 million people on the continent by 2010. Already, food shortages threaten 22 million people in sub-Saharan Africa. Trapped in a cycle of poverty and need, these people will continue to destroy their natural environment in a desperate effort to survive. Unless we recognize the larger environmental factors that create and exacerbate crises, the United States will continue to operate in a reactive mode, addressing tragic and costly emergencies and famines after they occur, and watching potentially strong societies and markets descend into disaster. The consequences of ignoring environmental issues in Africa extend beyond humanitarian and economic concerns. Africa's forests, like those in South America, act as carbon sinks--absorbing harmful carbon emissions. As global population rates grow, rural-to-urban migration continues, and more and more people drive cars, our capacity to manage air pollution here in the United States and around the world may depend on the survival of these forests. biodiversity Mr. President, in addition to these disturbing trends in land quality, biodiversity depletion in Africa also impacts our future-- particularly in the field of medicine. Over and over again, researchers have found highly effective cures in the forests of Africa: Some may smile at this. But this is scientific research that shows, as a matter of fact, that the rosy periwinkle that grows in Madagascar is highly effective in treating Hodgkin's disease and leukemia. Bark from the African plum tree has proven successful in treating enlarged prostate glands. Yet, in the 1980's, environmental mismanagement in west Africa brought the region's plum trees dangerously close to extinction. We cannot know what other cures may be contained in Africa's rapidly disappearing forest lands--and never will unless more is done to combat the environmental destruction sweeping the continent. Mr. President, just as environmental degradation puts the future of medical research at risk, we cannot begin to guess at what agricultural breakthroughs may never occur as the diversity of African crops is lost to environmental crises. For example, we have already learned: Germplasm from African crops may help the rest of the world to adjust to climate changes by breeding drought-resistant varieties of grain. Researchers at the National Academy of Sciences have identified pearl millet, which grows mainly in west Africa, as a potential jewel for genetic research, due its natural genetic diversity, robust nature, and quick maturation. The African Continent may be home to other, lesser known agricultural breakthroughs that will contribute to global well-being, provided they do not fall victim to the environmental devastation. Mr. President, in recent years, the international community and Africans have become increasingly concerned about threats to animal kingdom diversity. Poaching, human encroachment on animals' natural habitats, and ineffective wildlife management continue to endanger several unique species. While African elephants appear to be making a comeback, black rhinos remain in danger, as do cheetahs, mountain gorillas, and other magnificent species of wildlife. A basic respect for life and an appreciation for its diverse forms demands that we recognize and address the problem of endangered species on the African Continent. Mr. President, all of these trends, as well as the relationship between environmental upheaval and emerging diseases that I discussed earlier, make the case for a thoughtful and engaged foreign policy toward Africa. Responsible and creative environmental policies in Africa--including land management, agroforestry initiatives, pollution reduction, and biodiversity preservation--serve U.S. national interests. With patience and engagement, we gain new cures for painful diseases and new crops to feed our children into the 21st century. We preserve the magnificent diversity of animal life for our grandchildren. And we help bring stability, development and economic growth to the African Continent. We can't do this all by ourselves. That would not be successful policy in and of itself. But we should be mindful of the fact that it does influence the United States and other nations and other continents around the world. And that is why we should be concerned. Both Africans and Americans have a great deal to lose--and perhaps even more to gain--by addressing environmental issues on the African Continent. These are not easy issues, but we must proceed as we would with any long-term security concern--with sensitivity, determination, and wisdom. If we do so, generations of Africans--and Americans--will benefit from a sustainable, diverse, and thriving natural world. Mr. President, I yield the floor and appreciate the opportunity to speak on this issue at this time. Mr. DORGAN addressed the Chair.