Ted Kennedy

Mr. KENNEDY

Mr. KENNEDY. I yield whatever time the leader desires. I understand we have a time agreement; am I correct?

Mr. KENNEDY. May I inquire again, what is the time agreement? I understand there are going to be two amendments--one offered by Senator Daschle and one offered by Senator Nickles or Senator Lott. We were going to debate both of those this afternoon and vote on them tomorrow. Can the Chair tell me how much time we are allocated this afternoon to debate the two amendments?

Mr. KENNEDY. For this afternoon.

Mr. KENNEDY. I yield whatever time the leader wants.

Mr. KENNEDY. Madam President, I yield myself 15 minutes.

Mr. KENNEDY. Madam President, it has taken us a long time during this Congress to have the opportunity to present a legislative proposal to the Senate that would provide an increase in the minimum wage for America's workers who are working on the lower rung of the economic ladder: 50 cents next year and 50 cents the following year. We have tried to bring this before the Senate over the year in a number of different forms and shapes. We were unable to do so. Now we have the opportunity to debate it this afternoon and to vote on it tomorrow. Hopefully, we will have success in passing it. It is very clear that its outcome is uncertain because of the fact that, rather than having a chance to vote on a freestanding piece of legislation that would be considered freely and then considered by the House, passed on to the Senate, this will be wrapped into other extremely controversial legislation. But we are doing the best that we can. We want to give assurances to those Americans who are working at the minimum wage that we are going to continue this battle, as we have over these past years. We are going to continue the battle next year at each and every opportunity, until we have the chance to pass meaningful minimum wage legislation. So there should be no doubt in anyone's mind that this somehow is going to conclude the debate. American workers are entitled to an increase in the minimum wage. We are prepared to make their cases. I am absolutely convinced we will be successful. It is unfortunate we have to try and convince our colleagues on the other side on the basis of the merits of this case, but I think it is important that we, in a preliminary way, address some of the reasons that have been raised historically against the minimum wage. First of all, let's look at where we are on the issue of the minimum wage. This chart reflects where the minimum wage has been since 1967- 1968. These are real dollars. We see that if the minimum wage today was going to have the purchasing power it had in 1968, it would be $7.49, not $5.15 an hour. It would be about $2.30 higher than where it is today. What we have seen is a gradual decline of the purchasing power of the minimum wage. This is so despite the fact that we now have the greatest economic prosperity in the history of the country--more Americans employed, the greatest stock market, lowest interest rates, lowest rates of inflation, lowest unemployment, highest rate of employment in the history of the country. Nonetheless, for those individuals who are at the lower end of the economic ladder, they are slipping further and further and further behind. If our amendment does not pass, the purchasing power of the minimum wage will continue to decline--to the lowest minimum wage almost in the history of the country. Every day that we delay, minimum-wage workers fall further behind. If we don't raise the minimum wage by the end of this year, it will lose all of the value of the last increase in 1996. This is where we are. Now, what are we talking about in scope in terms of the minimum wage? How large an increase are we talking about? And what will be its impact in terms of our total economy? Increasing the minimum wage by a dollar is vital to workers, but it is a drop in the bucket of the national payroll. If you combine their wages and salaries, all Americans earn $4.2 trillion a year. An increase of $1 in the minimum wage would amount to one-fifth of 1 percent in terms of total wages over the country. We should not even hear the argument--and I hope we won't--that this effort to raise the minimum wage is somehow going to be inflationary. We are talking about one-fifth of 1 percent of total wages for those who are working 40 hours a week 52 weeks a year. In a moment, I will come to that. More of them are working 50 hours a week, trying to play by the rules, trying to bring up a family and they are still coming up short. This is what is happening. We are finding out that those who are on the bottom rung of the economic ladder are working hard but still in poverty. The annual minimum wage is not even keeping up with the poverty line. We are finding more and more workers who are affected by this. Then, finally, on this phase of the debate, I want to point out the employment figures. We find that we have seen, since the increase in the minimum wage that we passed in 1996 and 1997, there has still been an increase in job growth. This chart shows the increase in 1996, up to $4.75, and then to $5.15. Even with these increases we see new jobs being created and strong economic growth. All of those on the other side of the aisle who made the predictions that we are going to lose 300,000 to 400,000 jobs if we pass an increase in the minimum wage were wrong. To the contrary, we have seen an expansion of job opportunities. Since the last increase was enacted by Congress, the economy has created new jobs at a rate of 235,000 a month. That addresses, I hope, the economic reasons for not having an increase in the minimum wage. Let's take a moment and think about who these people are--who are the minimum-wage workers? This has to be enormously distressing to all Americans because there is no group of Americans that is working harder and slipping further behind than women in our society. Almost 60 percent of minimum wage workers are women. 7 million women across the nation--12.6 percent of all working women--would benefit from this increase. And working fathers are being affected too. We know now that employed fathers with children under 18 work longer hours, averaging 50 hours a week. That is well over the average work time for those tens of millions of Americans who go to work at 40 hours a week, and they get overtime. The average for fathers with children under 18 is 50 hours a week. Fathers' total work time has increased by 3 hours in the past 20 years, and mothers' total work time has increased by 5 hours. Almost one-half, 45 percent of the workers, report having to work overtime with little or no notice. One in five is asked to work overtime 4 or more days a week, with little or no notice. What does that mean to the families? Here they are working at minimum wage, they may have one job, but they probably two jobs, trying to make ends meet, already working 50 hours a week. Then they are told, without warning, they have to work overtime, which may disrupt their other employment. With the number of hours at each job, especially with the addition of overtime, we are seeing increasing numbers of mothers and fathers forced to spend more and more time away from their children. According to a 1999 Council of Economic Advisors study, families are suffering. The study says that parents have, on average, experienced a decrease of 22 hours per week available to spend time with their children. That is what this minimum wage is all about--parents having less time to spend with their children. I hope we are not going to hear a lot of speeches out here about the importance of family values by those who vote against this increase. Twenty-two hours per week less-- that is what is available for parents to spend time with their children. A decrease has happened and if we really care about families we need to change that. Another factor, in addition to parents having less time to spend with their children, is the increasing shift work. Shift work is growing fastest in the service sector, which is heavily reliant on women workers. According to the study by Harriet Presser at the University of Maryland, 70 percent of the fastest growing occupations in the United States have a disproportionate number of female employees and require more than 40 percent of their workers to put in nonstandard hours. Here we are finding out about who is being targeted. It is women. And for what? Nonstandard hours and overtime. At a crucial point in their lives when they are trying to bring up children and be there for them, we find out they are working harder, working longer, and they are making less. Two-thirds of the workers would like to work fewer hours-- almost 20 percent more than 5 years ago. But most of those workers believe they can't cut back on hours because they need the money--46 percent. These 20 percent of workers, might be able to work fewer hours if the minimum wage were increased. Another recent study, ``Working Hard, But Staying Poor,'' notes that working poor are predominantly hourly employees, and 71 percent have little paid vacation; 48 percent have no paid vacation at all--none, none. And 18 percent have a week or less. Madam President, 70 percent of those making the minimum wage have virtually no vacation, or less than a week of paid vacation. We can't give them an increase of 50 cents an hour? No. Even though we have just voted ourselves $4,600 a year, we are not going to vote for them 50 cents more an hour next year. No. This is what is happening to these families. This is what is happening to these fathers and mothers. This is what is happening to these children. And we say, oh, we can afford $4,600 a year for Members of Congress and the Senate, but we can't do something about mothers and fathers who are increasingly taken away from their children in order to make ends meet. That is what this issue is about when you come right down to it. We say: Wait a minute here. Where is productivity in all of this? In the last 10 years we have seen a 12-percent increase in productivity for workers in the United States, but only a 1.9 percent pay increase to match. That includes the highest increases by workers in the country, not the minimum wage. That is what has happened, a 1.9-percent increase. We have seen a 29-percent increase in productivity since 1973, and the minimum wage hasn't even kept up with it. What is going on here? No unemployment, no inflation, productivity going up through the roof, and we give ourselves $4,600, and Republicans oppose 50 cents more an hour increase in the minimum wage. And are Americans really working? There are no workers in the world-- none in the world--who are working longer and harder than American workers today. Japan works 54 hours less a year; the Canadians, 215; the British, 221; the French, 314; the Germans, 389. Every other industrial nation in the world is working less. The Americans, at the lowest end, are working longer and harder trying to make ends meet, with no kinds of health insurance programs, no paid vacations, and they are being jammed with increases in overtime without notification, and they are trying to provide for their children. What happens? I will tell you what happens. Today, we have the new census figures that are just out, and they are very interesting. The latest census figures show that the percentage of working poor--12.6 percent--is at its highest point in 20 years. That's right, at a time when our country is so strong economically we have the highest number of working poor in 20 years--the highest number of working poor. You can look at those figures and say, well, the median income for lower income families has gone up. OK. I am talking about those individuals who are getting the minimum wage. More of them are working in poverty than at any other time. More of them are working, and working for less, than at any other time. More of them are falling further behind than at any other time. What do we have to prove? What is there to prove? I can tell you this. If you look back on the movement from welfare to work, you will find that every economist virtually agrees that one of the principal reasons for movement from welfare to work was the increase in the minimum wage. About 700,000 of those moved from welfare to work because of the minimum wage. With this additional increase of a dollar, from every estimate, from 200,000 to 300,000 more will move from welfare to work. They value work. People want to work. They did when we increased it last time and I think they'll do it again. What does it mean for the taxpayer? It is beneficial to the taxpayer. Why? You will find if you pay more in the minimum wage, you have fewer people who qualify for support programs. That makes sense. Fewer will be qualified for food stamps, fuel assistance programs, and other kinds of support programs. And it will save taxpayers billions of dollars. So it is difficult for me to understand the opposition we are receiving. In the Democratic proposal, we added a small program, but an important one, that primarily helps working families in the tax program in terms of pensions and some other matters. But we have, on the opposition--and I will come to this later when we will have some time to talk about our Republican friends on the other side--they say don't give them a dollar in the next 2 years; they are not worth it. They are worth a dollar over 3 years, but we are worth $4,600 more a year. We are not going to spread our pay increase out, but we are going to spread out the increase for those at the lowest end of the economic ladder. That is the Republican leadership position. Now, the American people must wonder what in the world is going on when the Senate and House are trying to get together with the President on this budget, and we are talking about spending Social Security, and we have before us in the Senate a tax break for $75 billion over the next 10 years. Where are we getting all that money? I hope they have given up this argument that, ``Well, look out for the Democrats because they are going to spend Social Security.'' There is $75 billion in the Republican program that is unpaid for. As I mentioned, I think the compelling reason is the fact that these are men and women who are hard-working. They are child care and health care workers who we entrust with the care of our loved ones every day. They clean out the buildings of American industry and factories every single night. This is a women's issue because the great majority of the minimum- wage workers are women. It is a children's issue because whether those mothers and fathers are going to make a decent wage is going to affect those children. They worry that they are not going to have warm homes in the winter and enough to eat, which we know they don't have. We know what the Second Harvest reports are about--the number of families working and not making a livable wage are going out to the food pantries all across this country. That is why the mayors--Republican and Democrat alike --support our increase. It is a women's issue, a children's issue, and a civil rights issue because many of these men and women are people of color. And most of all, it is a fairness issue. How in the world does the Republican leadership go home to their communities and say we voted for a $4,600 pay increase and against your minimum wage? I hope every citizen will ask their Members of the Senate when we adjourn--whenever that may be, that particular issue is still in question--why a Member's salary is more important than theirs. Others desire to speak. I see my friend from Minnesota. How much time does he require?

Mr. KENNEDY. The Senator can have 10 minutes.

Mr. KENNEDY. Madam President, will the Senator yield for a question? Is the Senator familiar with this study by the Family Work Institute? They had an interview with the children of minimum-wage workers. Here are three of the top four things children would like to change about the working parents and the concern about being with their parents. They wish their parents were less stressed out by work, less tired because of work, and could spend more time with them. The kids are right. The parents have less chance to spend time with them. They are working longer. They are working harder. They have less time to spend with their children. The children are crying out for help, assistance, and for understanding. This isn't going to solve all of their problems. But this minimum will put $2,000 into the family income, and it would give those parents time to spend with their children, perhaps buy a Christmas present or a birthday present, and permit them to share some additional quality time. I was wondering if that kind of response from the children of minimum-wage workers surprised the Senator from Minnesota. He has spent a great deal of time traveling this country and talking to needy families.

Mr. KENNEDY. I yield 10 minutes to the Senator from Rhode Island.

Mr. KENNEDY. Madam President, I see the Senator from North Dakota on the floor. I yield him 7 minutes.

Mr. KENNEDY. Madam President, I understand I have 8 minutes remaining.

Mr. KENNEDY. The Senator from Virginia asked for 10 minutes. I ask unanimous consent that I have 2 additional minutes and yield 10 minutes to him.

Mr. KENNEDY. Madam President, I suggest the absence of a quorum and ask unanimous consent that it not be charged to either side.

Mr. KENNEDY

Mr. KENNEDY. Mr. President, I welcome this opportunity to commend the city of Boston's Crusade Against Cancer and I commend our outstanding Mayor, Thomas M. Menino, for his leadership on this excellent program. Donald Gudaitis, the chief executive officer of the American Cancer Society's New England Division, has called the Crusade Against Cancer, ``the most visionary public health initiative ever undertaken in any city around the prevention and early detection of cancer.'' Through innovative measures such as giving city employees time off for cancer screenings, Boston's Crusade Against Cancer uses a small public investment to create a large public health payoff. It may well serve as a model for communities throughout the nation. Boston's program provides essential preventive care to the city's low income and minority communities, who are hit disproportionately hard by the ravages of cancer. Many members of these communities are neglected by HMOs and private insurers and might otherwise never receive a cancer screening. Nearly a quarter of the women using the program's mobile mammography van were receiving a mammogram for the very first time. Since early detection is a critical factor in the successful treatment of cancer, these preventive screenings are literally a lifesaver for many Bostonians. Boston's program has gained nationwide attention and was described in a recent article in the New York Times. I believe the article will be of great interest to all of us in Congress and I ask that it be printed in the Record. The article follows: [From the New York Times, Nov. 2, 1999] Boston Battles Cancer With a Citywide Mailing (By Carey Goldberg) Boston, Nov. 2--Cities often undertake campaigns to fight crime or litter. This city is fighting what health officials call its No. 1 killer: cancer. Over the last few days, every household in Boston, in theory, has been mailed a brochure describing how to prevent cancer and to detect it early if it develop. The quarter-million English-and-Spanish brochures, Boston's largest public health mailing ever, are the flashiest element of the city's ``crusade against cancer,'' but they are only one of many. Boston's municipal employees are allowed to take four hours off each year for cancer screening--a rule that city officials say was the only one of its kind until Springfield, Mass, adopted a similar rule last week. Over the last several months, about 1,600 chemotherapy patients have been given free rides to and from their sessions, thanks to hospitals and taxis participating in the city's crusade. Other cities and states run anti-cancer programs as does the federal government. But overall, said Donald J. Gudaitis, chief executive officer of the American Cancer Society's New England division. ``This is the most visionary public health initiative ever undertaken in any city around prevention and early detection of cancer.'' Such a campaign may seem logical at a time when the death rate from heart disease has been dropping and cancer, the nation's No. 2 cause of death, kills more than half a million Americans every year. But Mr. Gudaitis attributed the anticancer campaign in Boston to a particular asset: a personally interested mayor. Mayor Thomas M. Menino's father died of prostate cancer, and the mayor, who does not normally play up his personal life, said in a telephone interview that he saw his father ``go from a big brawny guy to 70 pounds.'' ``And you ask yourself, why?'' Mayor Menino added. ``I want to try to help other people out.'' In particular, it seems, he wants to help the poor. Boston, like many other cities, has found that cancer death rates are especially high in poor and minority neighborhoods. Patchy health care makes poor people less likely to have checkups for cancer and thus more likely to die from it. More than a year ago, Mayor Menino convened a panel of medical experts and cancer survivors to help decide what to do. The process, which led to the crusade against cancer, is continuing, said John Rich, medical director of the Boston Public Health Commission. But the panel established three initial goals: that all Boston households, receive information on cancer prevention, that all Bostonians receive appropriate screenings and that all cancer patients have transportation to and from treatment sessions. Transportation may seem minor compared with the first two goals but not to chemotherapy patients, said Maureen Sullivan, vice president of the Massachusetts Bay region of the American Cancer Society who is a cancer survivor. It might not be bad getting to chemotherapy sessions, but, Ms. Sullivan added, ``Let me tell you, coming home can be really awful, and not only for you but for everyone else on that bus with you.'' Boston has introduced other help on wheels, a mobile mammography van that has been booked solid since it began six months ago. Officials say the city is fighting cancer in small ways as well--supplying sunscreen to its outdoor workers, for example--and in bigger ones: Mayor Menino supported a ban on smoking in Boston restaurants, despite heavy opposition from restaurateurs. The program includes television advertising and a new city agency, the Office of Cancer Prevention. The campaign costs little, Mr. Menino said, perhaps, $100,000 for the mammography van, about $250,000 for the brochures and nothing for the transportation and time off. Asked why Boston is undertaking an anticancer campaign now, when the disease has killed millions for decades, those involved cited two factors: the accumulation of research finding on cancer prevention and widespread disillusionment with the prevention promise offered by health maintenance organizations. ``If we look at the actual synthesis and explosion, if you will, of information on the relationship between life-style factors and cancer in the last 20 years, it really has moved beyond just smoking as a major cause,'' said Dr. Graham Colditz, director of education at the Harvard Center for Cancer Prevention, which is participating in the campaign. Dr. Colditz said the center had determined that at least 50 percent of cancer cases could be prevented through behavioral changes alone. The screenings could also prevent deaths among those whose cancer would be detected early, he said. The brochure advises people to eat a healthy diet, to get at least 30 minutes of physical activity every day, to keep their weight down, to drink less alcohol, to avoid smoking, to avoid sexually transmitted diseases and to protect themselves from the sun. None of that was news to Mary Caulfield, a 58-year-old retired resident of the Dorchester section of Boston. But, Ms. Caulfield said, ``I think a lot of newcomers, foreigners, probably don't understand even things like immunizations.'' The Boston anticancer program is impressive, Sandra Mullin, spokeswoman for the New York City Department of Health, said upon hearing it described. New York does not give municipal employees time off for screenings, Ms. Mullin said, though it periodically includes reminders of the need for screenings in employees' paychecks, and it has a program to encourage exercise at lunch. While New York has done no blanket mailing and is not as involved in cancer screening, it does provide cancer information through mobile health vans, Ms. Mullin said. The city focuses some of its other anticancer efforts on antismoking programs and on making sure that managed care plans screen Medicaid patients for cancer. What the Boston campaign will try next remains under discussion. Among some ideas mentioned: persuading private employers to give employees four hours off for cancer screening, making it easier for Bostonians to bicycle or job to work and making programs that help smokers quit available to anyone who wants them. As for immediate results, Mayor Menino said that the four hours off for screening had already led to the early detection of some cancer and that nearly 5 percent of the women who used the mammography van had found suspicious lumps. Nearly one-fourth of those who used the van said the mammogram was their first, the mayor added. For the most part, the campaign is expected to yield only gradual results. Certainly, the immediate effect of the brochure mailing seemed a bit underwhelming: Of more than a dozen people interviewed on the streets of Dorchester, most said they had paid little if any attention to the brochure, although some said they had set it aside to read later. ``Sometimes I'm just too tired to read,'' said Esther Ellis, 72, who nonetheless was having her annual mammogram at a local health center. ``I just leave it to God. God respects my body.'' Jose Navarro, a flea market vendor, said he did not recall getting the brochure. But when he read it in Spanish on the spot, he expressed surprise at what he learned. ``Drinking?'' he exclaimed. ``I know it's bad for you, I know it's bad for your liver, but I didn't know it causes cancer.'' David Sheets, a 45-year-old friend of Mr. Navarro, said that he had saved the brochure at his South End home to read later but that the idea of cancer ``doesn't bother me yet.'' ``My mother died of it, my father died of it,'' Mr. Sheets said. ``It doesn't faze me.'' He smokes and refuses to quit, he said. Then, referring to cancer, he added, ``I just think that it won't happen to me.''

Mr. KENNEDY

Mr. KENNEDY. Mr. President, ten years ago, Congress created the Agency for Health Care Policy and Research to help us deal more effectively with critical national priorities in health care and research. I introduced the legislation with Senator Hatch, and it passed as part of the Omnibus Budget Reconciliation Act of 1989. It was based on a precursor organization--the National Center for Health Services Research--that was created by President Lyndon Johnson. The Agency's focus is primarily on health services research and other cutting edge methods to improve clinical practice. In its first decade, the Agency has proven its worth time and again by providing valuable information to Congress, health professionals, patients, businesses, and many others. This reauthorization begins a new chapter for the Agency. New responsibilities come with its new name, the Agency for Healthcare Research and Quality. While the Agency's intramural and extramural research will remain focused on general outcomes research and assessments of the how well the nation is doing with respect to coverage and provision of health care, there will also be increased activity on research to monitor and improve the quality of care. The Agency will serve an increasingly important role in the nation's effort to measure and improve the quality of health care, and to expand access to health insurance and health care. Research supported by the Agency provides critical information about the use, cost and quality of health services. As the health care market evolves, these data are necessary for informed decisions to help patients, providers, employers, government administrators, and policymakers. While the Agency is not directly involved in making policy, its research and expertise provide informed guidance to those who are. This legislation will help the Agency maintain and expand its efforts to encourage public-private partnerships at every level of the health care system. The American people deserve to know that their hard-earned dollars are buying high-quality care. They want to know, as they are voluntarily or involuntarily enrolled in managed care plans, that the quality of care they receive is improving, not declining. Employers deserve to know that their investments in health benefits lead to healthier employees. As a result of the Agency's work, more and more Americans will be able to make the right decisions about their health care. The Agency also provides an important link between advances in medical research and technology, and adoption of these practices by the public and private sectors. The research conducted and supported by the Agency helps identify erroneous denials of treatment, and informs the nation about treatments that are the most effective or have the highest quality. While the Agency is not in the business of developing or promoting practice guidelines, its recommendations and research findings lead to significant savings for patients, providers, health plans, and taxpayers, while simultaneously improving the quality of care. For example, if the Agency's recommendations were applied to even 20 percent of patients, the nation could save hundreds of millions of dollars annually--ranging from $8.5 million for enhanced prenatal care for diabetic women to $130 million for therapies that prevent stroke. We should do all we can to see that decision-making on health care is guided by the best available scientific information. The Agency for Healthcare Research and Quality will to help us achieve that goal. The reauthorization of the Agency also provides an opportunity to expand research on health care for those with special needs. Our success in treating these patients is an important measure of the overall effectiveness of the nation's health care system. More needs to be done to evaluate how well our system treats those who need the most, and often the most complex, services. Persons with disabilities are often underrepresented in health services research. Assessing how well our fragmented system cares for a person with mental retardation or spina bifida or parapalegia or a person nearing the end-of-life will enable us to assess where better care can lead to both a higher quality of life and significant savings. Reliable information about medical technology is an essential component of providing high quality health care to all Americans at a reasonable cost. It is especially important for Congress to be able to compare and understand the effectiveness of different technologies. For this reason, I was a strong supporter of the Congressional Office of Technology Assessment, which evaluated technologies in a wide range of scientific disciplines and provided a great deal of useful information to Congress before its funding was cut off in 1995. Fortunately, the Agency is fulfilling this essential role in the area of health care, and its mission is now more important than ever. The ongoing biomedical revolution is bringing extraordinary benefits to our society. The next century may well be the century of life sciences. Every day, we hear about new medical procedures and technologies. To fulfill their promise, the quality and effectiveness of new procedures and technologies must be carefully evaluated. The Agency is uniquely qualified to meet this challenge, and to provide important information about the value and effectiveness of existing procedures and therapies. The assessment reports prepared by the Agency are based on sound scientific data. Expanding access to the Agency's findings is an important step toward improving the overall quality of health care for the nation. We need to do all we can to see that the extraordinary discoveries being made in biomedical research are brought as quickly as possible to the bedside of the patient. This reauthorization puts a new face on the Agency and refocuses and refines its functions. Adequate funding for the Agency is essential, and I look forward to working with the Appropriations Committees and the Administration to achieve these needed and wise investments in better health care for all.

Mr. KENNEDY. Mr. President, today marks an important landmark in our efforts to improve children's health. We are taking the first step toward ensuring that the nation's children's hospitals have the support they need to continue to train physicians to care for children. Less than one percent of the nation's hospitals are independent children's hospitals. Yet these hospitals train 30 percent of all pediatricians. These freestanding children's hospitals also train more than half of the country's pediatric specialists--the physicians who care for children with cancer, asthma, diabetes and many other chronic diseases and special needs. In addition to their teaching responsibilities, they care for uninsured children, conduct pediatric research, and provide state-of- the-art specialty care for children in all parts of the nation. The services they provide and the activities they conduct are indispensable. When a child has a rare disease or complicated condition, children's hospitals are the hospitals of choice. In Massachusetts, Boston Children's Hospital provides excellent care and conducts needed pediatric research and training. It provides the highest quality of care for sick or disabled children from Massachusetts, New England and the world. It is a national resource. The primary care and specialist physicians it trains serve in countless communities in Massachusetts and throughout the country. Boston Children's Hospital has been recognized as a world-class institution. Researchers at the hospital continue to offer new hope for children and adults, as they break new ground in battles to fight pediatric diseases. For example, Dr. Judah Folkman has developed two powerful agents that show great promise in the war on cancer. These agents-- angiostatin and endostatin--have been shown to shrink cancerous tumors in animals. Clinical trials are now underway to test the effectiveness of bladder tissue grown in a laboratory, and to treat high-risk heart patients with a tiny device that can close holes in the heart without invasive surgery. These advances are the result of the teaching hospital environment that is the heart of the mission of Boston Children's Hospital. Senior clinicians and scientists work with new doctors in training. The interns, residents and fellows who train at Boston Children's Hospital and other children's hospitals are the pediatricians, pediatric specialists and pediatric researchers of tomorrow. The federal government should invest in their training, just as we have invested in the training of physicians who care for adults. The benefits to the nation are immeasurable. In general, graduate medical education activities are supported through Medicare. However, because children's hospitals treat very few Medicare patients, they receive almost no federal support to train physicians. In fact, they receive less than 1/200th per resident compared to other teaching hospitals. The lack of federal support makes no sense. It unintentionally penalizes children's hospitals, and we need to correct this problem as soon as possible. The legislation accompanying the reauthorization of the Agency for Health Care Policy and Research authorizes a new discretionary program to provide support for pediatric graduate medical education. It authorizes the funding necessary to provide adequate support--$280 million in FY 2000 and $285 million in FY 2001. But this authorization is just a beginning. We need to continue to work together this year and next year to ensure that adequate funds are appropriated for this important new program to succeed. Adequate and stable funding for pediatric GME activities can best be achieved by a permanent mandatory program. The Senate Finance Committee has agreed to hold a hearing on this important issue next year, and I hope action will quickly follow. Senator Bob Kerrey and I have introduced legislation that will create a mandatory program. It has broad bipartisan support in the Senate. Forty senators, evenly divided among Democrats and Republicans, favor this approach, and I am confident that we will prevail in the end. However, this year we have an opportunity to begin to address this important children's health issue. Today's authorization lays the groundwork for a downpayment in the appropriations for FY2000. The President's budget proposed $40 million for pediatric graduate medical education. The Labor, Health and Human Services Appropriations conference bill includes $20 million for this program. Congress should follow the President's lead and provide at least $40 million for next year, while Congress pursues full funding through a long-term solution. It is an honor to support Boston Children's Hospital and other children's hospitals across the country as they strive to meet the health needs of the nation's children. I look forward to working with my colleagues in the House and Senate on this important issue in the coming year.

Mr. KENNEDY

Mr. KENNEDY. Mr. President, Federal Reserve Board Chairman Alan Greenspan has said numerous times that increased trade has raised the standard of living and the quality of life for almost all countries involved in trade, and especially the quality of life in our own country. Chairman Greenspan believes the No. 1 benefit of trade is not simply jobs but an enhanced standard of living. I can think of no more important enhancement to the standard of living of America's hardest pressed working families than to increase the minimum wage. Surely, it is appropriate to send a message on this legislation that increased trade must definitely mean a better quality of life for the working poor. I had hoped to offer an amendment to this bill to raise the minimum wage. Regrettably, it was perhaps the only vehicle that was going to be left in this year of this particular session. But the majority leader's actions prevented me from doing that. This trade bill has been offered to enhance the standard of living for workers in Africa and the Caribbean. I am certainly in favor of that. But there are honest disagreements as to whether the proposal before us effectively does so. While we express our concern for the workers in these nations, we cannot forget the workers in our own country. I believe the American people will hold this Congress responsible for refusing to address so many issues which are critical to our families and our communities, and the majority, I believe, has once again turned a deaf ear to the pleas of the American people for action. I regret this latest missed opportunity. I take this opportunity as we are coming into the final days of this congressional year to express what I know has to be the frustration of about 12 million Americans who had hoped this Congress would have raised the minimum wage, or at least had the opportunity to debate this issue and discuss this issue and consider this issue during this past summer, or this past fall, or even prior to the time that we were going to go into recess. But we have been denied the opportunity to do so. Every legislative possibility has been excluded from us doing so up to this time, and even excluded on this piece of legislation. I join with all of those who share this enormous frustration and a certain amount of disgust at the way this issue is being treated as we are moving into these final days. We now have seen some modification or adjustment to prior positions of opposition to any increase in the minimum wage which had been expressed by the Republican leadership in the House and also in the Senate. Now, evidently, there is a bidding war in the House of Representatives--hopefully, it won't take place in the Senate, but certainly in the House of Representatives--about not what we can do for the working poor but how many additional tax breaks we can add on to the minimum wage when we consider it in the House of Representatives. If we extend the minimum wage over a longer period of time, for some 3 years, actually the benefits that special interests would receive by the tax considerations, which in the House position would reach $100 billion over 10 years, which isn't paid for, the only way you could assume they could be paid for would be out of Social Security because it is not paid for--and the bidding war wants to keep adding that until finally, evidently, the financial interests, which are the most opposed to any increase in the minimum wage, would finally say: All right, let's go ahead because the benefits we are going to receive so exceed and outweigh the modest increase in the increase in the minimum wage that it is worthwhile. As we are coming to the end of this session, we are finding that this Senate refuses to address an issue which cries out for fairness and decency as the minimum wage slips further and further back for working families at the lower end of the economic ladder, who are in many instances doing such important work as teachers aides in the classrooms of this country, are doing important work in nursing homes and looking after the elderly people, or working in the great buildings of this country at nighttime in order to clean them so the American economy and efficiency can continue during the course of the day, that we have decided in this body evidently that we are going to leave this session granting ourselves a $4,600 pay increase and denying a one dollar-an- hour pay increase for over 11 million of our fellow citizens who are working at the lower rung of the economic ladder. That is not right. That is not fair. That is wrong. We ask ourselves: Why should this be the case? Certainly we have not heard those who have resisted us in bringing this matter to the floor make the economic argument that, well, this will mean an increase in the numbers of unemployed Americans. They haven't been willing to make that. They have made it at other times, and it was so totally refuted during the last increases in the minimum wage that they evidently are not prepared to come out and debate that issue. The other argument, that it was going to be an inflator in terms of our general economy, has been refuted completely, as a practical matter. The last time we raised the minimum wage it was demonstrated effectively that there was virtually no increase in the cost of living. We are denied the opportunity of even hearing a well thought out argument for opposing the minimum wage. All we hear is the same, tired, old arguments that have been disproved time in and time out. What we see as a result is that without the increase in the minimum wage, there is a continued deterioration in the purchasing power of the minimum-wage workers. Even without the minimum wage, if we did not consider it until even 2000 or 2001, we would be back to $4.80 an hour, close to the lowest point in the last 40 years of minimum wage, at a time of unprecedented economic prosperity for everyone except those at the lowest rung of the economic ladder. We will not even debate the issue. If Members want to vote against it, they can do so, but why deny Members the opportunity to debate the issue and take the time on this particular measure? Members cannot make the argument that it will take a lot of time after what we have gone through in the past days where, effectively, from a parliamentary point of view, we were in a stalemate in the Senate without any amendments being even considered on the trade bill for a number of days. We could have dealt with this issue in a matter of hours. We are certainly prepared to deal with this issue in a relatively short time period--a few hours if necessary. Obviously, the majority, the Republicans, retain their rights in terms of a very modest increase in the minimum wage, 50 cents next year and 50 cents the following year. That is too high for our Republican friends. We can debate that and at least have the Senate work its will. The position taken by the Republican leadership on the other side has been, if we are going to extend it, they will deny us the opportunity to bring the minimum wage up this year. If we bring it up at the end of the session, we will put it, effectively, well into next year and carry it on to the following year, which will extend it perhaps $1.00 over 5 years. Still, we will carry on the tax goodies which, over a 10-year period in the proposal recommended by the Republican leadership, will be $100 billion in tax breaks for the special interests. That is what is happening. That is what is so unacceptable. This morning, there was an excellent editorial in the Washington Post, and I ask unanimous consent it be printed in the Record.

Mr. KENNEDY. This article reminds everyone how the interests of some of the hardest working Americans are being toyed with by the Republican leadership. They say maybe we will add a little more in terms of tax breaks if we consider the increase in the minimum wage. This increase is a matter of enormous importance and consequence for the people receiving it. Sixty percent are women; over 75 percent of minimum wage workers heading up families are women. It is an issue in terms of children. It is a family issue. It is an issue relating to men and women of color since one-third of those who receive the minimum wage are men and women of color. It is a civil rights issue, a family issue, a children's issue, a women's issue. It is a fairness issue. Yet we are denied it. How quickly this institution went ahead with a $4,600-per-year increase for their pay while denying this side the opportunity to vote on 50 cents an hour over each of the next two years for the minimum- wage worker, an increase of $2,000 a year for people working at the lower end of the economic ladder. Yet, $4,600 for the Members of Congress. It is wrong to play with the life and the well-being of these workers. They are being toyed with by considering how much in additional tax breaks we will provide for special interests. That is what the bidding is that is going on. It is not the Congress or leadership acting in these workers' best interest. What does $2,000 mean to a minimum-wage family? The two increments, of 50 cents each, mean 7 months' of grocery. That means a lot to a family. It is 5 months of rent. It is 10 months of utilities. It is 18 months of tuition and fees at a 2-year college for a family of four living on the minimum wage. While many parts of our country have experienced the economic boom, we have found another very important area of need for minimum-wage workers: Housing. In so many areas of this country, the housing costs have gone off the chart and are virtually out of the reach of the minimum-wage workers. The hours a minimum-wage worker would have to work in Boston for a one-room apartment--100 a week. It is absolutely impossible to understand why we are not dealing with this issue. This chart/table shows what happened when we had the increase in the minimum wage in 1996 and 1997. The unemployment rates continued to go down. This is true in the industry that has expressed the greatest reservation about a minimum-wage increase, the restaurant industry. They have increased their total workers by 400,000 over the period since the last increase in the minimum wage. They are out here day in and day out trying to undermine and lobby against the increase in the minimum wage. This is not just an issue in which Democrats are interested, although we are interested in and we are committed to it. I daresay if we had a vote on an increase in the minimum wage, the way we have identified it, we would get virtually every member of our party and perhaps a few courageous Republicans as well. This is what Business Week says about the increase in the minimum wage: Old myths die hard. Old economic theories die even harder . . . higher minimum wages are supposed to lead to fewer jobs. Not today. In a fast-growth, low-inflation economy, higher minimum wages raise income, not unemployment. This is from Business Week--not a labor organization, although they would agree--from Business Week, which understands it. They have probably reviewed carefully what happened in the State of Oregon that now has the highest minimum wage with the largest growth rate in terms of reduction of unemployment when they introduced the minimum wage. Why? Because people not working went into the labor market, it created more economic activity, and they paid more in taxes. The whole economy moved along together. We are glad to debate it if people want to dispute that. What does this mean in people's lives? Melissa Albis lives in North Adams, MA. She works for the local Burger King for $5.25 an hour. She has five children all under 12. She is struggling to pay her $550-a-month rent and is looking for less expensive housing because she fears she and her children will be evicted if she cannot earn more. Cathi Zeman, 52 years old, works at the Rite Aid in Canonsburg, PA, a town near Pittsburgh. She earns $5.68 an hour: Base pay of $5.43, plus .25 for being a ``key carrier.'' Her husband has a heart condition and is only able to work sporadically, so she is the primary earner in her family. An increase in minimum wage means a lot to Cathi. Shirley Briggs is a senior citizen living near Williamstown, MA. Her husband passed away in 1982, and even though she has arthritis, she works for $5.50 an hour to try to make ends meet. Even with supplement income and Social Security, she has trouble paying for medicine. ``My income is not enough to live.'' Minimum wage means a lot to Shirley. Dianne Mitchell testified in June 1998 that she made $5.90 an hour at a laundry in Brockton, MA. For Dianne, with three daughters and a granddaughter, living on minimum wage is nervewracking. She is ``always juggling food and utilities,'' even having to choose one over the other. An increase in the minimum wage would give women like Dianne peace of mind--they could provide for their families. Cordelia Bradley testified at a Senate forum last year she was working at a clothing chain store outside of Philadelphia. She and her son lived in a rented room for $300 a month. She hoped to have her own apartment, but at the current minimum wage that goal was out of reach. Kimberly Frazier, also from Philadelphia, testified she was a full- time child care aide earning $5.20. A child care aide, how many times are we going to hear long speeches about children and looking out for children; children are our future; we need to do more caring for children. Kimberly Frazier is earning $5.20 an hour as a full-time child care aide. With three children, her pay barely covers the bills for rent, food, utilities, and clothes for her children. For Kimberly and her family, a pay increase of $1 an hour could make a real difference. This is enormously important to individuals. Republicans want to see how little they can do for the workers, and how much, evidently, they can do for the corporations and special interests. You cannot look at the conduct of leadership in these last 4 weeks and not understand that is what is happening. The workers are being nickled and dimed. This is absolutely unacceptable. We are going to continue. The days are going down, the hours are going down, but we are resolute in our determination, and we are not going to have a bidding war out here on the floor of the Senate on this issue. We are not going to permit the toying with the lives of American workers who are playing by the rules, working 40 hours a week, 52 weeks a year, who want to provide for their children. They should not have to live in poverty in the United States of America. By denying us the opportunity to do something about this, the leadership, Republican leadership, is denying us a chance to deal with that issue, and it is fundamentally and basically wrong. I will speak just briefly on another matter. In passing the Norwood-Dingell bill, a large bipartisan majority in the House voted for strong patient protections against abuses by HMOs. Despite an extraordinary lobbying and disinformation campaign by the health insurance industry, the House approved the bill by a solid majority of 275 to 151. Mr. President, 68 Republicans as well as almost every Democrat in the House stood up for patients and stood up against industry pressure. Now the insurance industry and its friends in the Republican leadership are at it again. Their emerging strategy is, once again, to delay and deny relief that American families need and that the House overwhelmingly approved. Every indication is that the intention of the Republican leadership is to see that this legislation, as it passed the House of Representatives, will not reach the President for his signature. According to the Los Angeles Times, Senator Lott's response to the passage of the House bill is that the House-Senate conferences on other legislation have a higher priority and resolving the differences on this bill will take some time. According to the Baltimore Sun, Senator Lott also indicated Congress might not have the time to work out differences or approve a final bill before it adjourns for the year. Senator Nickles said the conference committee will probably not begin serious work until early next year. I say: Why don't we consider the House bill--the bill that passed the House overwhelmingly with 68 Republicans--a bipartisan bill with Democrats and Republicans working together? Why don't we pass that in the Senate this afternoon? We could do that. I certainly urge that we go ahead and do that today. Every day we fail to pass the Patients' Bill of Rights, we are permitting insurance company accountants to make medical decisions that doctors and nurses and other trained medical personnel should have the opportunity to make. That is why the Patients' Bill of Rights is so important. We believe that medical professionals, trained, dedicated and committed to their patients, should make those decisions, not accountants. This chart shows what we will see as long as we permit accountants to make health care decisions. We are going to see about 35,000 patients every single day will have needed care delayed. Specialty referrals will be denied to 35,000 patients. It may be that a child with cancer will see a pediatrician but doesn't get the necessary referral to see a pediatric oncologist. Mr. President, 31,000 patients are forced to change doctors every day; 18,000 are forced to change medication because the HMOs refused to reimburse the medicine their physician prescribed. The final result is that 59,000 Americans every day experience unnecessary added pain and suffering; 41,000 Americans see their conditions worsen every day that we fail to act. We still have time to act in the final days of this session. Republicans are beginning to lay the groundwork for a failed conference. Comparing the Senate and House bills, Congressman Bill Thomas says you don't see many crossbreeds between Chihuahuas and Great Danes walking around. That is quite a quote--we don't see many crossbreeds between Chihuahuas and Great Danes walking around. I say, let's do what every health care professional organization in the United States has urged us to do, and pass the House bill. I am still waiting for the other side to list one major or minor health organization that supports their proposal: Zero, none, none. Every one of them--every doctors' organization, patients' organization, nursing organization, children's organization, women's health organization, consumer organization--supports our proposal. Here is how Bruce Johnston of the U.S. Chamber of Commerce put it: To see nothing come out of the conference is my hope. The best outcome is no outcome. But if the strategy of delay and denial ultimately breaks down, the Republican leadership once again has an alternative to try to weaken the House bill as much as possible. As the Baltimore Sun reported: The House majority whip suggested the Republican-dominated House conference would not fight vigorously for the House- approved measure in the conference committee. Mr. DeLay said, ``Remember who controls the conference: the Speaker of the House.'' That ought to give a lot of satisfaction to parents who are concerned about health care for their children. It ought to give a lot of satisfaction to the doctors who are trying to provide the best health care. This is what the House majority whip suggested: Remember who controls the conference: the Speaker of the House--unalterably opposed to the program. The conference that produces legislation that looks like the Senate Republican bill will break faith with the American people, make a mockery of the overwhelming vote in the House of Representatives, and cause unnecessary suffering for millions of patients. Every day we delay in passing meaningful reforms means more patients will suffer and die. Finally, I do not think, when we consider minimum wage and consider health, we have addressed these issues in the last few days. These are the matters about which most families are concerned. These are the issues they want addressed. The Republican leadership is considering what they will do on the bankruptcy issue. We have seen great economic prosperity. Do you know who is going bankrupt, by and large? It is the men and women who have lost out in the mergers, the supermergers that have brought extraordinary wealth and accumulation of wealth to individual stockholders. It is families who have had to pay increased costs for prescription drugs. It is women who are not receiving their alimony payments or women who are not getting child care support--there are some 400,000 of them. These are the individuals who are going into bankruptcy. Their needs should be protected. We have to ask ourselves, if we are going to call bankruptcy up, why aren't we dealing with minimum wage? Why aren't we working on the Patients' Bill of Rights? Why are we not coming to grips with these issues, which are at the center of every working family's hopes and dreams. In the months since the House passed the Norwood-Dingell bill and the Republican leadership has failed to allow a conference to proceed, 1 million patients have had needed care delayed; 1 million patients have been denied or delayed referral to a specialist; 940,000 patients have been forced to change doctors; more than 535,000 patients have been forced to change medication; Mr. President, 1.8 million patients have experienced added pain and suffering as a result of health plan abuses, and 1.2 million patients have seen their conditions worsen because of health plan abuses. In the final days of this Congress, we can still take some important steps that will have a direct impact on the well-being of families who are at the lower end of the economic ladder. We can still take important steps that will have a direct impact on families who are faced with health care challenges. We can have a positive impact. We have had the hearings. We have had the debates. We have had the deliberations. All we need is to have the vote the way the House of Representatives had the vote. We can pass what has been a bipartisan bill in the House of Representatives in a matter of a few short hours. The Republican leadership has waited a month since the House bill was passed to start this conference, effectively pushing action to next February at the earliest. Today is another litmus test of their intention with the appointment of House conferees. We expect those conferees to be stacked against meaningful reform. We are prepared to participate in a fair conference, and we are willing to enter into a reasonable compromise, but we are sending notice today that we will not tolerate a charade designed only to protect insurance company profits while patients continue to suffer. We will come back to this issue over and over until the American people prevail. Mr. President, I suggest the absence of a quorum.

Mr. KENNEDY

Mr. KENNEDY. Mr. President, this bill is the result of a concerted and cooperative bipartisan effort. It is an important and timely piece of legislation that is long overdue, and I urge the Senate to support it. Mental illness and substance abuse are national problems that need comprehensive and compassionate attention. These conditions do not respect party affiliation or race or age. They are equal opportunity destroyers, but they don't have to destroy at all. States and local communities provide some of the most critical and ongoing services for persons who struggle with mental illness and substance abuse. This bill enables these dedicated providers to do an even better job with limited resources to accomplish their prevention and treatment goals. Since we passed the original authorizing legislation for the Substance Abuse and Mental Health Services Administration in 1992, a number of major clinical and service delivery issues have emerged which require legislative attention. Now we have crafted a bill that accomplishes a great deal and that includes significant compromises on a number of key issues. The bill addresses three important clinical issues that have emerged in recent years: the growing problem of co-occurring mental health and substance abuse disorders, the distressing and pervasive impact of psychological trauma especially on our younger citizens, and the important relationship between mental health or substance abuse and primary care providers. It also places much greater emphasis on preventing and treating mental health and substance abuse problems in children and adolescents. The provisions for children demonstrate the breadth and depth of this bill. It contains a children and violence initiative, centers of excellence for psychological trauma, grants for persons who experience violence-related stress, comprehensive substance abuse prevention and treatment for children and adolescents, special attention for children of substance abusers, wrap-around services for youth offenders, and special training centers to increase the sensitivity and competency of staff who work on these issues in the juvenile justice system. The bill also addresses special problems that adults face. It maintains and expands support for critical programs that serve the homeless, extends its protection to persons who are served in community-based facilities, limits the use of seclusion and restraints in psychiatric facilities, and addresses the special circumstances of Native Americans. I am particularly pleased with the initiatives to meet the intense service needs of persons with co-occurring mental health and substance abuse disorders. Often, they need innovative treatment approaches, including integrated mental health and addiction treatment facilities. Over the next two years, the Secretary will compile a report that establishes the best practices for helping this very challenging but treatable group. The bill authorizes the Secretary to provide additional funding for projects on the increasingly important ties linking mental health or substance abuse and primary care. Family physicians and other primary care providers see many patients with a wide range of psychiatric and psychological problems. Too often, however, they do not recognize the mental health problems of their patients. Even if they do, they are often ill-prepared to provide adequate treatment or counseling. We can do much more to help primary care physicians do a better job of caring for patients with serious mental illnesses. This bill seeks to do that. The bill also accomplishes several important organizational goals. It gives States more flexibility in administering their grant funds, and removes a number of bureaucratic obstacles to greater efficiency. In exchange for this easing of certain mandates, the States will enter into a cooperative agreement with the Administration in developing outcomes-based accountability measures. The bill also gives the SAMHSA Administrator greater authority in managing discretionary grant funds. It enables the Administrator to make emergency grants to deal with immediate problems that cannot be addressed by the standard grant-making process. In spite of the many excellent features in this bill, one provision is seriously flawed. The section that allows religious organizations to compete for public funds for the provision of substance abuse services violates the prohibition against certain forms of discrimination. I recognize the valuable role that faith-based organizations can play in helping to address a wide array of social problems. However, the recent proliferation of charitable choice provisions in federal social service programs runs the risk of creating a religious litmus test for those who provide these services, thus barring many trained, qualified professionals from providing services for faith-based organizations. We need to do more to avoid that discrimination. Our goal is to help many of those in communities across the country who have received inadequate care in the past. The many excellent provisions in this bill will help to ensure that these children and adults will finally receive the care they need and deserve--without stigma or shame, but with dignity and respect--and America will be a better nation because of it. I commend my colleagues for this important action to reauthorize the Substance Abuse and Mental Health Services Administration. I want to thank Senator Frist and his Republican colleagues and their staffs for their skillful work for this genuine bipartisan achievement. I commend Senator Dodd, who worked effectively on children's issues and the seclusion and restraint provision. Senator Harkin contributed his important initiative on methamphetamine and inhalant abuse, and Senator Durbin contributed his critical provision on residential treatment for pregnant women and women who have given birth. Senators Bingaman, Wellstone, and Reed effectively collaborated on a series of significant child and adolescent provisions, and Senator Bingaman worked effectively on the needs of Native Americans. Senators Mikulski and Murray provided excellent counsel on many issues, especially the mental health and substance abuse treatment needs of women. I thank Joe Faha, SAMHSA's Director of Legislation, for his generous assistance throughout the process, as well as Nelba Chavez, the Administrator of SAMHSA. I especially thank David Pollack, David Nexon and Debra DeBruin on my staff, for their dedication and excellent work in bringing this bill to passage.

Mr. KENNEDY

Mr. KENNEDY. Mr. President, I appreciate the comments from my colleagues, and I thank them for bringing this matter to my attention. I will work with Chairman Jeffords during the reauthorization of the Elementary and Secondary Education Act to ensure that the Impact Aid Program adequately addresses the needs of students in federally impacted school districts, and that funding is directed to the districts with the most need, and is distributed in an equitable manner. I look forward to working with Senator Jeffords, Senator Inhofe, and other colleagues to address these issues fairly.

Mr. KENNEDY

Mr. KENNEDY. Mr. President, I would like to take a few moments to recognize an outstanding individual who will soon be retiring from public service. Helen L. Westbrook currently works in the Office of the Deputy Under Secretary of the National Oceanic and Atmospheric Administration. In December, she will complete a career that has spanned many years of distinguished service to our country. This is a special occasion for me and the Kennedy family, as Helen is truly one of our own. In 1955, as a Senator, my brother John F. Kennedy visited Chicopee, Massachusetts, and delivered an address about a recent visit he had made to Poland and Eastern Europe. Like many other young Americans of that time, Helen heard and heeded my brother's call to public service. She moved to Washington, D.C., and in January 1956, she began work as a secretary in my brother's Senate office. Following the 1960 election, Jack asked Helen to join his White House Staff, and she served as a Secretarial Assistant in the Office of the President until January 1963. Helen then decided she wanted to gain experience working overseas, and for the next year and a half, she served in our U.S. Embassy in Rome She then returned to America, and at the request of Jackie Kennedy, she came back to work with our family. For the next few years, she served as an assistant to Jackie in New York City. She watched Caroline and John F. Kennedy, Jr. grow up, and went on to marry and raise a family of her own. In 1992, Helen rejoined the Federal Government and started a career with NOAA. She has been a good friend to Massachusetts and has called for a balanced approach to fisheries management. She has been a skillful advocate for assistance to New England fishermen and coastal communities, and all of us who know her are proud of her achievements and her friendship. Helen Westbrook is a kind, thoughtful person who truly cares about people. She has brought professionalism, wisdom and dedication to each position that she has held. She is a valued and loyal friend of the Kennedy family. We don't have enough Helen Westbrooks in government and in the world. She is a shining example of the wonderful people who answered President Kennedy's call to serve their country. I'm proud of her contribution to public service, and I wish her well in her well-deserved retirement.

Mr. KENNEDY

Mr. KENNEDY. That is an excellent question. As the Senator from Illinois understands, these protections did not just come out of thin air. They were recommended. Recommended by whom? Virtually every medical society in the country supports our program. During this debate, we challenged the other side to produce one medical society that supported their program. We still have not heard it. Every medical society supports our program. Every nursing society supports our program. Every consumer group supports our program. Every patient organization supports our program. Every one of the consumer groups that have been trying to protect children understands the importance of getting specialists for children; not just a pediatrician, but a pediatrician oncologist to deal with cancer in children and specialists in these areas. We guarantee these. This Republican program does not. We have the legislative power of this body to pass something which the President will sign to provide the patient protections we are talking about. All the majority leader has to do is call up that legislation. Just call it up. Let us debate it, and let us act.

Mr. KENNEDY. I yield for a question.

Mr. KENNEDY. The Senator again has asked the important question. It is the insurance industry. You have on the one hand, as suggested by the two questions the Senator asked, all of the health professionals, all of the men and women who have devoted their lives to taking care of patients in this country, the doctors, the nurses, all of the various professional societies, all the consumer groups, all the children's organizations that care about this, all the elderly groups. And on the other side you have the insurance industry that is opposed to it. The basic reason for that is that it cuts into their bottom line--even though they have guaranteed the kinds of protections we are talking about. What we are trying to do is make sure the patients are going to get the kind of coverage and the kind of attention for which they had signed up. What happens in so many of these instances is the HMO, the policyholder, just will not give what their patients are guaranteed in these areas. And with all the other complexities in terms of denying the patients the opportunity to sue the HMO, we are denied an opportunity for remedy as well. There is rarely a public policy question that is as important as this one. We know what can be done. We have good legislation, that is almost at the door of the Senate, that could be called up. I am sure the Senator from Illinois would agree with me, and we could get that done today. Certainly we could do that, and the minimum wage as well. I see my time has just about expired, but I want to try to go through, briefly, some of these other areas where we have failed to take action. These are the kind of issues about which people talk to us. This is the kind of issue about which families are concerned--the minimum wage, a Patients' Bill of Rights. When I was in Methuen this past Monday, I must have had four different senior citizens come up to me and say: What's happening on that prescription drug proposal that the President is supporting--that so many of us are supporting? Try to get that up and get a debate, get that reported out of the Finance Committee and reported out here on the Senate floor. Please do something about prescription drugs. But we aren't able to get anything done on that. We aren't able to get anything done on the Patients' Bill of Rights. We have a Republican leader who said that ``House-Senate conferences on other legislation have a higher priority'' than consideration of the Patients' Bill of Rights. So this thing is just being kicked on over to next year. That may be satisfactory to some of the insurance companies. That may be satisfactory to some of the Republican leadership. But it is not satisfactory to the families in this country. In the final few moments, I want to once again mention the areas of education which we would have hopefully had some opportunity to address with greater time. In recent years, too many in Congress have paid lip-service to education--and then failed to act to meet the most basic needs of the Nation's schools. This Congress faces a major test in the coming days, as we seek to guarantee that education receives the funds it deserves for the coming fiscal year. If we want a better and stronger America tomorrow, we must invest more in education today.

Mr. KENNEDY

Mr. KENNEDY. Mr. President, we are almost a month into the new fiscal year and Congress still has not passed an appropriations bill for the Departments of Education, Labor, and Health and Human Services. The work of these Departments touches the lives of nearly every American, yet the Republican leadership has been unable to work out an acceptable budget for them which will enable them to carry out their responsibilities fully and effectively. The majority has used an extraordinary array of gimmicks, such as bogus emergency spending designations, and an unprecedented level of advance fundings. But even those budgetary slights of hand were insufficient to do the job. They considered reneging on Congress' commitment to provide TANF moneys to the States but backed off under pressure from the Republican Governors. They proposed increasing taxes on the working poor by changing the reimbursement rules for the Earned Income Tax Credit. Even the leading Republican Presidential candidate denounced that as ``balancing the budget on the backs of the poor.'' Again, the Republican leadership was forced to retreat from an outrageous proposal. The fact that these cuts were even considered shows how out of control the budget process is. In desperation, the Republicans have now proposed that we indiscriminately cut all Government programs by 1 percent across the board. In other words, they would treat essential health and education programs no differently than special interest pork barrel projects. They ignore the reality that some of the programs are far more important than others. This type of mindless cut is an admission of total budgetary failure. They pretend such a cut will not have any impact on the programs, but they are terribly wrong. The human cost of such an across-the-board cut would be very high. It would hurt many of our most vulnerable people: Some 5,000 fewer preschoolers in Head Start; 2,800 fewer children in the child care programs; 74,000 fewer babies receiving nutritional supplements; 2,775,000 fewer meals brought to the elderly and disabled; 120,000 fewer disadvantaged students helped; 6,000 fewer job opportunities for youth; 10,000 fewer work-study grants for college students; 10,000 fewer children helped to read; 3,000 fewer children immunized; 20,000 fewer homes for low-income families. Each one of these is an unacceptable price to pay for the Republicans' inability to produce a fair and fiscally sound budget. That was with a 1% cut. Now CBO has made available to us a letter that was sent to the Honorable John Spratt, who is the ranking Democratic member of the Committee on the Budget in the House, with copies also to Mr. Kasich and Mr. Domenici. The conclusion of these letters is that the 0.97% cut that will be included in the conference report, which perhaps we will consider later, is going to be insufficient, according to the latest calculations of CBO, to avoid tapping social security funds this fiscal year. Their estimate is, it would have to be not 0.97 percent but a total of 5.8 percent. If you were to eliminate defense, military construction, veterans programs, it would be in excess of 11 percent. So here on this chart are the cuts with 1 percent. And the CBO says, if you are going to do the job and follow the pathway that is being recommended by the Republican leadership, it will have to be a 5.8 percent cut. So you can multiply all of the cuts to programs needed by our most vulnerable citizens by 5.8, which yields a much more devastating impact. Those are the circumstances we are in. The fact is that the President and the ranking Democrats on the various committees say: Why don't you go back and cut out the pork you put in and cut out the excesses you have added, and send us something that is responsible? Then we can have true negotiations. But that isn't the way the Republican leadership is moving. They are just favoring across-the-board cuts, which will cut valuable, helpful programs that are indispensable to needy people, for infants and for children, for education, and for health--the same amount as the pork programs that have been added by the Republicans. These consequences are all the more deplorable because they are unnecessary. President Clinton and the Democrats here in Congress have proposed fiscally responsible measures to keep our hands entirely off Social Security money even while we make the critical investments needed to strengthen our Nation in the coming year. But the Republicans repeatedly said ``no.'' ``No'' to a cigarette tax that would prevent teen smoking while paying for children's health initiatives; ``no'' to making oil companies pay royalties they owe the Federal Government; ``no'' to reducing corporate welfare; ``no'' even to military officers when they ask to defer or delay programs the Republicans want in their districts. By consistently declining opportunities to reduce a balanced budget, Republicans are on a course to raid Social Security, regardless of this proposed 1 percent cut. Why have Republicans proposed this latest gimmick? To avoid using this year's Social Security surplus to pay for this year's Government spending, they tell us. But what Republicans don't say is that the gimmicks they have already voted for guarantee that the Social Security money will be used in the budget this year. That is what the latest CBO report that has been given to the leaders today has indicated. I have but one simple question for anyone who would disagree: Where will the money come from to pay for the census, which Republicans have suddenly declared to be an emergency? This money must be paid to contractors and staff this budget year, yet it cannot be found anywhere except in the Social Security trust fund. By simply calling a $4 billion entirely foreseeable program an ``emergency,'' Republicans cannot escape the fact that they will certainly spend Social Security surpluses this year, regardless of whether there is an across-the-board cut. The census gimmick is but one of many instances in which Social Security funds have already been spent by Republicans this budget year. When all the smoke and mirrors produced by the Republicans are removed, we can see that the true goal of their 1-percent cut is not to preserve Social Security surpluses but to gut Government spending on core education, health, and criminal justice programs. Republicans in this Congress are returning to the time of Speaker Gingrich when they proposed abolishing the Department of Education, only now they are dismantling it piece by piece. Today's Republicans have proposed a $288 million cut for the Department of Education--continuing their longstanding assault on our children's futures. Let's not forget that when Republicans first assumed the control of Congress in 1995, their top agenda item was to rescind $1.7 billion in education funding that had already been enacted into law by the Democratic Congress. Then, in the first full funding cycle subject to Republican control, their appropriators in the House socked the Department of Education with a $3.9 billion proposed cut-- almost 20 percent. They tried again in the budget year 1997 when Senate appropriators sought a $3.1 billion cut to the President's request for education programs. Democrats in the Congress, together with President Clinton, successfully resisted each one of these Republican cuts in education. So since 1997, Republicans have sought more modest education cuts of $200 million or more below the President. Today's proposed $288 million cut is consistent with the Republicans' longstanding goal of decreasing support for education. It is wrong. It is shortsighted. It is not what the American people want or deserve. Of course, Senator Nickles and Representative DeLay want us to believe their 1-percent cut won't hurt a bit. It might not hurt the oil companies they want to protect from paying full royalties to the Government this year, but it will hurt the real people I described when I listed some effects of their proposed cut. The cut might not affect the tobacco companies, now that the Republicans have rejected President Clinton's plan to raise cigarette taxes, but it will hurt those who rely on the programs Republicans want to cut. In conclusion, I want to just point out--on this other chart--what the current situation is with regard to the Head Start Program. Today, we have, for the Early Head Start Program, only 1 in 100 eligible children who are actually enrolled. This is what the Carnegie Commission and virtually all recent studies show is probably the wisest investment of funds of any other Government program because these are the earliest years of confidence building among children. And as all of the research has demonstrated, the earliest intervention in these years, in the first, second, third, and fourth years of life, has enormous consequences in the child's cognitive development and future education. Only 1 in 100 eligible children are presently enrolled in Early Head Start. In the Head Start Program, which has been tried and tested, evaluated and strengthened and improved, only 2 in 5 eligible children are enrolled now; 3 out of 5 are financially eligible, and cannot enroll in the program. The Child Care Development Block Grant program only assists 1 in 10 eligible children. Education for the disabled, only 1 in 4 eligible children are assisted. This is the current situation. It is against that background we are going to see tens of millions, hundreds of millions of dollars in reduction in those programs because the Republican leadership, over the course of the year, have added a lot of boondoggle programs of their own in these other appropriations. I indicated what those reductions would be if they were going to be 1 percent. Now we know it is going to be 5.8 percent, according to the CBO. The proposed cut is wrong. It is an abdication of their duty to state what they believe the nation's priorities should be. It is irresponsible. I hope our colleagues would vote in the negative on this.