Ted Kennedy

Mr. KENNEDY

Mr. KENNEDY. Mr. President, I rise to introduce the Children's Gun Violence Prevention Act, together with Senator Boxer, Senator Durbin, Senator Dodd and Senator Reed. The continuing epidemic of gun violence involving children demands action by Congress. The wave of school shootings in communities across the country is a wake-up call for the nation. We need to do more--and we can do more--to protect children from guns. Every day in the United States, 14 children are killed by a gun; 24 percent of children say they have access to a gun at home; 10 percent have recently carried a gun to school. We need to deal more effectively with all aspects of the culture of violence that is killing our children. The legislation we propose today is a concrete step to do more to keep children safe from gun violence. I know that some in Congress are reluctant to challenge the National Rifle Association, but there are common sense steps that we can take and should take to protect children from guns. Our bill says that gun owners must take responsibility for securing their guns so that children can't use them. It says that gun dealers must be more vigilant in not selling guns and ammunition to children. It says we must develop child-proof safety locks and other child safety features for guns. We do more today to regulate the safety of toy guns than real guns, and that's a national disgrace. The legislation we are introducing today is the least we can do to stop more schoolyard tragedies and to deal more responsibly with the festering crisis of gun violence involving children. In a press conference earlier today, we heard what gun violence has done to Susan Wilson of Jonesboro with the loss of her daughter Brittheny, and what it has done to the families in Oregon, and the thousands of other families who lose children to gun violence every year, and we know that action is needed. I want to commend Sarah Brady and Handgun Control for their leadership on this legislation, and for bringing us to this point today. Practical steps can clearly be taken to protect children more effectively from guns, and to promote greater responsibility by parents, gun manufacturers, and gun dealers alike. This legislation calls for such steps and it deserves to be enacted this year by this Congress. Mr. President, I ask that the full text and a description of the bill be included in the Record.

Mr. KENNEDY

Mr. KENNEDY. Reserving the right to object, and I will not, but does the majority leader understand that there will be an opportunity for this body to offer this particular measure, the McCain bill, on any other piece of legislation that is coming down the pike? This may go back to the committee, but it ought to be very clear to this Membership that this issue is not going away and that this body ought to get prepared to consider this legislation on every appropriate measure. I have no objection. Mr. DURBIN addressed the Chair.

Mr. KENNEDY

Mr. KENNEDY. I ask unanimous consent that we might extend that for 7 minutes.

Mr. KENNEDY. I thank the Chair. Mr. President, as Senator Durbin and Senator Conrad have pointed out, the current amendment is not really about saving money for the States. The amendment is one more backhanded attempt to protect the tobacco industry. It is the third amendment offered on attorneys' fees. The prior two were rejected by a substantial majority. It is a transparent effort to distract attention from the enormous public health issues on which the American people want us to focus. Let's defeat this amendment and turn our attention to stopping youth smoking. The Senate has debated this landmark youth smoking reduction bill for a month. Each of us has had an ample opportunity to state our views. The Senate should commit to vote on final passage this week. We owe it to the children who are being entrapped into a life of addiction and premature death by the tobacco industry every day. The opponents of this legislation have used every parliamentary tool at their disposal to extend the debate and divert attention to an unrelated issue. They want to talk about every subject but the impact of smoking on the Nation's health. However, the real issue cannot be obscured by their verbal smokescreen. It is time for us to move from talking to voting. Each day that the opponents delay final Senate passage of the bill, 3,000 more children begin to smoke and a third of these children will die prematurely from lung cancer, emphysema, heart disease, and other smoking-caused illnesses. Each day that we delay, the price of a pack of cigarettes will continue to be affordable to the Nation's children and more and more of them will take up this deadly habit. And each day that we delay, tobacco will continue to target children with billions of dollars in advertising and promotional giveaways that promise popularity, excitement, and success for young men and women who start smoking. Each day that we delay, millions of nonsmokers will be exposed to secondhand smoke. According to the Environmental Protection Agency, secondhand smoke causes 3,000 to 5,000 lung cancer deaths each year in the United States--more than all other regulated hazardous air pollutants combined. Secondhand smoke is also responsible for as many as 60 percent of cases of asthma, bronchitis, and wheezing among young children. Each day that we delay, tobacco will remain virtually the only product manufactured for human consumption that is not subject to federal health and safety regulations, despite the fact that it causes over 400,000 deaths a year. Preventing this human tragedy should be the Senate's first order of business. With so much at stake for so many of our children, it is truly irresponsible for the opponents of this legislation to practice the politics of obstruction. Let the Senate vote. The public supports this bill overwhelmingly, despite the tobacco industry's extravagantly funded campaign of misinformation. A new poll released this morning shows that the American people want the McCain bill to pass by a margin of two to one; 62 percent support the legislation, while only 31 percent oppose it. The American people can see through the tobacco industry's smokescreen, why can't the Senate? The same survey shows that the public knows who will be responsible if the McCain bill does not pass. By a 2\1/2\ to 1 margin, the American people say the Republicans in Congress will be most responsible if the bill dies. By a similar margin, voters say they would be more likely to vote for a candidate who supported the McCain bill, and less likely to vote for a candidate who opposed it. This bill will do an effective job of providing that protection for our children. It will save 5 million of today's children from a lifetime of addiction and premature death. It contains a series of strong provisions that have withstood repeated attempts to weaken them: It contains a substantial price increase to keep children from starting to smoke. It gives the FDA strong authority to regulate tobacco like the drug it is. It has tough restrictions on advertising, to stop tobacco companies from cynically targeting children. It contains a strong lookback provision that requires large additional payments by tobacco companies if they fail to meet the targets in the bill for reducing youth smoking in the years ahead. It gives no immunity from liability to the tobacco companies for the illnesses they have caused. We can reach a reasonable accommodation on how best to protect tobacco farmers, and how best to use the revenues obtained from the tobacco industry. There is no excuse for further delay. The Senate should pass this bill this week, and send it to the House. Senators who refuse to act will pay a high price for abdicating their responsibility. Mr. President, I yield the floor. Mr. GORTON addressed the Chair.

Mr. KENNEDY. Mr. President, as I understand, we have an order for adjournment at 12:30?

Mr. KENNEDY

Mr. KENNEDY. Mr. President, is there a time limit for addressing the Senate?

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

Mr. KENNEDY

Mr. KENNEDY. Mr. President, I ask unanimous consent to proceed for 10 minutes.

Mr. KENNEDY

Mr. KENNEDY. Mr. President, I see our colleague and friend from Arizona in the Chamber at this time. I just want to join with the others in commending him for his leadership on this issue, on tobacco legislation. I think he has really been a very important and powerful voice in moving this process forward, and we certainly hope under his leadership we will move towards a successful conclusion in this next week. I yield the floor. Mr. McCAIN addressed the Chair.

Mr. KENNEDY

Mr. KENNEDY. Mr. President, I want to take a moment or two to talk about an issue that is related to the health and well-being of our fellow citizens--the Patients' Bill of Rights legislation, which I think cries out for action in these next very few days. Mr. President, the Patients' Bill of Rights is not on the majority leader's list of bills to be considered. The majority leader has made available to the Members which pieces of legislation he is going to call up to the floor of the Senate over the period of these next few weeks until the Fourth of July break, then the period of July and then coming into the time that we will be meeting in September. There is a whole series of bills on that list, but one that is missing and one that cries out for action as well is the Patients' Bill of Rights. We want to have the opportunity to debate and consider it, but we are unable to either get a markup of the legislation in our Human Resources Committee, the committee of appropriate jurisdiction, or on the floor of the U.S. Senate. And that is, I think, unacceptable. We are not able to have it considered--not this month, not next month, not for the remainder of this Congress. Evidently, he stands shoulder to shoulder with the guardians of the status quo who want to continue the health insurance abuses. Protecting patients may not be on the majority leader's priority list, but it is on the priority list of American families. And it is on the priority list of more than 100 organizations of doctors, nurses and patients who wrote Leader Lott and Speaker Gingrich yesterday asking that this legislation be considered. I believe this is on the priority list of a majority of Members of the Senate and House--a bipartisan majority that want to protect families, not the profits of the insurance companies. Our leader on this side of the aisle, Tom Daschle, has said that we will offer the Patients' Bill of Rights on the first available appropriate vehicle. The American people deserve action. The American people deserve to have their health care decisions decided by the doctors and the medical profession rather than the accountants for the insurance industry. We have had over the period of these past weeks series after series of incidents of how our fellow citizens' lives have been lost or permanently damaged because of our failure to address this particular issue. The President last year called forth a commission, which was bipartisan, which made unanimous recommendations--Republican and Democrat alike. The Patients' Bill of Rights legislation, which has been introduced by Senator Daschle and which I have been honored to cosponsor with a number of our colleagues, basically reflects the judgment put forward by that bipartisan group of outstanding, thoughtful men and women who are a part of our health care system. We here in this body should address this issue, and we will. We are giving as much notice as possible to the leaders that this is an issue that is not going to go away. We are going to address it. We would vastly prefer addressing it in a way that will accommodate the kind of debate and discussion this issue deserves, but if we are not given that kind of assurance, if we are not given time to address this issue, then we will use whatever parliamentary means we must because the American people expect it. This is a measure of enormous importance in protecting the health and the well-being of families in this country. Families that are facing medical crises, as I mentioned, should have these decisions decided by the health professions. They ought to be able to get the specialists they need. If it is, in a woman's case, a gynecologist or obstetrician, they ought to be able to call on and get the kind of specialty care they need. Women in our society ought to be able to participate in clinical trials, not be denied some of the best that is available out there that offers, in many instances, the opportunity for real hope of a possible cure or a significant improvement in their well-being. They should not be denied that. They are denied that in too many instances today. Newborn children ought to be guaranteed they are going to be able to get the pediatric specialists who can help guide a newborn child or a baby to be able to deal with some of those extraordinary challenges that are evidenced in the first days and weeks of life. We ought to prohibit the kind of gag orders that are out there today in so many instances where doctors who are trying to practice their medicine are denied the opportunity to provide the whole range of choices and options to their patients and they are prohibited because of the HMO's decision. We want to eliminate the kinds of incidents that have been reported on the floor of the Senate where ambulances will drive by the emergency room of a particular hospital and take someone who is in need of emergency treatment to a distant hospital because the HMO is not going to reimburse that individual for the treatment and emergency services at that particular hospital. That makes no common sense, and it does not make any sense even on the bottom line for these companies. These kinds of things are happening every single day, and every single day we delay the debate, discussion, and conclusion of this legislation, the health of Americans across this country is being compromised. That is wrong. We have had bipartisan support for this legislation. The two doctors in the House of Representatives, Republicans, have both supported a Patients' Bill of Rights. They are urging that we take action. I commend them for their courage and for their leadership. It is imperative that we move ahead and take action in the very near future. Every day that goes on and we fail to do so, thousands of families are being put at risk. I hope that on the first vehicle after we conclude this legislation we will have an opportunity to address it.

Mr. KENNEDY

Mr. KENNEDY. Mr. President, I commend Senator Reed for his leadership on the amendment that is before the Senate at the present time. He has proposed a creative and effective enforcement mechanism to deter tobacco industry marketing targeted to children. I strongly support his amendment to eliminate the tax deduction for tobacco industry advertisements that violate FDA advertising restrictions. Clearly, the tobacco industry should not be marketing its addictive products to children. For years, Big Tobacco has appealed to children through its advertising and promotional campaigns. Tobacco advertising was banned from television in the 1970s, but cigarette manufacturers have found new ways to hook kids on their products through colorful magazine advertisements, free t-shirts and caps with brand logos, product placements on prime-time television shows and in the movies, and sponsorship of sports events and cultural events. In fact, studies show that more cigarette ads are placed in stores near schools than in other stores. Ads are put next to the candy counters more often than elsewhere in stores. Displays are set at eye- level for children. In stores near schools and in neighborhoods with large numbers of children under 17, there are more tobacco ads outside the store and in the store windows than in cases where schools are nearby. Recently in Massachusetts, 3,000 teenagers surveyed stores in their communities to identify cigarette advertising aimed at children. Stores within a thousand feet of schools in low-income and minority neighborhoods had more cigarette advertising than stores in affluent communities. According to a recent study in the Journal of the American Medical Association, children watching the Marlboro Meadowland Auto Race on television were exposed to Marlboro ads over 4,700 times in 90 minutes--4,700 times in 90 minutes. Cigarette ads are theoretically prohibited on television--but the tobacco companies have obviously found a way to get around that prohibition. These advertising placements do not happen by accident. Tobacco companies have consistently targeted children as young as 12--because they know that once children are hooked on cigarettes, they are customers for life. In fact, a 1996 study in the Journal on Marketing found that teenagers are three times as responsible as adults to cigarette advertising. Before the Joe Camel advertising campaign began, less than 0.5 percent of young smokers chose Camel. After a few years of intensive Joe Camel advertising, Camel's share of the youth market rose to 33 percent--33 percent. Some 90 percent of current adult smokers began to smoke before the age of 18. If young men and women reach that age without beginning to smoke, it is very likely that they will never take up the habit in later years. And so the industry has cynically conducted its advertising in a way calculated to hook as many children as possible. For at least a generation, Big Tobacco has targeted children with billions of dollars in advertising and promotional giveaways that promise popularity, maturity and success for those who begin this deadly habit. The Centers for Disease Control and Prevention found that the average 14-year-old is exposed to $20 billion in tobacco advertising--$20 billion--beginning at age 6. It is no coincidence that the three most heavily advertised brands are preferred by 80 percent of children-- Marlboro, Camel, and Newport. A study published in the February 8, 1998 Journal of the American Medical Association also reported a strong correlation between cigarette advertising and youth smoking. It analyzed tobacco advertising in 34 popular U.S. magazines and found that as youth readership increased, the likelihood of youth- targeted cigarette advertising increased as well. Two recently disclosed industry documents reveal that Big Tobacco had a deliberate strategy to market its products to children. In a 1981 Philip Morris memo entitled ``Young Smokers--Prevalence, Implications, and Related Demographic Trends,'' the author wrote that ``it is important to know as much as possible about teenage smoking patterns and attitudes. Today's teenager is tomorrow's regular customer, and the overwhelming majority of smokers first begin to smoke while still in their teens. Because of our high share of the market among the youngest smokers, Philip Morris will suffer more than other companies from the decline in the number of teenager smokers.'' A 1976 R.J. Reynolds Tobacco Company memorandum stated that ``young people will continue to become smokers at or above the present rates during the projection period. The brands which these beginning smokers accept and use will become the dominant brands in future years. Evidence is now available to indicate that the 14- to 18-year-old group is an increasing segment of the smoking population. R.J. Reynolds Tobacco must soon establish a successful new brand in this market if our position in the industry is to be maintained over the long-term.'' The conclusion is obvious. Big Tobacco's goal is to hook children into a lifetime of nicotine addiction and smoking-related illnesses. They've used Joe Camel, the Marlboro Man, and the prominent placement of tobacco advertising. Obviously, Big Tobacco knows how to stop targeting children. That's why the Reed amendment is so important. If tobacco companies continue to target children with their billboard advertisements near schools, giveways of branded items, sponsorships of sporting events, and magazine promotions, they'll lose their tax deduction. The health of the nation's children deserves to be protected. The Reed amendment is an important enforcement mechanism to ensure that Big Tobacco plays by the rules. If we continue to permit tobacco companies to deduct the cost of advertising targeted to children as an ordinary and necessary business expense, we will literally be providing a tax subsidy for this unlawful and immoral conduct. Unless we adopt the Reed amendment, the taxpayers will be paying approximately 35 cents of every dollar spent by the industry on a billboard, on a magazine ad, on a promotional item designed to entrap our children into a lifetime of addiction and premature death. The Senate should declare in one resounding voice that we do not consider addicting children to be ``an ordinary and necessary business expense.'' This amendment speaks to the tobacco industry in the only language it understands--money. It will dramatically increase the cost, and therefore help to deter, marketing campaigns which seek to convert impressionable kids into lifelong smokers. For every advertisement which does not appear because of this amendment, there may well be a child who does not light up his or her first cigarette. The Reed amendment deserves the support of every Senator. I urge my colleagues to support it.

Mr. KENNEDY

Mr. KENNEDY. Mr. President, I strongly support the Kerry/Bond Youth Smoking Reduction Amendment. This year has featured hearings, press conferences, and legislation from both sides of the aisle promoting children's programs. Over 50 bills have been introduced to improve childhood development and after school programs. Headlines have focused the nation's attention on the difficulties that many parents face in finding quality care for their children. The struggle for decent child care is a daily fact of life that all working families understand, regardless of their income. Yet millions of families today cannot afford the child care they need in order to raise, and protect their children. Both Republicans and Democrats agree that the number one goal of this tobacco bill ought to be protecting our children and reducing teenage smoking. Rightly, so. Millions of young lives hang in the balance. Every piece of tobacco legislation that has been introduced is intended to help children. Republicans have called their bills ``Placing Restraints on Tobacco's Endangerment of Children and Teens Act'' and the ``Kids Deserve Freedom from Tobacco Act.'' Democrats have introduced the ``Healthy Kids Act.'' It's time to make this legislation reflect the rhetoric about children. Senator Grams was right when he recently explained why he will not support the tobacco settlement--``It's not about protecting kids from tobacco, because if it were, the dollars the federal government collects would go to the kids.'' I agree that these funds should be used for early childhood development, child care and after school programs--programs that directly help kids. These programs are effective ways to curb teen smoking and promote a healthy future for our children. It's time to stand up for the nation's children, and stand against the tobacco industry. During this debate, there has been a great deal of discussion about restricting tobacco advertising and increasing the price of cigarettes. Both steps are intended to curb teenage smoking, and both will help to do just that. But there are other steps we can take as well to deal with realities that make children vulnerable to the lure of tobacco. By investing in essential early childhood development and care that can really help us save children from the dangers of smoking. The purpose of this tobacco legislation is to help children and to stop teenage smoking. For more than a generation, the tobacco industry has been profiteering by abusing the nation's children, stunting their growth and stealing their futures. The full dimension of this cynical tobacco industry strategy is finally becoming clear. The avalanche of secret industry documents disclosed in recent months reveals a blatant nationwide scheme to target children and addict them to tobacco in order to maximize industry profits. For a quarter century the R.J. Reynolds Company has referred to children as ``tomorrow's cigarette business.'' Newly released documents show that Philip Morris provided money to movie makers to add smoking scenes to popular movies, such as the Muppets, in order to observe attitudes toward smoking by children as young as 5 years old. As a result of the tobacco industry's tactics, 93 percent of 6 year olds can identify Joe Camel as a symbol of smoking. Investing in child development is sensible ``public health'' strategy. It is based on sound science and common sense. Doctors and public health officials who are on the front lines, working tirelessly to help children grow and develop into productive citizens, know all too well the dangers of tobacco. They have seen all too frequently its tight grip on our young people. They have called upon us to do all we can to reduce teen smoking, including an essential investment in early childhood development and after school programs. Forty-two doctors, public health officials, business leaders, and child development experts including Dr. T. Berry Brazelton, America's foremost pediatrician, have strongly supported this strategy, and have asked Congress to invest in child care and after school programs to prevent youth smoking addiction. Recent research reminds us that brain development in the first three years of life is critical to laying the foundation for positive self esteem, effective decision-making and the ability to resist destructive habits such as smoking. If we want children to grow up healthy and tobacco free, we must ensure that they receive the stimulation and nurturing they need early. If we wait until adolescence to help them develop the will and the skill to say no to smoking--what we do will be too little and too late. After school and summer programs also make a large difference. Over 5 million children are left home alone after school each day. They are more vulnerable to negative peer pressure and pressure from the tobacco industry. These are precisely the teenagers targeted and manipulated by the industry's marketing schemes. After school programs help keep young people off the streets and engaged in constructive activities that do not jeopardize their futures. Many of these after school programs specifically incorporate anti-smoking initiatives to teach participants about the dangers to tobacco and equip them with the skills to make important life and death decisions. Teenagers left home alone are significantly more likely to smoke cigarettes, drink alcohol, and experiment with drugs. In stark contrast, children who participate in productive after school activities are far less likely, to smoke, drink alcohol, or use drugs. We also know that cigarettes are a ``starter drug'' and often lead to hard drug use and substance abuse. High quality child care and after school programs can help children develop the skills they need to avoid unhealthy habits such as smoking. But, every day across America, millions of low-income working families face the daunting task of finding affordable child care on their limited budgets. The reality is that far too many children are at risk. Ten million low-income children today theoretically qualify for services under current federal child care programs. But because of the lack of funding, only 1 in 10 actually receive it. The cost of decent child care often ranges from $4,000 to $10,000 per year--yet a minimum wage job pays only $10,700 a year. Low-income parents need support to ensure that their children are safe and well cared for. Unfortunately, far too few of them receive the help they need and deserve. Sadly, they are the one group that has been deliberately targeted by the tobacco industry for addiction and early death. That is why I support the Kerry-Bond Amendment, which will ensure that at least half of the federal share of the state funds received under this legislation will be spent by states on after school care and early childhood development by increasing the Child Care Development Block Grant. The American people understand the importance of funding these child development programs. They agree that tobacco settlement revenues should be invested in child care and child development programs. I have received numerous letters from groups, experts, and parents from across the country urging Congress to do so. If we want children to say no to tobacco, then Congress needs to say yes to making children's programs part of our national strategy for keeping children healthy and tobacco free. Mr. President, I join in commending my friend and colleagues, Senator Kerry and Senator Bond, for bringing up this amendment. I think it is very consistent with the central thrust of this legislation which is addressed to reducing the number of young people in this country--the children of this country--from becoming involved in smoking. What we all find out in listening to those who have thought about this, studied it, and reviewed the various real-life experiences that we have seen in different communities, countries, and States is that there are some very, very powerful conclusions. There is no one single answer, but there are a series of answers. I believe that this amendment addresses one of the very important conclusions that have been drawn on the basis of sound science and common sense. We have learned that if you see a significant increase in the cost of a pack of cigarettes, that it provides a significant disincentive to children to involve themselves in smoking. We find out that if you provide counteradvertising in making young people aware of the dangers, that it can have a powerful impact in offsetting the $5 billion a year that is out there to try to draw young children into smoking by presenting the case that, if they start to smoke, their life will be more exciting, more pleasurable, and more successful. You don't need to match the tobacco industry dollar for dollar, but you do need to have an effective counteradvertising campaign. That reduces youth smoking. We have seen it in Massachusetts. We have seen it in California. I have referred to those studies at other times in the course of this debate. Cessation programs to help young people to stop smoking have had some important success. Support for school-based programs, which I see in my own State of Massachusetts, where young people involve themselves in working with law enforcement to discourage retailers from violating the law, has had some success. We have a number of young people now in my State of Massachusetts who are involved in programs to have the various malls around Massachusetts smoke free. They are doing it as volunteers. The young people are doing it. They are also educating the public and their colleagues about the dangers of smoking. There are a number of things that can be done. But the importance of providing early child development to equip young children with the confidence-building tools so that they have the ability to resist various peer pressures and develop those skills of competence is absolutely imperative and essential if we are expecting the children in the future to resist dangerous types of behavior. That has been demonstrated time in and time out. The various Carnegie studies have amply demonstrated that. This legislation is focused on early child development, building those confidence-building skills, helping and assisting in augmenting and supporting children at the earliest ages. We find as the study goes on and on that the earlier, really, the better. Then by providing an atmosphere where these children are going to be able to be challenged intellectually and socially in child care settings provides the kind of supporting atmosphere and climate, again, for building their confidence-building skills. Also, providing some after-school programs, whether it is in the day when the children are attending school, or whether it is at a time when the children are not in school, such as during vacations and also the summertime, considered together, have a very powerful impact in strengthening the willingness of children to resist the negative behavior patterns that start out with smoking, then yield to smoking and drinking, and then, as the law enforcement experts provide, smoking and drinking lead their way to significant substance abuse. That empirical evidence has been included during the period of these last couple of weeks and has been amply justified over a period of time. The benefit of this particular amendment, I think, primarily rests with helping the children at their most vulnerable time, as they are developing their own kinds of confidence-building skills--giving them the kind of help, support, and the power to resist abnormal, negative, and destructive behavior. Second, it provides an important investment in terms of the children so they will have a more useful, constructive, happier, and productive life. All we have to do is consider the Beethoven studies that have been done in Chicago and the Ypsilanti studies that have been done, which have demonstrated this kind of investment in terms of children's attitude and support pays off in just the way that has been represented by those who have advanced this amendment. This is right on target in helping to reduce children's smoking. It is right on target in ensuring that children who are the most vulnerable will be able to develop the kind of skills to resist smoking. It is right on target and consistent with the public health drive, which is the central purpose of this bill, and cannot be distorted and cannot be misrepresented by those who are opposed to any kind of legislation. As hard as they try, this legislation is moving forward. But with this particular amendment, it will be a more effective bill in helping the children in this country. It is an amendment that should be accepted, supported, approved, and made a part of this bill. Mr. President, I hope that the amendment will be accepted.

Mr. KENNEDY

Mr. KENNEDY. Mr. President, I am deeply concerned about the continuing lack of commitment by the Republican Leadership to schedule floor debate on legislation to end abuses by health insurance managed care plans. Today, more than 100 groups have sent a letter to Senator Lott and Speaker Gingrich asking for quick, full and fair floor consideration of this legislation, which is called the Patients' Bill of Rights. These groups represent millions of patients, doctors, nurses, therapists, and working families. Yet, in a memo sent to all Senators and in recent floor statements, it appears that our patient protection legislation--the Patients' Bill of Rights--is not even on the Republican Leader's radar screen. It is not on the list of priorities designated by the Republican Leadership to be taken up this month, or even this session. I have here a list of more than 20 bills, ranging from regular appropriations bills and reauthorization bills to the nuclear waste disposal legislation and a constitutional amendment on flag burning. But, I have yet to see any interest from the Republican Leadership in taking action to ensure that medical decisions are made by treating physicians, and not by insurance company accountants. And I have yet to see any interest from the Republican Leadership in curbing abusive activities by the worst plans and insurance companies that are dedicated to their profits, not their patients. Instead, it appears that, by this inaction, the Republican Leadership is interested only in defending the indefensible, the status quo. In addition, the House Republican Leader, Dick Armey, recently lashed out at doctors, nurses and other health care professionals by grossly misinterpreting and distorting a provision in the Patients' Bill of Rights that allows health care professionals to support their patients in appeals procedures, and to report concerns about the quality of care without fear of retaliation. These are reasonable patient-oriented protections. Congressman Armey's misguided effort offends and impugns the character and professionalism of hundreds of thousands of nurses, doctors and patients. In fact, his harsh attack has helped mobilize even more organizations to support the bill. Representatives Lois Capps, Carolyn McCarthy and Eddie Bernice Johnson, who are former nurses, and nurses from communities around the country have rallied around the Patients' Bill of Rights. Today, they have sent a letter to Congressman Armey asking for a meeting on these critically important issues. They are supported, in a separate letter, by a number of groups who represent persons with disabilities, mental illness and HIV/AIDS, and other organizations that rely regularly on trained and devoted health care professionals. These issues matter a great deal to families across the country. Too often today, managed care is mismanaged care. In state after state across the country, patients are paying for these industry abuses with their lives. Just ask Frances Jennings of Andover, Massachusetts. In November, 1992, at the age of 57, her husband Jack was diagnosed with mild emphysema by his pulmonologist. A few years later, in March, 1997, Mr. Jennings was hospitalized for a pneumothorax, which can lead to a collapsed lung. His physician, Dr. Newsome, determined that a lung reduction procedure would improve Jack's health and overall quality of life. Two months later, in May, 1997, Jack's condition was stable enough for the operation, and he was referred to Dr. Sugerbaker, a top surgeon who specialized in the procedure. But in late May, Jack's insurance plan--U.S. HealthCare--denied his referral to the specialist. Frances and Jack were disappointed that the plan refused to authorize the referral, and they requested a referral for consultation with a plan-approved physician. This appointment was finally scheduled for June 12. But, on June 11, the new doctor's office called Jack to cancel his appointment, stating that the physician no longer accepted patients from the health plan. Immediately following this cancellation, Jack's primary care physician--Dr. Newsome--contacted the health plan to obtain yet another referral. On June 18, a new appointment was confirmed for mid-July, four months after his initial hospitalization. Tragically, Jack Jennings never had the opportunity to benefit from the procedure recommended by his doctor. Jack had been having trouble breathing, despite his continuous use of oxygen, and had been hospitalized at the end of June. During this hospitalization, they discovered a fast growing cancer in his chest. Lung surgery was out of the question, and it was too late for chemotherapy to be effective. Mr. Jennings died on July 10--four days before his long-awaited appointment with the specialist. In fact, this appointment would have been with Dr. Sugarbaker's group, the same physician that U.S. Health Care had prevented Jack from seeing in May. This is a clear case where needed health care was unnecessarily delayed, with tragic implications. Timely care could have saved Jack's life. The health plan's inability or unwillingness to provide it cost him his life. Unfortunately, such abuses are far too common in managed care plans today. Congressional offices are flooded with letters and calls from constituents who need assistance. Newspapers tell story after story of the human costs of these abuses. The Patients' Bill of Rights will help solve these problems, and restore confidence in the health care system. The Patients' Bill of Rights is a common sense solution. Nearly all of its provisions were recommended by the Presidential Advisory Commission on Quality in the Health Care Industry. Many are included in the voluntary code of conduct for members of the American Association of Health Plans, the managed care trade association. Some of the provisions are already being implemented for federal health programs, including Medicare. Still others are included in model laws written by the National Association of Insurance Commissioners. The Senate should act on this important legislation, and it should act now. Mr. President, I ask unanimous consent that the letters I have mentioned may be printed in the Record.

Mr. KENNEDY

Mr. KENNEDY. Mr. President, I would like to ask unanimous consent to be able to proceed maybe for 20 minutes, 10 minutes for myself and the other 10 minutes for our friend, the Senator from Minnesota.

Mr. KENNEDY. I thank the Chair. Mr. President, the Senate has been considering the comprehensive tobacco legislation offered by Senator McCain for three weeks. In fact, since the Senate began to debate the tobacco bill on May 18, 69,000 children have begun to smoke, and 23,000 will die prematurely from a smoking-caused disease. In the past day, however, we have made significant progress in moving forward in a bipartisan manner to resolve our differences and bring this bill to final passage. The Senate should once and for all reject the dilatory tactics of the opponents of this legislation, who care more about protecting the profits of Big Tobacco than they do about protecting the health of the nation's children. They have used every strategy in the book to delay and obstruct this important legislation while thousands of children begin a lifetime of nicotine addiction and smoking-caused illness. But the pressure is starting to build in every corner of this nation, and the American voters are demanding that the Senate take quick and decisive action to bring this bill to a vote. The stakes have rarely, if ever, been higher on any public health issue. Tobacco use is the leading preventable cause of death and disability in the nation. Of the 48 million smokers in the United States today, it is estimated that 20 million adults and 5 million children will die prematurely from a tobacco-induced disease. In fact, tobacco products are responsible for a third of all cancers, and 90% of all lung cancers. 170,000 new cases of lung cancer are expected in 1998. 90,000 men and 65,000 women are expected to die of the disease in this year alone. Tobacco use is also linked to a wide variety of other illnesses. Smoking by children and adolescents is associated with higher cholesterol levels which can significantly increase the risk of early development of cardiovascular diseases. New research also indicates that tobacco use is a risk factor in alcoholism, depression, hearing loss, and vision loss among the elderly. The use of smokeless tobacco products is associated with cancers of the mouth, gum disease, and tooth loss. The dangers of secondhand smoke are also becoming increasingly clear. It is linked to low birthweight, respiratory distress syndrome, and sudden infant death syndrome. A recent report by the Agency for Health Care Policy and Research says that secondhand smoke is responsible for as many as 60% of cases of asthma, bronchitis, and wheezing among young children. It is also clear that smoking-related illnesses impose an enormous burden on the United States economy. According to the Department of Treasury, smoking will cost society $130 billion this year, of which $45 million is attributable to medical costs due to smoking-caused diseases. Smoking during pregnancy, which results in increased costs from complicated deliveries, medical care of low-weight babies, and developmental disabilities, adds up to a $4 billion loss for the U.S. economy. The damage resulting from smoking-caused fires is $500 million a year, which does not even account for the 2,000 lives lost in these tragic accidents. $500 million is attributable to lost productivity, since smokers miss 50% more work days than nonsmokers. In addition, smokers tend to die younger and retire sooner, which costs society an astounding $80 billion in lost output and wages. Much higher priority is obviously needed for smoking cessation programs and tobacco prevention initiatives, which are among the most cost-effective means available to reduce health care costs while, at the same time, improve the lives of millions of Americans. The pending amendment by the Senator from Texas seeks to divert approximately $47 billion over the next ten years away from smoking prevention, away from smoking cessation, away from medical research, and away from reimbursing states. When we add the combined impact of the pending Gramm amendment and the Coverdell amendment which was approved yesterday, no funds would be left for programs which are essential to reducing youth smoking and to helping current smokers quit. In fact, the Gramm amendment alone would result in roughly 4 million fewer Americans served by smoking cessation programs, 20 million fewer people discouraged from smoking by counteradvertising campaigns, and 48 million fewer children participating in school-based smoking prevention activities. These numbers speak for themselves. Reasonable marriage penalty relief makes sense. But the Gramm amendment goes too far. It would destroy the underlying smoking prevention legislation. All of the money raised by the cigarette price increase contained in the legislation is currently earmarked for smoking related purposes: 22 percent is directed to smoking prevention and cessation, 22 percent is to be used for medical research, 16 percent is for transitional assistance for tobacco farmers, and 40 percent is to compensate states for the cost of medical treatment of smoking related illnesses. Which of these smoking related initiatives would the Senator from Texas eliminate? Does he propose to eliminate all compensation to the states for their tobacco related health costs? After all, it was the state lawsuits which provided the genesis for this legislation and which exposed the most dramatic evidence of industry wrongdoing. That would not be fair. Even if every dollar intended for the states was taken to fund the Gramm amendment, it would not be enough to cover the cost. Does he propose to eliminate all transition assistance for tobacco farmers and communities? It would not even cover one-third of the cost of the Gramm amendment. All of the remaining dollars are directed to smoking prevention, to smoking cessation, and to medical research. These initiatives are the heart of the legislation, yet both the pending Gramm amendment and the Coverdell amendment approved yesterday will deny needed resources to prevent teenagers from beginning to smoke. If we are serious about stopping children from smoking and saving lives from tobacco-induced diseases, we have to make these investments. These programs work. Let me give you a few examples: Every dollar invested in a smoking cessation program for a pregnant woman saves $6 in costs for neonatal intensive care and long-term care for low birth weight babies. In addition, smoking cessation programs have an added benefit of reducing tobacco use among children. According to Michael Fiore, Director of Tobacco Research at the University of Wisconsin Medical School, children who smoke have twice the risk of becoming smokers than children of nonsmokers have. By helping parents to quit, the risk of children becoming smokers is reduced as well. The effect of the Gramm amendment would be to reduce funds for these programs, and that makes no sense. The Gramm amendment would deny funds needed to help states and communities conduct educational programs on the health dangers of smoking. The tobacco industry spends $5 billion a year--$5 billion--on advertising to encourage young people to smoke. Shouldn't we spend at least one tenth of that amount to counteract the industry's lethal message? Counteradvertising is a key element of an effective tobacco control strategy. We know that children are easily swayed by the tobacco industry's marketing campaigns, which promise popularity, excitement, and success for those who take up smoking. We can use counteradvertising to reverse the damage by deglamorizing the use of tobacco among children. Both Massachusetts and California have demonstrated that paid counteradvertising can cut smoking rates. It helped reduce cigarette use in Massachusetts by 17 percent between 1992 and 1996, or three times the national average. Smoking by junior high students dropped 8 percent, while the rest of the nation has seen an increase. In California, a counteradvertising campaign also reduced smoking rates by 15 percent over the last three years. The Gramm amendment also would take money from law enforcement efforts to prevent the sale of tobacco products to minors, even though young people currently spend $1 billion a year to buy tobacco products illegally. According to Professor Joseph DiFranza of the University of Massachusetts Medical Center, ``if $1 billion in illegal sales were spread out evenly over an estimated 1 million tobacco retailers nationwide, it would indicate that the average retailer breaks the law about 500 times a year.'' The Gramm amendment will diminish funding for medical research on tobacco-related diseases, which kill 400,000 Americans each year and incapacitate millions more. Given the damage that smoking inflicts on the nation's public health, it makes little sense to deny funds that should be directed to finding a cure for cancer and other tobacco- induced illnesses. In essence, the Gramm amendment would destroy much of the public health benefit this legislation is designed to achieve. The goal of eliminating the marriage penalty for low and moderate income families is a worthy one. It is shared on both sides of the aisle. However, it must be accomplished in a way that does not imperil our primary goal-- preventing youth smoking and helping smokers overcome their addiction. The Daschle amendment, which offers relief from the marriage penalty without imperiling our smoking prevention efforts, will cost far less than the Gramm amendment, and it does a much better job of targeting tax relief to those most in need. The Daschle amendment will cost only $27 billion over the first ten years. That is the most which can be accommodated without damaging our ability to achieve the legislation's core anti-smoking purposes. The cost of the Gramm proposal mushrooms after the fifth year. Thus, over ten years, the cost of the Daschle amendment is approximately $20 billion less than the Gramm amendment. This is the difference between preserving a viable youth smoking reduction effort and destroying it. That is the difference between helping millions of smokers quit and leaving them at the mercy of their addiction. That is the difference between advancing medical research that can cure tobacco induced diseases and indefinitely delaying it. Because it is carefully targeted, the Daschle amendment actually provides more tax relief to those two income families earning $50,000 a year or less who currently pay the marriage penalty. By contrast, more than half the tax relief provided by the Gramm amendment would go to families that are not subject to the marriage penalty. Senator Daschle's proposal will do more to achieve tax fairness at a much lower cost. Once this issue is decided, there is little excuse for further delay. The remaining amendments can be considered in a few days if we move conscientiously forward. There is no valid reason why the Senate cannot vote on final passage soon. If we do not, the American people will know why. A small group of willful defenders of Big Tobacco will have succeeded in obstructing the work of the Senate on this vital issue of public health. On an issue of this importance, our constituents will not tolerate such obstruction. Now is the time for the Senate to act. I yield the floor.

Mr. KENNEDY. I will.

Mr. KENNEDY

Mr. KENNEDY. Mr. President, thirty-five years ago today, in his commencement address to the graduating class of The American University in 1963, President Kennedy announced his support for a comprehensive nuclear test ban. As he said on that occasion: The conclusion of such a treaty, so near and yet so far, would check the spiraling arms race in one of its most dangerous areas. It would place the nuclear powers in a position to deal more effectively with one of the greatest hazards which man faces in 1963, the further spread of nuclear arms. It would increase our security--it would decrease the prospects of war. Surely this goal is sufficiently important to require our steady pursuit, yielding neither to the temptation to give up the whole effort nor the temptation to give up our insistence on vital and responsible safeguards. In the weeks that followed, President Kennedy secured one of the most important of successes of his New Frontier--the signing of the Limited Test Ban Treaty. But, today, 35 years later, we still have not achieved the larger goal of a Comprehensive Test Ban Treaty. Especially in the wake of the recent nuclear tests by India and Pakistan, we need to do all we can to achieve the rapid ratification of this important treaty. The arguments in favor of the CTBT are stronger and more important than ever. The recent tests are a reminder that the greatest threat to humanity is still the danger of nuclear war. The end of the Cold War has presented us with a unique opportunity to step back from the nuclear brink and end nuclear testing worldwide. A Comprehensive Test Ban now would also end the current discrepancy between the world's recognized nuclear states which are permitted to test and the rest of the world's countries which are not. The Senate can take the lead in creating a more secure world by putting the United States in the front of the international effort to achieve a Comprehensive Test Ban. This is the right time for the CTBT. We no longer need to develop more powerful or more accurate nuclear weapons to deter the nations of the former Soviet Union, or any other nuclear-capable state. Through the Stockpile Stewardship Program, we are learning more each day about how to keep our nuclear arsenal safe and reliable without testing. One-hundred and forty-nine nations around the world have already signed the CTBT, including all five of the recognized nuclear states. The United States signed it in September 1996, but the Senate has not yet ratified it. President Kennedy said it best 35 years ago when he told the students at American University, ``. . . in the final analysis, our most basic common link is that we all inhabit this small planet. We all breathe the same air. We all cherish our children's future. And we are all mortal.'' I urge the Senate to act on the ratification of the Comprehensive Test Ban Treaty. The most important single step we can take today to reduce the dangers of nuclear war.

Mr. KENNEDY

Mr. KENNEDY. If the Senator will yield further, it seems to me that we have been talking about whether it has been in the area of education, the area of health care, about partnerships. We have understood that we don't have all the resources given the budgetary considerations, but we are talking about the partnership that exists between the public and the private sector. We also listened, I thought with very strong approval, to the excellent presentation that the President made up in my own State of Massachusetts at the Massachusetts Institute of Technology. I see the chairman of the Foreign Relations Committee. If I could yield for whatever interventions he would like to make, I see an outstanding guest who honors us and who made a wonderful speech that many of us had the chance to listen to a short time ago. It is a great pleasure to yield at this time.

Mr. KENNEDY. Mr. President, I wonder if the Senator will yield for a brief question. Does the Senator remember the debate on the telecommunications legislation where at least there was an understanding that the major carriers were going to be favorably disposed, as a result of the competitiveness, to give those assurances to schools, to libraries, and to rural public health settings around the country? Telemedicine is extremely important, I know, in many regions of the country. It provides extraordinary upgrading of quality health in terms of diagnosis and treatment and care for many of those who live in remote areas, whether it is in urban areas that might benefit from the museums and libraries or educational centers, or those kinds of facilities that exist in rural America, or the public health facilities, small clinics, that provide in many instances life support services for people who live in those communities. It seems to me that many of us were under the understanding that there was an agreement to provide for those kinds of services. I am just wondering whether the leader shared my impression that this was something they had every reason to expect to go into effect, that they had planned on it and made provisions for it, and in many instances are very dependent upon these kinds of services.

Mr. KENNEDY

Mr. KENNEDY. Further parliamentary inquiry. Since I was recognized by the Chair, could I retain my right to continue to address the Senate?

Mr. KENNEDY. Mr. President, I want to express strong support for what my friend and colleague from Arizona has commented to the Senate and thank him for this long and continuing battle. He has been a leader in terms of trying to have a responsible position on this tobacco issue. As all of us understand, this has been an issue where there has been a great deal of diversity in this body, but there has been an enormously admirable, noble, and I think commendable effort on his part to try to move this legislation in a responsible way that tries to find a common ground. I want to just commend him for his continued efforts to move this process forward. We may have some differences on some particular issues as we address them, but I think every Member of this body who believes in the importance of developing a responsible position has to recognize his very, very strong and positive leadership. I join with others who have expressed that previously but, again, take note based upon his continuing efforts and upon his very reasoned statements that he made here earlier today. Now, I want to just join in welcoming many of our colleagues' focus and attention on the problems that this Nation is facing in terms of substance abuse. I am so delighted that many of our colleagues on the other side of the aisle have brought forth their strong support for this Nation to be addressing this particular problem in a more aggressive way. And I welcome that, because many of us stood on the floor of the U.S. Senate in the period of the past 3 years when we saw the Drug-Free School Program, which is the one program that has been developed that had bipartisan support, that is focused on the high schools of this country, that is focused on dealing with the problems of substance abuse, alcohol abuse, and conflict resolution. It doesn't provide a lot of resources--maybe $12 or $14 per school. Nonetheless, there have been a number of very impressive and important programs that have been developed on that. We have seen in recent times many of those who have spoken in favor of this particular amendment voting in favor of cutting the program back in a significant way that would bring targeted help and assistance in terms of the at-risk youth. We have seen that program, which includes the young people who are attempting to try to acquire some kind of treatment and attention and have been afflicted by this horrific kind of addiction in terms of substance abuse, significantly cut back and cut back again. We have seen the important success, I believe, of adding police officers to the streets across this country. The neighborhood policing concept reaches far beyond the total number of 100,000 police officers. I can tell you that in my city of Boston, where they have had the additional kinds of police officers that are community policing, that are involved in the community policing network and are out in schools setting up local kinds of police departments in these schools, in recreational areas, working virtually around the clock and doing a lot of work with community groups, nonprofit agencies, outreaching in terms of trying to deal with some of the problems of gangs. They have had a very important success. In my State of Massachusetts--particularly in Boston--up to just 2 months ago we went close to 2 years without a youth homicide. There are a lot of factors included in the efforts in Boston. Paul Evans, our commissioner, deserves great credit. The neighborhood policing support that was received as a result of some of these programs played an important part, and, again, that program was opposed. So I am not going to take much time here this morning to go through the opposition that many of us faced as we were looking for drug courts which have, I think, demonstrated to be very important and very effective in dealing with the more violent aspects of those that are involved in substance abuse, and the battle we have had in terms of support for those kinds of programs that have been developing to try to demonstrate their success in different regions and communities across the country. So over the period of these past years, many of us have been trying to give additional life to the problems of substance abuse in our society and we haven't been able to get very much support. So whatever the circumstances, we are glad that at least we are hearing on the floor of the U.S. Senate an increasing priority for this Nation in terms of focusing resources. We are not saying that necessarily just adding dollars to a particular program is going to solve the issue, but we do say that the allocations of resources--in this case, the commitment of appropriations, is at least the Nation's priorities in terms of allocating these resources. For many of those, I might say, in watching this debate on the problems of substance abuse and the so- called drug amendment, we have not heard their voices, we have not seen their support, we have not had their votes in the very recent times as all of us are trying to find ways of dealing with a problem that affects too many communities and families in this Nation. So if nothing comes out--and hopefully something will--of the debate, at least we will have additional kinds of focus and attention and, hopefully, support to try to help families, schools, and communities deal with the problems of substance abuse. Let's go back again to what we have here on the floor of the U.S. Senate. What we will find out, Mr. President, if you bring the experts in, in terms of substance abuse, is that virtually without exception the gateway drug to substance abuse is smoking. It is smoking. They will say that is the predominant one, and access to beer is a secondary aspect. But they will say smoking is the gateway drug to substance abuse. We won't take the time this morning--perhaps later in the debate--to show the correlation of smokers to those who get into the use of marijuana, or young smokers that start at 12, 13, and 14 years old that begin to use substances like heroin. The correlation is powerful, it is compelling, and it is convincing. If we are trying to come back to the problems in terms of substance abuse, the first place and the best place to start is with the issue of smoking. The younger the better. The younger the better. That is why I think it is important, as we are coming to this time in the debate and discussion, to keep our focus on what the underlying legislation is all about, which is the public health of young people in this country, to discourage them from smoking with the increase in price and a vigorous antismoking campaign on the back end to try to help provide both information and assistance, cessation programs, and others, in dealing with the challenge that this Nation is facing, and which other countries are facing as well. So, Mr. President, this is why it is so important that we get on with the business that is before the Senate, which is getting, I think, action in terms of voting rather than talking on the issue of tobacco legislation. We have all been through these various battles and we have legislation on the floor of the Senate, where there are strong differences of opinion, and the ability to delay action is readily available by Members on this issue. It seems that the debate has moved along. The issues before us are imperative and we ought to go ahead in having the cloture vote, and we can then deal with those amendments that are relevant at that time. The first vote we are going to be facing this afternoon on the motion to invoke cloture on the tobacco legislation is a key vote. For more than 3 weeks, opponents of the legislation have used every parliamentary trick in the book to prevent the Senate from passing this bill, even though a clear majority are for it. In the 3 weeks since the Senate started this debate, 66,000 more children have started to smoke, and 3,000 more will start each day until the legislation is enacted and implemented. While the Senate fiddles, the cigarettes burn. The opponents have attempted to create a smokescreen to divert attention from the real purpose of this legislation, which is to prevent children from beginning to smoke and becoming addicted to tobacco and help current smokers stop smoking. The opponents are desperate to have the Senate focus on anything else--limiting attorneys' fees, reducing the marriage penalty in the tax laws, prohibiting illegal drug use, school vouchers--any issue but the real issue. They would prefer to ignore the fact that tobacco use is responsible for 20 percent of all premature deaths in the United States. Tobacco is the Nation's leading cause of preventable death and disability. It accounts for 400,000 deaths a year--more deaths than from alcohol, more deaths than from car accidents, more deaths than from suicides, more deaths than from AIDS, more deaths than from homicides, more deaths than from illegal drugs, more deaths than from fires, more deaths than from all of these combined. Yet, the opponents of this legislation are not interested in protecting the public health and saving lives from tobacco use. They are interested in protecting big tobacco and blocking any effective action that would reduce tobacco use and therefore reduce tobacco profits. The American people understand what is going on here. Today's vote will lift the smokescreen and demonstrate where each Senator stands on this fundamental issue. Do they stand for further delay and obstruction, or do they have the courage to act against the will of the tobacco lobbyists? Parents are watching to see if the Senate will continue to allow tobacco companies to blatantly market their products to children, or will we force the Marlboro Man into the sunset? People are watching to see if the Senate will continue to allow nonsmokers to be exposed to secondhand smoke, which causes 3,000 to 5,000 lung cancer deaths each year in the United States and up to 60 percent of all cases of asthma and bronchitis in young children. Are we willing to stand up against the tobacco industry, and stand for the smoking cessation programs and the counter-advertising campaigns and the law enforcement efforts that are needed to prevent tobacco sales to minors? There is no valid reason why the Senate cannot vote on final passage this week. If the majority leader was willing to permit the fair and timely scheduling of amendments from both sides of the aisle, we could complete action on them within a few days. We have filed for cloture because it is the only way to break the parliamentary logjam created by a small group of willful defenders of the tobacco industry. It will provide an irrefutable public record of who is ready to vote for strong legislation to prevent youth smoking and who is attempting to talk the legislation to death. The opponents of the McCain bill are engaging in filibuster by amendment--amendments which do not even deal with the subject of smoking prevention. These amendments are transparent attempts to scuttle the legislation, not improve it. The Coverdell amendment would divert more than 80 percent of the funds currently directed to anti- smoking prevention and cessation programs. According to the analysis, the Coverdell-Craig amendment will slash, as I mentioned, funding for the smoking prevention programs by 82 percent over 5 years. This will be $13 billion, down to the $2.4 billion that will match reduction for these programs that have been demonstrated to be effective. We have gone through that in the course of the debate, including my own State of Massachusetts, California, and other various communities, and neighboring countries such as Canada. The list goes on. Effectively what we are saying is the Office of Management and Budget says this amendment would drain $10 billion from the $13 billion set aside by the bill each year for the antismoking programs. Effectively it guts the program. These anti-smoking initiatives are at the very heart of the legislation. If the Senate is serious about stopping children from beginning to smoke and saving lives from tobacco-induced diseases, we have to invest in these important public health measures. If the Coverdell amendment is enacted, there will be less funding for smoking cessation programs, for counter-advertising programs, and for school and community-based education initiatives, all of which have an excellent track record of preventing smoking by children and helping adults to stop smoking. Clearly, we need greater enforcement efforts to prevent the illegal sale of tobacco products to minors. Each year, American youths spend over $1 billion to purchase tobacco products, despite laws in all 50 states that prohibit underage sales. According to Professor Joseph DiFranza of the University of Massachusetts Medical Center, ``if $1 billion in illegal sales were spread out evenly over an estimated 1 million tobacco retailers nationwide, it would indicate that the average tobacco retailer breaks the law about 500 times a year.'' We shouldn't weaken these important law enforcement efforts by reducing their funding, when they could have such a significant effect in reducing teenage smoking. The federal government currently spends $520 million a year on tobacco control efforts. That sum is dwarfed by the amount spent to fight illegal drugs, which will total $16 billion this year--thirty times as much. Deaths caused by tobacco, 400,000; the amount that is actually spent on Federal spending, $520 million; deaths caused by substance and illegal drugs is 20,000. We spend close to $16 billion. Of course, we are all concerned about the problems of substance abuse. But we are talking about now dealing with the issue of tobacco because it is the gateway to the substance abuse problem that we are facing in this country. If we don't understand that interconnection, we don't really understand this problem in a very important way. This disparity is especially significant, since tobacco use causes 400,000 deaths a year, while illegal drugs are responsible for 20,000 deaths. Clearly, we can do more to reduce illegal drug use, but those efforts should not come at the expense of needed anti-smoking initiatives. President Clinton has already asked Congress to act this year on a $17 billion counter-drug budget--the largest anti-drug budget in our history. The National Drug Control Strategy increases funds for drug intervention programs for youth and for treatment programs. It adds 1,000 officers to the Border Patrol and 540 new DEA positions. Two hundred counter-narcotics agents will be assigned to initiatives to combat heroin and other drug smuggling. In fact, some of the components of the Coverdell amendment duplicate anti-drug strategies set in motion months ago. The Coverdell amendment contains another provision--private school vouchers--which are poison pills for the tobacco legislation. I strongly oppose these provisions, and the Senate should reject them. The private school voucher provisions are a blatant attempt to force the Republican anti-public school agenda on the tobacco bill. The Senate has already debated this issue at length earlier this year. We all know that it is a highly contentious issue. We should not revisit it in the context of the tobacco legislation, since private school vouchers are totally unrelated to reducing youth smoking. The only reason it was included in this amendment is to serve as an anchor to weigh down this important bill. Our goal is to improve the public schools, not abandon them. Instead of draining much-needed resources from public schools, we need to take steps to help all schools, not just a few schools--and to help all students, not just a few students. The Coverdell amendment would undermine these efforts by diverting federal funds to help private schools. Supporters of this legislation are certainly prepared to allocate part of the funds to the anti-drug measures in the Coverdell amendment, but it makes no sense to allocate the vast majority of the funds to those programs. It is time for Republicans in Congress to stop holding the tobacco bill hostage. We should free the prisoner, and do what's needed to reduce smoking. Cloture should be invoked now to prevent any more delaying tactics. I urge my colleagues to vote to end this pro-tobacco filibuster and pass this needed legislation. Mr. President, just to reiterate, we welcome the new voices that are speaking in terms of support for the substance abuse programs. We could have used both their voice and their vote in recent years when those programs were under attack and assault here in the appropriations committees as we were trying to deal with those issues. But now that we find new interest in these programs, we welcome their effort. But you can't get away from the fact that even in dealing with the illegal problems of substance abuse and illegal drugs that the gateway to all of this is tobacco. That is what we are focused on. That is the core issue. We take meaningful steps in terms of tobacco by discouraging young people from purchasing as a matter of price, and by taking the antismoking kinds of programs that have been included in this effort, we are going to have a meaningful impact on the number of young people that are going to smoke, and we are going to have a meaningful impact on the problem of substance abuse. Mr. President, I hope we can come back this afternoon and move towards cloture and get on with the business before the Senate. The American people have been listening to this debate for some 3 weeks. Families are entitled to have a vote to protect their children in this country. We ought to be able to take a stand. We should be willing to take such a stand and be held accountable for that. We will have the first opportunity to do so this afternoon. I hope all of our colleagues will give support for that program so we can move this legislation, so the House will move it, eventually the President will sign it, and we will make meaningful progress in reducing the problems of youth smoking in this country.

Mr. KENNEDY. Parliamentary inquiry. I thought I was recognized and was asked to yield so that the clerk could report. Do I understand that I lost the floor and the Chair recognized another Senator?

Mr. KENNEDY

Mr. KENNEDY. Mr. President, it is a privilege to join Senator Frist on this important legislation, which is strongly supported by the Clinton Administration, patient groups, and the American Association of Blood Banks. The National Marrow Donor Program was established in 1986 to meet the need for a single large, nationwide registry of bone marrow donors. For those facing the diagnosis of leukemia or other life-threatening diseases, the registry can literally save their lives. Of particular importance is the need for identifying potential donors for African Americans, Asian/Pacific Islanders, Hispanics, and Native Americans, since each individual's likelihood of finding a matching donor, apart from family members, is higher in the individual's racial or ethnic group. By cooperation with international registries and targeted campaigns to increase the representation of minorities, the NMDP has made remarkable progress in improving the likelihood that patients of every racial and ethnic group can find suitable donors. Through skillful work and commitment, the NMDP has grown rapidly in recent years. It now maintains a registry of over three million volunteer bone marrow donors. The very important work of the registry must be continued. Its success in identifying matching donors and recipients is bringing the miracle of better health to families across the country. Congress has a responsibility to support this critical work. In fact, this reauthorization is long overdue, and I hope that Congress will act expeditiously so that the National Marrow Donor Program can continue its life-saving work.

Mr. KENNEDY

Mr. KENNEDY. Mr. President, on May 29, during the Memorial Day recess last week, the Kennedy Library Foundation held its annual ``Profile in Courage'' Award Ceremony at the Kennedy Library in Boston. The 1998 Profile in Courage Award was presented to Nickolas C. Murnion, the County Attorney of Garfield County, Montana, for his courageous leadership in the confrontation earlier in this decade with the militia group called the Freemen. The Profile in Courage award takes its name from President Kennedy's Pulitzer Prize-winning book, ``Profiles in Courage,'' which my brother wrote in the 1950's, while he was still a Senator. The book told the stories of elected officials in American history who showed extraordinary political courage by doing what they thought was right, in spite of powerful resistance and opposition. Nick Murnion clearly demonstrated that quality of political courage, and he did so at great physical risk to himself as well. His small rural community in Montana came under siege, beginning in 1993, from the Freemen, a belligerent anti-government militia that took root in the area. The members of the Freemen refused to abide by local laws or pay taxes. They harassed and threatened public officials, and threatened the life of Nick Murnion and anyone else who challenged them. But Nick Murnion stood his ground, and armed with the rule of law and the strong support of other citizens in the community, he prevailed. Finally, in 1996, the FBI came to provide assistance, and after a dramatic 81-day siege, the militia members surrendered peacefully. Today, as the nation struggles to deal with extremist groups, hate crimes, church bombings, schoolyard shootings, and other distressing acts of violence in our society, Nick Murnion's inspiring story reminds us of leadership at its best in our democracy. In accepting the Profile in Courage Award, Nick Murnion delivered a truly eloquent address at the Kennedy Library in Boston, and I ask unanimous consent that his remarks be printed in the Record.

Mr. KENNEDY

Mr. KENNEDY. Mr. President, the Senate debate on this landmark youth smoking reduction bill began more than two weeks ago. The time for debate on this legislation is rapidly drawing to a close. Each of us has had ample opportunity to state our views. The Senate should commit to a vote on final passage within a week. We owe it to our children who are being entrapped into a life of addiction and premature death by the tobacco industry every day. The opponents of this legislation have used every parliamentary tool at their disposal to extend the debate and to divert attention to unrelated issues. They want to talk about every subject but the impact of smoking on the nation's health. However, the real issue cannot be obscured by their verbal smokescreen. It is time for us to move from talking to voting. Each day that the opponents delay final Senate passage of this bill, 3,000 more children begin to smoke. A third of these children will die prematurely from lung cancer, emphysema, heart disease, or other smoking-caused illnesses. Each day that we delay, the price of a pack of cigarettes will continue to be affordable to the nation's children, and more and more of them will take up this deadly habit. Each day that we delay, Big Tobacco will continue to target children with billions of dollars in advertising and promotional giveaways that promise popularity, excitement, and success for young men and women who start smoking. Each day that we delay, millions of nonsmokers will be exposed to secondhand smoke. According to the Environmental Protection Agency, secondhand smoke causes 3,000 to 5,000 lung cancer deaths each year in the United States--more than all other regulated hazardous air pollutants combined. Secondhand smoke is also responsible for as many as 60 percent of cases of asthma, bronchitis, and wheezing among young children. Each day that we delay, tobacco will remain virtually the only product manufactured for human consumption that is not subject to Federal health and safety regulations, despite the fact that it causes over 400,000 deaths a year. In fact, Kraft Cheese is more heavily regulated than Marlboro cigarettes, although both are manufactured by Philip Morris. With so much at stake for so many of our children, it is truly irresponsible for the opponents of this legislation to practice the politics of obstruction. Let the Senate vote. There are two pending amendments before us today--the Gramm amendment on the marriage penalty and the Durbin-DeWine amendment on the youth smoking reduction lookback. I would like to address each of them in turn. The pending amendment by the Senator from Texas seeks to divert $52 billion over the next 5 years away from smoking prevention, away from smoking cessation, away from medical research, and away from reimbursing states. He proposes to take 80 percent of all the money raised by the cigarette price increase and use it for unrelated tax cuts. No funds would be left for programs which are essential to reducing youth smoking and to helping current smokers quit. By offering such an amendment, the Senator from Texas shows his true intent. It is he who wants to convert this legislation from a youth smoking prevention bill into a piggybank for unrelated projects. Although he has complained that the tobacco bill is a piggybank that Democrats are using to fund new programs, in fact it is the Gramm amendment which would hog 80 percent of the money taking resources which are needed to prevent young Americans from beginning to smoke and to help current smokers overcome their addiction. These numbers speak for themselves. This tax cut was not designed to help working families--it was intended to destroy the underlying smoking prevention legislation. The criticism of the Gramm amendment has been so strong and so widespread that even the sponsor has agreed to reduce the size of the proposed moneygrab. Under his new proposal, he only wants to take one- third of the revenue generated in the first 5 years and one-half of the money in succeeding years. That would amount to approximately $60 billion over a 10-year period. It would still cripple the smoking prevention and cessation efforts which are essential to effectively reducing youth smoking. All of the money raised by the cigarette price increase contained in the legislation is currently earmarked for smoking related purposes: 22 percent is directed to smoking prevention and cessation, 22 percent is to be used for medical research, 16 percent is for transitional assistance for tobacco farmers, and 40 percent is to compensate states for the cost of medical treatment of smoking related illnesses. There it is, Mr. President. Which of these smoking related initiatives would the Senator from Texas eliminate? Does he propose to eliminate all compensation to the States for their tobacco related health costs? After all, it was the State lawsuits which provided the genesis for this legislation and which exposed the most dramatic evidence of industry wrongdoing. That would not be fair. Even if every dollar intended for the States was taken to fund the Gramm amendment, it would not be enough to cover the cost. Does he propose to eliminate all transition assistance for tobacco farmers and communities? It would not even cover one-third of the cost of the Gramm amendment. All of the remaining dollars are directed to smoking prevention, to smoking cessation, and to medical research. These initiatives are the heart of the legislation. If we are serious about stopping children from smoking and saving lives from tobacco-induced diseases, we have to make these investments. Would the Senator from Texas propose that we take money from these programs and use it to fund an unrelated tax cut instead? How can we in good conscience raise the price of cigarettes and then refuse to fund programs which will address the evils of smoking? These programs work. Let me give you a few examples: Every dollar invested in a smoking cessation program for a pregnant woman saves $6 in costs for neonatal intensive care and long-term care for low-birthweight babies. The effect of the Gramm amendment would be to reduce funds for these programs, and that makes no sense. The Gramm amendment would take funds intended to assist states and communities to conduct educational programs on the health dangers of smoking. The tobacco industry spends $5 billion a year--$5 billion--on advertising to encourage young people to smoke. Shouldn't we spend at least one tenth of that amount to counteract the industry's lethal message? Counteradvertising is a key element of an effective tobacco control strategy. We know that if children are easily swayed by the tobacco industry's marketing campaigns, which promise popularity, excitement, and success for those who take up smoking, we can reverse the damage by deglamorizing the use of tobacco among children with counteradvertising. Both Massachusetts and California have demonstrated that paid counteradvertising can cut smoking rates. It helped reduce cigarette use in Massachusetts by 17 percent between 1992 and 1996, or three times the national average. Smoking by junior high students dropped 8 percent, while the rest of the nation has seen an increase. In California, a counteradvertising campaign also reduced smoking rates by 15 percent over the last 3 years. The Gramm amendment also would take money from law enforcement efforts to prevent the sale of tobacco products to minors, even though young people currently spend $1 billion a year to buy tobacco products illegally. The Gramm amendment will diminish funding for medical research on tobacco-related diseases, which kill 400,000 Americans each year and incapacitates millions more. Given the damage that smoking inflicts on the nation's public health, it make little sense to divert tobacco revenues to tax cuts when they could be directed to finding a cure for cancer and other tobacco-induced illnesses. Since tobacco induced disease costs America $130 billion per year, it certainly is not cost effective to reduce research spending. In essence, the Gramm amendment would destroy much of the public health benefit this legislation is designed to achieve. It would be a tragic mistake. The goal of eliminating the marriage penalty for low and moderate income families is a worthy one. It is shared on both sides of the aisle. However, it must be accomplished in a way that does not imperil our primary goal--preventing youth smoking and helping smokers overcome their addiction. I anticipate that an alternative amendment will be offered which will provide relief from the marriage penalty without imperiling our smoking prevention efforts. It will cost far less than the Gramm amendment, and it will do a much better job of targeting tax relief to those most in need. That is the difference between preserving a viable youth smoking reduction effort and destroying it. That is the difference between helping millions of smokers quit and leaving them at the mercy of their addiction. That is the difference between advancing medical research that can cure tobacco induced diseases and indefinitely delaying it. The second issue I want to address is the Durbin-DeWine look-back amendment. It will assess increased sums for noncompliance with the youth smoking reduction targets. In addition, the emphasis will be shifted from industry-wide assessments to company-by-company assessments, in order to more effectively deter individual tobacco companies from marketing their products to children. Big Tobacco knows how to hook children into a lifetime of nicotine addiction and smoking-related illnesses--whether appealing through characters like Joe Camel and the Marlboro Man, through the prominent placement of tobacco advertising, or through a strategic cut in cigarette prices. And Big Tobacco also knows how to stop appealing to children. The purpose of the look-back is to give tobacco companies an overwhelming financial incentive to turn their focus away from the youth market. Our goal is to influence every business decision by taking the profit away from addicting teenagers. The Durbin-DeWine amendment will accomplish that goal much more effectively than the current look-back provisions in the manager's amendment. It will substantially increase the total amount of the surcharges which companies must pay if youth smoking levels do not decline in accordance with the reduction targets. It also shifts the payment obligations from a predominately industrywide system to a predominately company-specific system. This will dramatically increase the deterrent influence of the look-back on company policy. The current McCain provision provides for a maximum industrywide penalty of $4 billion, or about 20 cents a pack. The company-specific portion is extremely small, amounting to only a few pennies per pack. The Durbin-DeWine amendment provides for substantial company-specific penalties, which in the aggregate could reach $5 billion per year if companies continue to flaunt the law and blatantly target children. The amendment also provides for an industrywide surcharge of up to $2 billion a year. Through this important amendment we are speaking to the tobacco companies in the only language they understand--money. If they continue to target children, these companies will pay a financial price far in excess of the profits raised from addicting children. But if they are willing to cooperate in efforts to prevent teenage smoking, the companies may never have to pay a dollar of look-back surcharges. A strong, company-specific look-back, such as the one we are proposing, will give the tobacco companies a powerful financial incentive to use their skill in market manipulation to further, rather than undermine, the public interest in reducing youth smoking. Each tobacco company must be held accountable for its actions on teenage smoking. The stakes involved are nothing less than the health of the Nation's children. For each percentage point that the tobacco industry misses the target, 55,000 children will begin to smoke. One- third of these children will die prematurely from smoking-induced diseases. This bipartisan amendment deserves the support of the full Senate, and I urge my colleagues to adopt it. These two issues--the marriage penalty and the look-back--should be resolved quickly. Once they are decided, there is little excuse for further delay. The remaining amendments can be considered in a few days if we move conscientiously forward. There is no valid reason why the Senate cannot vote on final passage by the middle of next week. If we do not, the American people will know why. A small group of willful defenders of the tobacco industry will have succeeded in obstructing the work of the Senate on this vital issue of public health. On an issue of this importance, which is literally a matter of life and death, our constituents will not tolerate such obstruction. Now is the time for the Senate to act. Mr. President, I suggest the absence of a quorum.