Ted Kennedy

Mr. KENNEDY

Mr. KENNEDY. That is the issue before the U.S. Senate. Many of us do not believe that this President is right on it. The Baker-Hamilton commission did not agree with that policy. General Abizaid did not agree with that policy before the Armed Services Committee. And the American people don't. We on this side are interested in protecting American servicemen from the crossfire of a civil war. Some on the other side are more interested in protecting the President from a rebuke for his policy of escalation in Iraq.

Mr. KENNEDY

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 President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. KENNEDY

Mr. KENNEDY. Mr. President, the war in Iraq is the most important issue of our time. The American people know that our soldiers are serving nobly under extraordinarily difficult circumstances and that far too many of them are making the ultimate sacrifice for our country. Citizens are calling on us--begging us--to address this issue with the seriousness and the urgency it deserves. The House of Representatives will vote later today on a major resolution supporting our troops and opposing the escalation of the war. It will be a historic vote and a clear response to the American people's clarion call for change. The Senate will have a chance to do so soon as well. The voices of the American people are growing louder and louder, and the need for us to act could not be clearer. Under the President's current policy, the war continues to impose an enormous human toll on our soldiers, their families, and their loved ones. Our men and women in uniform have served with great courage and honor for nearly 4 years--longer than it took to win World War II. More than 3,000 of our forces have been killed and more than 23,000 wounded. The casualties keep mounting. Last fall was the deadliest period since the war began. Mr. President, 287 American soldiers were killed in October, November, and December. Already, 118 have been killed since the President announced the surge, and the numbers keep rising. The toll in Massachusetts has been heavy. Just last week, CPT Jennifer Harris of Swampscott, MA, was killed when her helicopter went down north of Baghdad. She was the first woman from our State to make the ultimate sacrifice in Iraq, and our hearts and prayers go out to her family and loved ones. So far, 65 Massachusetts members of our forces have given the last full measure of devotion to our country. The youngest was 19, the oldest was 46. They died far from their homes in Bedford and Bristol, Lawrence and Lowell, Plymouth and Pittsfield, Weymouth and Woburn, and other towns and cities across the State. They were fathers, sons, a daughter, brothers, and friends. Each of them represents a life cut short in service to our country. More than 3,000 families across America share in such heartbreak. Their loved ones have died in Iraq, and we mourn their loss. We honor their service, and we pray that God's grace and mercy may ease the anguish of those they have left behind. Citizens of Massachusetts have answered their country's call from the first days of the Republic, and those we honor today are members of that noble company. Each knew they were going into harm's way. They faced dangers in Iraq that vast numbers of our troops had never seen before, such as suicide bombers and improvised explosive devices. We mourn the loss of these heroes. We honor their sacrifice and extend our deepest condolences to their families. Words cannot ease the grief of losing a loved one, but I hope the families may find comfort in the words of Abraham Lincoln in the famous letter he sent to a bereaved mother during the Civil War. He wrote: Dear Madam, I feel how weak and fruitless must be any words of mine which should attempt to beguile you from the grief of a loss so overwhelming. But I cannot refrain from tendering to you the consolation that may be found in the thanks of the Republic they died to save. I pray that our Heavenly Father may assuage the anguish of your bereavement, and leave you only the cherished memory of the loved and the lost, and the solemn pride that must be yours to have laid so costly a sacrifice upon the altar of freedom. The consequences of the decisions we make here in Congress profoundly affect our military, their families, and the communities they have left. We have an obligation to our soldiers to make sensible decisions that will not place them needlessly in harm's way. We in Massachusetts feel especially deeply the loss of the 65 soldiers who have died in Iraq: SGT Justin W. Garvey; PFC John D. Hart; SPC Christopher J. Holland; SGT Pierre A. Raymond; CPL Brian Oliveira; LCpl Travis Reid Desiato; LCpl Dimitrios Gavriel; SGT Andrew Farrar; 1LT Brian McPhillips; SSG Joseph P. Belavia; LCpl John J. Vangyzen IV; SGT Kurt D. Schamberg; CPT John W. Maloney; SPC Ray M. Fuhrmann II; 1SG Alan N. Grifford; PVT Michael E. Bouthot; SPC Daniel R. Gionet; SGT Gregory A. Belanger; PFC Kerry D. Scott; SGT Daniel J. Londono; CPL David Marques Vincente; LCpl Jeffrey Charles Burgess; LCpl Alexander Scott Arrendodo; 1LT Travis John Fuller; CPT Benjamin Sammis; CWO2 Stephen M. Wells; SPC Matthew Boule; CWO Kyran E. Kennedy; CPT Christopher J. Sullivan; LCpl Shayne Cabino; LTC Leon G. James, II; CPT Joel E. Cahill; LCpl Michael Ford; CPL Scott Procopio; LCpl Patrick Gallagher; CPL Donald E. Fisher II; SPC Gabriel T. Palacios; SGT Benjamin E. Mejia; SGT Glenn R. Allison; GySgt Elia Paietta Fontecchio; LCpl Andrew Zabierek; LCpl Nickolas David Schiavoni; SPC Daniel F. Cunningham; LCpl Gregory E. MacDonald; SPC Peter G. Enos; PFC Norman Darling; PVT Cory R. Depew; SSG Joseph Camara; SGT Charles Caldwell; PFC Markus J. Johnson; SPC David J. Babineau; CPL Paul N. King; LCpl Geoffrey R. Cayer; SGT Mark R. Vecchione; SSG Clint J. Storey; SPC Edgardo Zayas; LCpl Eric P. Valdepenas; SPC Jared J. Raymond; LCpl Edward Garvin; LT Joshua Booth; SPC Matthew J. Stanley; SGT Gregory Wright; SFC Keith Callahan; SGT Alexander H. Fuller; and CPT Jennifer Harris. Mr. President, I ask unanimous consent that the chart I have be printed in the Record. It is a chart of their hometowns and where they died in Iraq.

Mr. KENNEDY

Mr. KENNEDY. Mr. President, today, we are introducing legislation to give the Food and Drug Administration broad authority to regulate tobacco products. Congress cannot in good conscience allow the Federal agency most responsible for protecting the public health to remain powerless to deal with the enormous risks of tobacco, the most deadly of all consumer products. Health experts believe this legislation is the most important action Congress could take to protect children from this deadly addiction. This is a bipartisan, bicameral initiative. The bill that Senator Cornyn and I are introducing already has over 25 cosponsors. Congressman Waxman and Davis will introduce identical legislation in the House. Our bill has the support of a broad coalition of public health organizations led by the Campaign for Tobacco-Free Kids, the American Cancer Society, the American Heart Association and the American Lung Association. They all recognize the importance of enacting this bill this year. The legislation we are introducing today is well known. It is the same bill that passed the Senate in 2004, and that we introduced in the last Congress. However, in this new Congress, the likelihood of passage is greatly enhanced. Last November's election swept away many of the barriers to passage from prior years. We believe 2007 is the year that legislation empowering the FDA to regulate tobacco products will finally become law. We intend to move forward on the legislation quickly. I have already scheduled a hearing in the HELP Committee for February 27, and a markup is planned soon thereafter. The stakes are vast. Four thousand children have their first cigarette every day, and one thousand become daily smokers. More than one-third of them will die prematurely from tobacco-induced diseases. Cigarettes kill well over 400,000 Americans each year. That is more lives lost than from automobile accidents, alcohol abuse, illegal drugs, AIDS, murder, and suicide combined. Congress's response to a public health problem of this magnitude is long overdue. Regulating the conduct of tobacco companies is as necessary today as it has been in years past. The facts presented in the Federal Government's landmark lawsuit against the tobacco industry demonstrate that the misconduct is substantial and ongoing. The decision of the court states: ``The evidence in this case clearly establishes that Defendants have not ceased engaging in unlawful activity . . . Defendants continue to engage in conduct that is materially indistinguishable from their previous actions, activity that continues to this day.'' We must deal firmly with tobacco company marketing practices that target children and mislead the public. The Food and Drug Administration needs broad authority to regulate the sale, distribution, and advertising of cigarettes and smokeless tobacco. The tobacco industry currently spends over $15 billion a year to promote its products. Much of that money is spent in ways designed to tempt children to start smoking, before they are mature enough to appreciate the enormity of the health risk. The industry knows that nearly 90 percent of smokers begin as children and are addicted by the time they reach adulthood. Documents obtained from tobacco companies prove, in the companies' own words, the magnitude of the industry's efforts to trap children into dependency on their deadly product. Studies by the Institute of Medicine and the Centers for Disease Control show the substantial role of industry advertising in decisions by young people to use tobacco products. If we are serious about reducing youth smoking, FDA must have the power to prevent industry advertising designed to appeal to children wherever it will be seen by children. This legislation will give FDA the authority to stop tobacco advertising that glamorizes smoking to kids. It grants FDA full authority to regulate tobacco advertising ``consistent with and to the full extent permitted by the First Amendment.'' FDA authority must also extend to the sale of tobacco products. Nearly every State makes it illegal to sell cigarettes to children under 18, but surveys show that those laws are rarely enforced and frequently violated. FDA must have the power to limit the sale of cigarettes to face-to-face transactions in which the age of the purchaser can be verified by identification. This means an end to self- service displays and vending machine sales. There must also be serious enforcement efforts with real penalties for those caught selling tobacco products to children. This is the only way to ensure that children under 18 are not able to buy cigarettes. The FDA conducted the longest rulemaking proceeding in its history, studying which regulations would most effectively reduce the number of children who smoke. Seven hundred thousand public comments were received in the course of that rulemaking. At the conclusion of its proceeding, the agency promulgated rules on the manner in which cigarettes are advertised and sold. Due to litigation, most of those regulations were never implemented. If we are serious about curbing youth smoking as much as possible, as soon as possible; it makes no sense to require FDA to reinvent the wheel by conducting a new multi- year rulemaking process on the same issues. This legislation will give the youth access and advertising restrictions already developed by FDA the immediate force of law, as if they had been issued under the new statute. The legislation also provides for stronger warnings on all cigarette and smokeless tobacco packages, and in all print advertisements. These warnings will be more explicit in their description of the medical problems which can result from tobacco use. The FDA is given the authority to change the text of these warning labels periodically, to keep their impact strong. The nicotine in cigarettes is highly addictive. Medical experts say that it is as addictive as heroin or cocaine. Yet for decades, tobacco companies vehemently denied the addictiveness of their products. No one can forget the parade of tobacco executives who testified under oath before Congress that smoking cigarettes is not addictive. Overwhelming evidence in industry documents obtained through the discovery process proves that the companies not only knew of this addictiveness for decades, but actually relied on it as the basis for their marketing strategy. As we now know, cigarette manufacturers chemically manipulated the nicotine in their products to make it even more addictive. A newly released analysis by the Harvard School of Public Health demonstrates that cigarette manufacturers are still manipulating nicotine levels. Between 1998 and 2005, they significantly increased the nicotine yield from major brand name cigarettes. The average increase in nicotine yield over the period was 11 percent. The tobacco industry has a long, dishonorable history of providing misleading information about the health consequences of smoking. These companies have repeatedly sought to characterize their products as far less hazardous than they are. They made minor innovations in product design seem far more significant for the health of the user than they actually were. It is essential that FDA have clear and unambiguous authority to prevent such misrepresentations in the future. The largest disinformation campaign in the history of the corporate world must end. Given the addictiveness of tobacco products, it is essential that the FDA regulate them for the protection of the public. Over 40 million Americans are currently addicted to cigarettes. No responsible public health official believes that cigarettes should be banned. A ban would leave 40 million people without a way to satisfy their drug dependency. FDA should be able to take the necessary steps to help addicted smokers overcome their addiction, and to make the product less toxic for smokers who are unable or unwilling to stop. To do so, FDA must have the authority to reduce or remove hazardous ingredients from cigarettes, to the extent that it becomes scientifically feasible. The inherent risk in smoking should not be unnecessarily compounded. Recent statements by several tobacco companies make clear that they plan to develop what they characterize as ``reduced risk'' cigarettes. Some are already on the market making unsubstantiated claims. This legislation will require manufacturers to submit such ``reduced risk'' products to the FDA for analysis before they can be marketed. No health-related claims will be permitted until they have been verified to the FDA's satisfaction. These safeguards are essential to prevent deceptive industry marketing campaigns, which could lull the public into a false sense of health safety. Smoking is the number one preventable cause of death in America. Congress must vest FDA not only with the responsibility for regulating tobacco products, but with full authority to do the job effectively. This legislation will give the FDA the legal authority it needs to reduce youth smoking by preventing tobacco advertising which targets children, to prevent the sale of tobacco products to minors, to help smokers overcome their addiction, to make tobacco products less toxic for those who continue to use them, and to prevent the tobacco industry from misleading the public about the dangers of smoking. Enacting this bill this year is the right thing to do for America's children. They are depending on us. By passing this legislation, we can help them live longer, healthier lives. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. KENNEDY. Mr. President, it is a privilege to join Senator Bond in introducing ``The Arthritis Prevention, Control and Cure Act.'' Our goal in this important initiative is to provide a strong federal response to arthritis. Early diagnosis, treatment, and appropriate management of arthritis can control its symptoms, improve the quality of life of patients, and Federal action will improve the lives of the family members and caregivers of those affected by the disease. Arthritis exits in more than a hundred different forms. It's one of the most devastating diseases impairing the health of the American people. It's second only to heart disease as a cause of work disability. It undermines everyday activities such as walking, dressing and bathing for more than seven million Americans. One out of very five adults in the United States suffers from some form of arthritis. The number of patients in the U.S. with arthritis will keep growing as the number of older Americans continues to increase dramatically in the next few decades. Today, 8.7 million adults, ages 18 through 44, have arthritis and millions of others are at risk of developing the disease. In fact, arthritis is one of the most prevalent chronic illnesses and the leading cause of disability among Americans over age 15. More than 40 percent of adults with arthritis are limited in their activities because of their arthritis. By 2030, nearly 25 percent of the projected United States adult population will have arthritis and these numbers don't account for the current trends in obesity, which may contribute to future cases of the disease. It is an illness that affects all types of people in the U.S., not just older Americans. Arthritis knows no boundaries. Men, women and children are all afflicted with the disease. According to the Arthritis Foundation, 24 million women and 17 million men have been diagnosed with arthritis by their doctors. Women are still disproportionately affected by the disease. Nearly 3 out of every 1,000 American children are affected by arthritis. The devastating effects of pediatric arthritis justifies greater investment by the federal government in research and to identify more effective treatments. Special concerns are raised by juvenile arthritis because of its impact on family relationships, school life, dating, sports and other aspects active, growing youths. Teens and young adults entering the workforce face even greater challenges. Arthritis an other rheumatic diseases cost our economy $128 billion annually, according to the Centers for Disease Control and Prevention. In 2003, the cost was equivalent to 1.2 percent of the nation's gross domestic product. $80 million of that amount were direct costs for medical care and $47 million were indirect costs for lost earnings. National medical costs attributed to arthritis grew by 24 percent between 1997 and 2003, with an increase attributed to the growing number of people affected with the disease. In 1975, Congress enacted the National Arthritis Act to encourage basic and clinical research, establish Multipurpose Arthritis Centers and expand clinical knowledge of the illness. The act was successful in implementing and continued funding of research and has led to important advances in the control, treatment and prevention of the illness. Early diagnosis, treatment and management can control symptoms and improve the quality of life. Weight control and exercise can help lower risks. Patient education, training and self-management also contribute to greater control of these diseases. Innovative and increasingly effective drug therapies, joint replacements, and other therapeutic alternatives are being developed. Despite much research identifying effective interventions, many of them are not being used well enough and the inevitable result is unnecessary loss of life, poorer health and poorer quality of life. Our legislation will expand the effort to find new ways to prevent, treat and care for patients with arthritis and related rheumatic diseases. It will enhance the National Arthritis Action Plan by providing additional support to federal, state and private efforts to prevent and manage arthritis. It will establish a National Arthritis Education and Outreach Campaign to inform the health care profession and the public about the most successful self-management strategies for controlling the illness. With greater coordination and intensification of federal research, this bill will organize a National Arthritis and Rheumatic Diseases Summit to look at the challenges and opportunities related to these efforts. In addition, the bill will provide greater attention to juvenile arthritis research by offering planning grants for research specific to juveniles and by prioritizing the activities that create better understanding of the incidence and outcomes associated with juvenile arthritis. Finally the bill contains incentives to encourage health professionals to enter the field of pediatric rheumatology by education loan repayment and career development awards. I urge my colleagues to support this public health initiative to reduce the pain and disability of arthritis. Early diagnosis, effective treatment and greater investment in research and prevention can help us wage a stronger battle against one of the most widespread and devastating conditions affecting our Nation.

Mr. KENNEDY

Mr. KENNEDY. Mr. President, today, we are introducing legislation to give the Food and Drug Administration broad authority to regulate tobacco products. Congress cannot in good conscience allow the Federal agency most responsible for protecting the public health to remain powerless to deal with the enormous risks of tobacco, the most deadly of all consumer products. Health experts believe this legislation is the most important action Congress could take to protect children from this deadly addiction. This is a bipartisan, bicameral initiative. The bill that Senator Cornyn and I are introducing already has over 25 cosponsors. Congressman Waxman and Davis will introduce identical legislation in the House. Our bill has the support of a broad coalition of public health organizations led by the Campaign for Tobacco-Free Kids, the American Cancer Society, the American Heart Association and the American Lung Association. They all recognize the importance of enacting this bill this year. The legislation we are introducing today is well known. It is the same bill that passed the Senate in 2004, and that we introduced in the last Congress. However, in this new Congress, the likelihood of passage is greatly enhanced. Last November's election swept away many of the barriers to passage from prior years. We believe 2007 is the year that legislation empowering the FDA to regulate tobacco products will finally become law. We intend to move forward on the legislation quickly. I have already scheduled a hearing in the HELP Committee for February 27, and a markup is planned soon thereafter. The stakes are vast. Four thousand children have their first cigarette every day, and one thousand become daily smokers. More than one-third of them will die prematurely from tobacco-induced diseases. Cigarettes kill well over 400,000 Americans each year. That is more lives lost than from automobile accidents, alcohol abuse, illegal drugs, AIDS, murder, and suicide combined. Congress's response to a public health problem of this magnitude is long overdue. Regulating the conduct of tobacco companies is as necessary today as it has been in years past. The facts presented in the Federal Government's landmark lawsuit against the tobacco industry demonstrate that the misconduct is substantial and ongoing. The decision of the court states: ``The evidence in this case clearly establishes that Defendants have not ceased engaging in unlawful activity . . . Defendants continue to engage in conduct that is materially indistinguishable from their previous actions, activity that continues to this day.'' We must deal firmly with tobacco company marketing practices that target children and mislead the public. The Food and Drug Administration needs broad authority to regulate the sale, distribution, and advertising of cigarettes and smokeless tobacco. The tobacco industry currently spends over $15 billion a year to promote its products. Much of that money is spent in ways designed to tempt children to start smoking, before they are mature enough to appreciate the enormity of the health risk. The industry knows that nearly 90 percent of smokers begin as children and are addicted by the time they reach adulthood. Documents obtained from tobacco companies prove, in the companies' own words, the magnitude of the industry's efforts to trap children into dependency on their deadly product. Studies by the Institute of Medicine and the Centers for Disease Control show the substantial role of industry advertising in decisions by young people to use tobacco products. If we are serious about reducing youth smoking, FDA must have the power to prevent industry advertising designed to appeal to children wherever it will be seen by children. This legislation will give FDA the authority to stop tobacco advertising that glamorizes smoking to kids. It grants FDA full authority to regulate tobacco advertising ``consistent with and to the full extent permitted by the First Amendment.'' FDA authority must also extend to the sale of tobacco products. Nearly every State makes it illegal to sell cigarettes to children under 18, but surveys show that those laws are rarely enforced and frequently violated. FDA must have the power to limit the sale of cigarettes to face-to-face transactions in which the age of the purchaser can be verified by identification. This means an end to self- service displays and vending machine sales. There must also be serious enforcement efforts with real penalties for those caught selling tobacco products to children. This is the only way to ensure that children under 18 are not able to buy cigarettes. The FDA conducted the longest rulemaking proceeding in its history, studying which regulations would most effectively reduce the number of children who smoke. Seven hundred thousand public comments were received in the course of that rulemaking. At the conclusion of its proceeding, the agency promulgated rules on the manner in which cigarettes are advertised and sold. Due to litigation, most of those regulations were never implemented. If we are serious about curbing youth smoking as much as possible, as soon as possible; it makes no sense to require FDA to reinvent the wheel by conducting a new multi- year rulemaking process on the same issues. This legislation will give the youth access and advertising restrictions already developed by FDA the immediate force of law, as if they had been issued under the new statute. The legislation also provides for stronger warnings on all cigarette and smokeless tobacco packages, and in all print advertisements. These warnings will be more explicit in their description of the medical problems which can result from tobacco use. The FDA is given the authority to change the text of these warning labels periodically, to keep their impact strong. The nicotine in cigarettes is highly addictive. Medical experts say that it is as addictive as heroin or cocaine. Yet for decades, tobacco companies vehemently denied the addictiveness of their products. No one can forget the parade of tobacco executives who testified under oath before Congress that smoking cigarettes is not addictive. Overwhelming evidence in industry documents obtained through the discovery process proves that the companies not only knew of this addictiveness for decades, but actually relied on it as the basis for their marketing strategy. As we now know, cigarette manufacturers chemically manipulated the nicotine in their products to make it even more addictive. A newly released analysis by the Harvard School of Public Health demonstrates that cigarette manufacturers are still manipulating nicotine levels. Between 1998 and 2005, they significantly increased the nicotine yield from major brand name cigarettes. The average increase in nicotine yield over the period was 11 percent. The tobacco industry has a long, dishonorable history of providing misleading information about the health consequences of smoking. These companies have repeatedly sought to characterize their products as far less hazardous than they are. They made minor innovations in product design seem far more significant for the health of the user than they actually were. It is essential that FDA have clear and unambiguous authority to prevent such misrepresentations in the future. The largest disinformation campaign in the history of the corporate world must end. Given the addictiveness of tobacco products, it is essential that the FDA regulate them for the protection of the public. Over 40 million Americans are currently addicted to cigarettes. No responsible public health official believes that cigarettes should be banned. A ban would leave 40 million people without a way to satisfy their drug dependency. FDA should be able to take the necessary steps to help addicted smokers overcome their addiction, and to make the product less toxic for smokers who are unable or unwilling to stop. To do so, FDA must have the authority to reduce or remove hazardous ingredients from cigarettes, to the extent that it becomes scientifically feasible. The inherent risk in smoking should not be unnecessarily compounded. Recent statements by several tobacco companies make clear that they plan to develop what they characterize as ``reduced risk'' cigarettes. Some are already on the market making unsubstantiated claims. This legislation will require manufacturers to submit such ``reduced risk'' products to the FDA for analysis before they can be marketed. No health-related claims will be permitted until they have been verified to the FDA's satisfaction. These safeguards are essential to prevent deceptive industry marketing campaigns, which could lull the public into a false sense of health safety. Smoking is the number one preventable cause of death in America. Congress must vest FDA not only with the responsibility for regulating tobacco products, but with full authority to do the job effectively. This legislation will give the FDA the legal authority it needs to reduce youth smoking by preventing tobacco advertising which targets children, to prevent the sale of tobacco products to minors, to help smokers overcome their addiction, to make tobacco products less toxic for those who continue to use them, and to prevent the tobacco industry from misleading the public about the dangers of smoking. Enacting this bill this year is the right thing to do for America's children. They are depending on us. By passing this legislation, we can help them live longer, healthier lives. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. KENNEDY

Mr. KENNEDY. Mr. President, it is a privilege to join Senator Bond in introducing ``The Arthritis Prevention, Control and Cure Act.'' Our goal in this important initiative is to provide a strong federal response to arthritis. Early diagnosis, treatment, and appropriate management of arthritis can control its symptoms, improve the quality of life of patients, and Federal action will improve the lives of the family members and caregivers of those affected by the disease. Arthritis exits in more than a hundred different forms. It's one of the most devastating diseases impairing the health of the American people. It's second only to heart disease as a cause of work disability. It undermines everyday activities such as walking, dressing and bathing for more than seven million Americans. One out of very five adults in the United States suffers from some form of arthritis. The number of patients in the U.S. with arthritis will keep growing as the number of older Americans continues to increase dramatically in the next few decades. Today, 8.7 million adults, ages 18 through 44, have arthritis and millions of others are at risk of developing the disease. In fact, arthritis is one of the most prevalent chronic illnesses and the leading cause of disability among Americans over age 15. More than 40 percent of adults with arthritis are limited in their activities because of their arthritis. By 2030, nearly 25 percent of the projected United States adult population will have arthritis and these numbers don't account for the current trends in obesity, which may contribute to future cases of the disease. It is an illness that affects all types of people in the U.S., not just older Americans. Arthritis knows no boundaries. Men, women and children are all afflicted with the disease. According to the Arthritis Foundation, 24 million women and 17 million men have been diagnosed with arthritis by their doctors. Women are still disproportionately affected by the disease. Nearly 3 out of every 1,000 American children are affected by arthritis. The devastating effects of pediatric arthritis justifies greater investment by the federal government in research and to identify more effective treatments. Special concerns are raised by juvenile arthritis because of its impact on family relationships, school life, dating, sports and other aspects active, growing youths. Teens and young adults entering the workforce face even greater challenges. Arthritis an other rheumatic diseases cost our economy $128 billion annually, according to the Centers for Disease Control and Prevention. In 2003, the cost was equivalent to 1.2 percent of the nation's gross domestic product. $80 million of that amount were direct costs for medical care and $47 million were indirect costs for lost earnings. National medical costs attributed to arthritis grew by 24 percent between 1997 and 2003, with an increase attributed to the growing number of people affected with the disease. In 1975, Congress enacted the National Arthritis Act to encourage basic and clinical research, establish Multipurpose Arthritis Centers and expand clinical knowledge of the illness. The act was successful in implementing and continued funding of research and has led to important advances in the control, treatment and prevention of the illness. Early diagnosis, treatment and management can control symptoms and improve the quality of life. Weight control and exercise can help lower risks. Patient education, training and self-management also contribute to greater control of these diseases. Innovative and increasingly effective drug therapies, joint replacements, and other therapeutic alternatives are being developed. Despite much research identifying effective interventions, many of them are not being used well enough and the inevitable result is unnecessary loss of life, poorer health and poorer quality of life. Our legislation will expand the effort to find new ways to prevent, treat and care for patients with arthritis and related rheumatic diseases. It will enhance the National Arthritis Action Plan by providing additional support to federal, state and private efforts to prevent and manage arthritis. It will establish a National Arthritis Education and Outreach Campaign to inform the health care profession and the public about the most successful self-management strategies for controlling the illness. With greater coordination and intensification of federal research, this bill will organize a National Arthritis and Rheumatic Diseases Summit to look at the challenges and opportunities related to these efforts. In addition, the bill will provide greater attention to juvenile arthritis research by offering planning grants for research specific to juveniles and by prioritizing the activities that create better understanding of the incidence and outcomes associated with juvenile arthritis. Finally the bill contains incentives to encourage health professionals to enter the field of pediatric rheumatology by education loan repayment and career development awards. I urge my colleagues to support this public health initiative to reduce the pain and disability of arthritis. Early diagnosis, effective treatment and greater investment in research and prevention can help us wage a stronger battle against one of the most widespread and devastating conditions affecting our Nation.

Mr. KENNEDY

Mr. KENNEDY. Madam President, I commend Senator Leahy, chairman of the Foreign Operations Subcommittee of the Appropriations Committee, for including an additional $20 million for Iraqi refugees in the continuing resolution. More than 3 million Iraqis have been displaced from their homes, and many of them have fled the country. America has a special obligation to help them and the neighboring countries in meeting their needs. The UNHCR has made an international appeal for $60 million to deal with this emerging crisis, and the United States plans to provide $20 million to that appeal. Our invasion of Iraq led to this crisis, and we have a clear responsibility to do more to ease it. We should provide at least half the funding for this $60 million appeal to help this growing refugee population. I believe $10 million of the funds in this bill should be for the UNHCR appeal, in an effort to raise the total U.S. contribution to $30 million. Is that the chairman's intent?

Mr. KENNEDY

Mr. KENNEDY. Mr. President, more than 40 years ago, Congress recognized the importance of a college education in opening the door to the American dream. We agreed then that no qualified student should be denied the opportunity to go to college because of the cost. Guided by that principle, we enacted the Higher Education Act of 1965. Times have changed since then. College education has become even more critical to success in the global economy. Yet, Congress has shamefully lost sight of this fundamental principle, especially in recent years. Today, 400,000 qualified students a year don't attend a four-year college because they can't afford it. The cost of college has more than tripled over the last twenty years, and vast numbers of families can't keep up. Twenty years ago, the maximum Pell Grant--the lifeline to college for low-income and first-generation students--covered more than half the cost of attendance at a typical four-year public college. Today, it only covers 32 percent. Yet each year, the federal government wastes billions of taxpayer dollars on subsidies to private lenders to do a job that could be done much more efficiently without these middlemen. At a time when students and families are pinching pennies more than ever to pay for college, we can't let this situation continue. We should use scarce tax dollars to help students, not banks. The system we created 40 years ago involved federally-guaranteed student loans made by private lenders, and it's now known as the Federal Family Education Loan Program, or FFEL. At that time, Congress wasn't sure lenders would be willing to loan money to students with no credit history, so we created a system with guarantees against default. Four decades later, student default rates are near an all-time low and private lenders hold over $100 billion in federal student loan volume. Federal guarantees and subsidies have made student loans the second most profitable business for banks, after credit cards. The stock price of the biggest lender, Sallie Mae, has skyrocketed from $3 to more than $40 in the last decade. In 1994, Congress finally recognized that we could give students a better deal and save billions of dollars by cutting out the middleman. We created the Direct Loan program, in which loans are issued directly to students, from the United States Treasury. The loans are serviced and collected under contracts with private companies, but there is no middleman making the loans. The Direct Loan program is much less expensive for taxpayers, because it provides loan capital at a lower rate than banks, and avoids billions of dollars in unnecessary subsidies to lenders. If we had gone to a system of 100 percent Direct Loans in 1994, the government would have saved over $30 billion since the program was created. Unfortunately, because of the lobbying of the private lenders, the FFEL program continues, and the Direct Loan program has never been allowed to compete on a level playing field. As a result, we continue to waste taxpayer money by paying an unnecessary middleman, we shield lenders from risk, and we continue to guarantee them a very profitable return. It's time to encourage serious competition in the college loan marketplace, and let students reap the benefits. Today, Senator Gordon Smith (R-OR), Congressmen George Miller (D-CA) and Tom Petri (R-WI) and I are proposing a bipartisan plan to do that. Our bill will increase student financial aid by squeezing billions of dollars in corporate welfare out of the student loan program. Our bill, The Student Aid Reward Act, will provide colleges and universities with grant aid to increase scholarships for their students. It is completely paid for by increased efficiency in delivering student loans. The bill encourages colleges to use the direct loans, which are cheaper for both the government and taxpayers, and allows them to keep half the savings to increase need-based aid. The Congressional Budget Office estimates that our plan will generate $13 billion in savings over the next 10 years from schools switching to the more efficient program. The bill would provide at least $10 billion for additional college scholarship aid at no additional cost to taxpayers. According to President Bush's 2008 education budget, student loans made through the more expensive FFEL program in 2007 cost $3 more for every $100 in loans than the same loans made directly from the Treasury. Yet, colleges and students have no incentive under current law to use the more efficient program. Our Student Aid Reward Act encourages colleges to choose the less expensive of the government's student loan programs. It requires the Secretary of Education to determine every year which loan program is more efficient. Schools are rewarded with additional scholarship funds for using the more efficient of the two programs. Competition will encourage both programs to improve the efficiency of their operations. Schools, students, and taxpayers will all benefit. Estimates based on the most recent Bush Administration budget indicate that under our plan, each college will receive an incentive payment equal to one and a half percent of the total amount borrowed by students at the college. In Massachusetts: students at Boston College will receive almost $1.4 million in additional financial aid. Students at UMASS Amherst will receive $1.3 million more. Students at Springfield College will receive over $700,000 more. Students at Emerson College would receive nearly half a million dollars more. For students nationwide, college will be more affordable for millions of young men and women at no additional taxpayer cost. Title IV of the Higher Education Act today is called ``Student Assistance''--not ``Lender Assistance.'' The federal student aid system was created to help students and families afford college. But in recent years, it has been corrupted into a system that lines the pockets of the banks. It's time to throw the private money lenders out of the temple of higher education. Scarce Federal education dollars should go to deserving students, not greedy private lenders. Mr. President, I ask unanimous consent that the text of the Student Aid Reward Act of 2007 be printed in the Record.

Mr. KENNEDY. Mr. President, it's a privilege to join my Senate and House colleagues in introducing the ``Protecting Children's Health in Schools Act of 2006.'' This bill will ensure that the Nation's 7 million school children with disabilities will have continued access to health care in school. In 1975, the Nation made a commitment to guarantee children with disabilities equal access to education. For these children to learn and thrive in schools, the integration of education with health care is of paramount importance. Coordination with Medicaid makes an immense difference to schools in meeting the needs of these children. This year, however, the Bush Administration has declared its intent to end Medicaid reimbursements to schools for the support services they need in order to provide medical and health-related services to disabled children. The Administration is saying ``NO'' to any further financial help to Medicaid-covered disabled children who need specialized transportation to obtain their health services at school. It is saying ``NO'' to any legitimate reimbursement to the school for costs incurred for administrative duties related to Medicaid services. It's bad enough that Congress and the Administration have not kept the commitment to ``glide-path'' funding of IDEA needs in 2004. Now the Administration proposes to deny funding to schools under the Federal program that supports the health needs of disabled children. It makes no sense to make it so difficult for disabled children to achieve in school--both under IDEA and the No Child Left Behind. At stake is an estimated $3.6 billion in Medicaid funds over the next five years. Such funding is essential to help identify disabled children and connect them to services that can meet their special health and learning needs during the school day. This decision by the Administration follows years of resisting Medicaid reimbursements to schools that provide these services, without clear guidance on how schools should appropriately seek reimbursement. The ``Protecting Children's Health in Schools Act'' recognizes the importance of schools as a site of delivery of health care. It ensures that children with disabilities can continue to obtain health services during the school day. The bill also provides for clear and consistent guidelines to be established, so that schools can be held accountable and seek appropriate reimbursement. The legislation has the support of over 60 groups, including parents, teachers, principals, school boards, and health care providers--people who work with children with disabilities every day and know what is needed to facilitate their growth, development, and long-term success. I urge all of our colleagues to join us in supporting these children across the Nation, by providing the realistic support their schools need in order to meet these basic health care requirements of their students.

Mr. KENNEDY

Mr. KENNEDY. Mr. President, more than 40 years ago, Congress recognized the importance of a college education in opening the door to the American dream. We agreed then that no qualified student should be denied the opportunity to go to college because of the cost. Guided by that principle, we enacted the Higher Education Act of 1965. Times have changed since then. College education has become even more critical to success in the global economy. Yet, Congress has shamefully lost sight of this fundamental principle, especially in recent years. Today, 400,000 qualified students a year don't attend a four-year college because they can't afford it. The cost of college has more than tripled over the last twenty years, and vast numbers of families can't keep up. Twenty years ago, the maximum Pell Grant--the lifeline to college for low-income and first-generation students--covered more than half the cost of attendance at a typical four-year public college. Today, it only covers 32 percent. Yet each year, the federal government wastes billions of taxpayer dollars on subsidies to private lenders to do a job that could be done much more efficiently without these middlemen. At a time when students and families are pinching pennies more than ever to pay for college, we can't let this situation continue. We should use scarce tax dollars to help students, not banks. The system we created 40 years ago involved federally-guaranteed student loans made by private lenders, and it's now known as the Federal Family Education Loan Program, or FFEL. At that time, Congress wasn't sure lenders would be willing to loan money to students with no credit history, so we created a system with guarantees against default. Four decades later, student default rates are near an all-time low and private lenders hold over $100 billion in federal student loan volume. Federal guarantees and subsidies have made student loans the second most profitable business for banks, after credit cards. The stock price of the biggest lender, Sallie Mae, has skyrocketed from $3 to more than $40 in the last decade. In 1994, Congress finally recognized that we could give students a better deal and save billions of dollars by cutting out the middleman. We created the Direct Loan program, in which loans are issued directly to students, from the United States Treasury. The loans are serviced and collected under contracts with private companies, but there is no middleman making the loans. The Direct Loan program is much less expensive for taxpayers, because it provides loan capital at a lower rate than banks, and avoids billions of dollars in unnecessary subsidies to lenders. If we had gone to a system of 100 percent Direct Loans in 1994, the government would have saved over $30 billion since the program was created. Unfortunately, because of the lobbying of the private lenders, the FFEL program continues, and the Direct Loan program has never been allowed to compete on a level playing field. As a result, we continue to waste taxpayer money by paying an unnecessary middleman, we shield lenders from risk, and we continue to guarantee them a very profitable return. It's time to encourage serious competition in the college loan marketplace, and let students reap the benefits. Today, Senator Gordon Smith (R-OR), Congressmen George Miller (D-CA) and Tom Petri (R-WI) and I are proposing a bipartisan plan to do that. Our bill will increase student financial aid by squeezing billions of dollars in corporate welfare out of the student loan program. Our bill, The Student Aid Reward Act, will provide colleges and universities with grant aid to increase scholarships for their students. It is completely paid for by increased efficiency in delivering student loans. The bill encourages colleges to use the direct loans, which are cheaper for both the government and taxpayers, and allows them to keep half the savings to increase need-based aid. The Congressional Budget Office estimates that our plan will generate $13 billion in savings over the next 10 years from schools switching to the more efficient program. The bill would provide at least $10 billion for additional college scholarship aid at no additional cost to taxpayers. According to President Bush's 2008 education budget, student loans made through the more expensive FFEL program in 2007 cost $3 more for every $100 in loans than the same loans made directly from the Treasury. Yet, colleges and students have no incentive under current law to use the more efficient program. Our Student Aid Reward Act encourages colleges to choose the less expensive of the government's student loan programs. It requires the Secretary of Education to determine every year which loan program is more efficient. Schools are rewarded with additional scholarship funds for using the more efficient of the two programs. Competition will encourage both programs to improve the efficiency of their operations. Schools, students, and taxpayers will all benefit. Estimates based on the most recent Bush Administration budget indicate that under our plan, each college will receive an incentive payment equal to one and a half percent of the total amount borrowed by students at the college. In Massachusetts: students at Boston College will receive almost $1.4 million in additional financial aid. Students at UMASS Amherst will receive $1.3 million more. Students at Springfield College will receive over $700,000 more. Students at Emerson College would receive nearly half a million dollars more. For students nationwide, college will be more affordable for millions of young men and women at no additional taxpayer cost. Title IV of the Higher Education Act today is called ``Student Assistance''--not ``Lender Assistance.'' The federal student aid system was created to help students and families afford college. But in recent years, it has been corrupted into a system that lines the pockets of the banks. It's time to throw the private money lenders out of the temple of higher education. Scarce Federal education dollars should go to deserving students, not greedy private lenders. Mr. President, I ask unanimous consent that the text of the Student Aid Reward Act of 2007 be printed in the Record.

Mr. KENNEDY

Mr. KENNEDY. Mr. President, it's a privilege to join my Senate and House colleagues in introducing the ``Protecting Children's Health in Schools Act of 2006.'' This bill will ensure that the Nation's 7 million school children with disabilities will have continued access to health care in school. In 1975, the Nation made a commitment to guarantee children with disabilities equal access to education. For these children to learn and thrive in schools, the integration of education with health care is of paramount importance. Coordination with Medicaid makes an immense difference to schools in meeting the needs of these children. This year, however, the Bush Administration has declared its intent to end Medicaid reimbursements to schools for the support services they need in order to provide medical and health-related services to disabled children. The Administration is saying ``NO'' to any further financial help to Medicaid-covered disabled children who need specialized transportation to obtain their health services at school. It is saying ``NO'' to any legitimate reimbursement to the school for costs incurred for administrative duties related to Medicaid services. It's bad enough that Congress and the Administration have not kept the commitment to ``glide-path'' funding of IDEA needs in 2004. Now the Administration proposes to deny funding to schools under the Federal program that supports the health needs of disabled children. It makes no sense to make it so difficult for disabled children to achieve in school--both under IDEA and the No Child Left Behind. At stake is an estimated $3.6 billion in Medicaid funds over the next five years. Such funding is essential to help identify disabled children and connect them to services that can meet their special health and learning needs during the school day. This decision by the Administration follows years of resisting Medicaid reimbursements to schools that provide these services, without clear guidance on how schools should appropriately seek reimbursement. The ``Protecting Children's Health in Schools Act'' recognizes the importance of schools as a site of delivery of health care. It ensures that children with disabilities can continue to obtain health services during the school day. The bill also provides for clear and consistent guidelines to be established, so that schools can be held accountable and seek appropriate reimbursement. The legislation has the support of over 60 groups, including parents, teachers, principals, school boards, and health care providers--people who work with children with disabilities every day and know what is needed to facilitate their growth, development, and long-term success. I urge all of our colleagues to join us in supporting these children across the Nation, by providing the realistic support their schools need in order to meet these basic health care requirements of their students.

Mr. KENNEDY

Mr. KENNEDY. Mr. President, it is a privilege to join Senator Snowe in introducing ``The Preservation of Antibiotics for Medical Treatment Act of 2007.'' I am also pleased that this year we are joined by Senator Sherrod Brown, who championed this legislation so ably as a member of the House of Representatives. Our goal in this important initiative is to take needed action to preserve the effectiveness of antibiotics in treating diseases. These drugs are truly modern medical miracles. During World War II, the newly developed ``wonder drug'' penicillin revolutionized care for our soldiers wounded in battle. Since then, such drugs have become indispensable in modern medicine, protecting all of us from deadly infections. They are even more valuable today, safeguarding the Nation from the threat of bioterrorism. Unfortunately, in recent years, we have done too little to prevent the emergence of antibiotic-resistant strains of bacteria and other germs, and many of our most powerful drugs are no longer effective. Partly, the resistance is the result of over-prescribing such drugs in routine medical care. Mounting evidence shows that indiscriminate use of such drugs in animal feed is also a major factor in the development of antibiotic resistant germs. Obviously, if animals are sick, whether as pets or livestock, they should be treated with the best veterinary medications available. That is not the problem. The problem is the widespread use of antibiotics to promote growth and fatten healthy livestock. Such nontherapeutic use clearly undermines the effectiveness of these important drugs, because it leads to greater development of antibiotic-resistant bacteria that can make infections in humans difficult or impossible to treat. In 1998--nine years ago--a report prepared at the request of the Department of Agriculture and the Food and Drug Administration by the National Academy of Sciences, concluded: ``There is a link between the use of antibiotics in food animals, the development of bacterial resistance to these drugs, and human disease.'' The World Health Organization has specifically recommended that antibiotics used to treat humans should not be used to promote animal growth, although they could still be used to treat sick animals. In 2001, a Federal interagency task force on antibiotic resistance concluded that ``drug-resistant pathogens are a growing menace to all people, regardless of age, gender, or socio-economic background. If we do not act to address the problem . . . [d]rug choices for the treatment of common infections will become increasingly limited and expensive--and, in some cases, nonexistent.'' The Union of Concerned Scientists estimates that 70 percent of all U.S. antibiotics are used nontherapeutically in animal agriculture--8 times more than are used in all of human medicine. This indiscriminate use clearly reduces their potency. Major medical associations have been increasingly concerned, and have taken strong stands against antibiotic use in animal agriculture. In June 2001, the American Medical Association adopted a resolution opposing nontherapeutic use of antibiotics in animals. Other professional medical organizations that have taken similar stands include the American College of Preventive Medicine, the American Public Health Association, and the Council of State and Territorial Epidemiologists. The legislation we are offering has been strongly endorsed by the American Public Health Association and numerous other groups and independent experts in the field. Ending the current detrimental practice is feasible and cost- effective. Last month an economic study by researchers at Johns Hopkins University examined data from the poultry producer Perdue. In this study of 7 million chickens, the slight benefit from the nontherapeutic use of antibiotics was more than offset by the cost of purchasing antibiotics. In fact, most of the developed countries in the world, except for the United States and Canada, already restrict the use of antibiotics to promote growth in raising livestock. In 1999, the European Union banned such use, and funds saved on drugs have been invested in improving hygiene and animal husbandry practices. Researchers in Denmark found a dramatic decline in the number of drug-resistant organisms in animals-- and no significant increase in animal diseases or consumer prices. These results have encouraged clinicians and researchers to call for a similar ban in the United States. The title of an editorial in the New England Journal of Medicine 6 years ago said it all: ``Antimicrobial Use in Animal Feed--Time to Stop.'' In the last Congress, over 350 organizations representing scientific and medical associations, consumer and environmental groups as well as animal rights and religious groups endorsed this legislation and called for an end to the reckless and irresponsible use of these critically important medicines. The Nation is clearly at risk of an epidemic outbreak of food poisoning caused by drug-resistant bacteria or other germs. In recent years, many nations, including the United States, have been plagued by outbreaks of food-borne illnesses. Imagine the consequences of an outbreak caused by a strain of bacteria immune to any drugs we have. It is time to put public safety first and stop this promiscuous use of drugs essential for protecting human health. The bill we are introducing will phase out the non-therapeutic use in livestock of medically important antibiotics, unless manufacturers can demonstrate that such use is no danger to public health. The Act applies this same strict standard to applications for approval of new animal antibiotics. Such use is not restricted if the animals are sick, or if they are pets or are animals not used for food. In addition, FDA is also given authority to restrict the use of important drugs to treat such animals, if risk to humans is in question. According to the National Academy of Sciences, eliminating the use of antibiotics as feed additives in agriculture will cost each American consumer not more than five to ten dollars a year. The legislation recognizes, however, that economic costs to farmers in making the transition to antibiotic-free practices may be substantial. In such cases, the Act provides for Federal payments to defray the cost of shifting to antibiotic-free practices, with special preference for family farms. Antibiotics are one of the great miracles of modem medicine. Yet today, we are destroying them faster than the pharmaceutical industry can replace them with new discoveries. If doctors lose these vital medications, the most vulnerable Americans will suffer the most-- children, the elderly, persons with HIV/AIDS, and others who are most in danger of drug resistant infections. I urge my colleagues to support this clearly needed legislation to protect the health of all Americans from the reckless and unjustified use of antibiotics.

Mr. KENNEDY. Mr. President, it is a privilege to join Senators Enzi, Dodd, and Alexander in introducing the Head Start for School Readiness Act. Our goal is to reauthorize Head Start and continue our bipartisan support for this very successful program to prepare low-income children for school. For over forty years, Head Start has given disadvantaged children the assistance they need to arrive at school ready to learn. It's comprehensive services guarantee balanced meals for children, and a well-defined curriculum to see that children develop early skills in reading, writing, and math, and positive social skills as well. It provides visits to doctors and dentists, and outreach to parents to encourage them to participate actively in their child's early development. It is clear that Head Start works. A federal evaluation found that Head Start children make gains during the program itself, and the gains continue when the children enter kindergarten. Once Head Start children complete their kindergarten year, they are near the national average of 100 in key areas, with scores of 93 in vocabulary, 96 in early writing, and 92 in early math. We've made tremendous, bipartisan progress this year in our effort to reauthorize Head Start and build upon a program that serves as a lifeline for the neediest families and children across the Nation. In this legislation, we build on Head Start's proven track record and expand it to include thousands of low-income children who are not yet served by the program. We provide for better coordination of Head Start with state programs for low-income children. We strengthen Head Start's focus on school readiness and early literacy. We enhance the educational goals for Head Start teachers. And we provide greater accountability for the program, including new policies to ensure improved monitoring visits and new policies to address programs with serious deficiencies. To strengthen Head Start, we have to begin by providing more resources for it. The need for Head Start is greater than ever. Child poverty is on the rise again. Today, less than 50 percent of children eligible for Head Start participate in the program. Hundreds of thousands of three- and four-year-olds are left out because of the inadequate funding level of the program. Early Head Start serves only 3 percent of eligible infants and toddlers. It is shameful that 97 percent of the children eligible for Early Head Start have no access to it. It's long past time for Congress to expand access to Head Start to serve as many infants, toddlers, and preschool children as possible. The bill that we introduce today will set a goal to expand Head Start over the next several years. We call for increases in funding, from $6.9 billion in the current fiscal year, to $7.3 billion in FY 2008, $7.5 billion in FY 2009, and $7.9 billion in 2010. These funding levels are critical to advance the essential reforms in this legislation, and to serve thousands of additional children in the Head Start program. Early Head Start is an especially important program for needy infants and toddlers. Research clearly shows its benefit to infants and toddlers and their families. Early Head Start children have larger vocabularies, lower levels of aggressive behavior, and higher levels of sustained attention than children not enrolled in the program. Parents are more likely to play with their children and read to them. This bill will double the size of Early Head Start over the course of this authorization, and deliver services to over 56,000 additional children over the course of this authorization. Our bill establishes a Head Start Collaboration Office in every state to maximize services to Head Start children, align Head Start with kindergarten classrooms, and strengthen its local partnerships with other agencies. These offices will work hand in hand with the Head Start network of training and technical assistance to support Head Start grantees in better meeting the goals of preparing children for school. States will also have an active role in coordinating their system of early childhood programs, and increasing the quality of those programs. Our bill designates an Early Care and Education Council in each State to conduct an inventory of children's needs, develop plans for data collection and for supporting early childhood educators, review and upgrade early learning standards, and make recommendations on technical assistance and training. For those States ready to move forward and implement their statewide plan, our bill will offer a one-time incentive grant to implement these important efforts. Over the past four decades, Head Start has built up quality and performance standards to guarantee a full range of services, so that children are educated in the basics about letters and numbers and books, and are also healthy, well-fed, and supported in stable and nurturing relationships. Head Start is a model program, and we can enhance its quality even more. One way to do that is to strengthen Head Start's current literacy initiative. We know the key to later reading success is to get young children excited about letters and books and numbers. Our bill emphasizes language and literacy, by enhancing the literacy training required of Head Start teachers, by continuing to promote parent literacy, and by working to put more books into Head Start classrooms and into children's homes. We also make a commitment in this bill to upgrade all of the educational components of Head Start, and ensure that services are aligned with expectations for children's kindergarten year and continue to be driven by the effective Head Start Child Outcomes Framework. At the heart of Head Start's success are its teachers and staff. They are caring, committed persons who know the children they serve and are dedicated to improving their lives. They help children learn to identify letters of the alphabet and arrange the pieces of puzzles. They teach them to brush their teeth, wash their hands, make friends and follow rules. Yet their salary is still half the salary of kindergarten teachers, and turnover is high--11 percent a year. Because a teacher's quality is directly related to a child's outcome, our bill establishes a goal to ensue that every Head Start teacher have their A.A. degree and 50 percent earn their B.A. degree over the course of this authorization. Head Start teachers and staff are the greatest resource to children and families in the program, and we must match these ambitious reforms and improvements with the funding needed to see that Head Start programs can meet these goals. We have also granted additional flexibility in this bill for Head Start programs to serve families and children that need services at the local level. We've lifted the eligibility requirements so that families living below 130 percent of the federal poverty rate can qualify and participate in Head Start. Often, these are the neighbors of Head Start children with similar needs, but currently remain barred from participating in the program. Under this bill, Head Start programs will be empowered with greater authority to determine the needs of families in their local communities and define services to meet those needs. If programs determine that there is a greater share infants and toddlers in need of services, our bill allows them to apply to the Secretary to convert and expand Head Start to serve those youngest children, consistent with Early Head Start standards. If programs identify a need to provide full-day or full-year care for children and families, they can take steps to do so. Accountability is a cornerstone of excellence in education and should start early. Head Start should be accountable for its promise to provide safe and healthy learning environments, to support each child's individual pattern of development and learning, to cement community partnerships in services for children, and to involve parents in their child's growth. Head Start reviews are already among the most extensive in the field. Every 3 years, a federal and local team spends a week thoroughly examining every aspect of every Head Start program. They check everything from batteries in flashlights to how parents feel about the program. Our bill takes a further step to improve the monitoring of Head Start programs, ensures that programs receive useful and timely feedback and information, and strengthens annual reviews and plans for improvement. Our bill also takes an important step to suspend the Head Start National Reporting System. Four years ago, I insisted that instead of rushing forward with a national assessment for every four- and five- year-old in Head Start, this Administration should instead move more deliberately to develop and implement an assessment tool that would help guide and improve Head Start programs. Unfortunately, they rejected that call and proceeded with an assessment--absent sufficient authorization or oversight from Congress--that was later proven by a GAO study to be flawed and inconsistent with professional standards for testing and measurement. Any assessment used in Head Start must be held to the highest standard. It must be valid and reliable, fair to children from all backgrounds, balanced in what it measures, and address the development of the whole child. Our bill calls on the National Academy of Sciences to continue their work in surveying assessments and outcomes appropriate for early childhood programs, and to make recommendations to the Secretary and to Congress on the use of assessments and outcomes in Head Start programs. I hope the National Academy's work will be helpful as we consider future improvements in the Head Start program. Finally, this bill appropriately rejects earlier calls to block grant Head Start services, preserving the community-based structure of the program. It makes no sense to turn Head Start into a block grant to the states. To do so would have dismantled the program and undermined Head Start's guarantees that children can see doctors and dentists, eat nutritious meals, and learn early academic and social skills. The current Federal-to-local structure of Head Start enables it to tailor its services to meet local community needs. Performance standards guarantee a high level of quality across all programs. Yet each program is unique and specifically adapted to the local community. Head Start is successful in serving Inuit children in Alaska, migrant-workers' children in Tennessee, and inner-city children in Boston. It is essential to maintain the ability of local Head Start programs to tailor their services to meet the needs of local neighborhoods and their children. The Head Start for School Readiness Act we are introducing today will keep Head Start on its successful path, and enable this vital program to continue to thrive and improve. I urge our colleagues on both sides of the aisle to join us in advancing and strengthening this program, and give children the head start they need and deserve to prepare for school and for life.

Mr. KENNEDY. Access to mental health services is one of the most important and most neglected civil rights issues facing the Nation. For too long, persons living with mental disorders have suffered discriminatory treatment at all levels of society. They have been forced to pay more for the services they need and to worry about their job security if their employer finds out about their condition. Sadly, in America today, patients with biochemical problems in their liver are treated with better care and greater compassion than patients with biochemical problems in their brain. That kind of discrimination must end. No one questions the need for affordable treatment of physical illnesses. But those who suffer from mental illnesses face serious barriers in obtaining the care they need at a cost they can afford. Like those suffering from physical illnesses, persons with mental disorders deserve the opportunity for quality care. The failure to obtain treatment can mean years of shattered dreams and unfulfilled potential. Eleven years ago, Congress passed the first Mental Health Parity Act. That legislation was an important first step in bringing attention to discriminatory practices against the mentally ill, but it did little to correct the injustices that so many Americans continue to face. The 1996 legislation required that annual and lifetime dollar limits for mental health coverage must be no less than the limits for medical and surgical coverage. But more steps are clearly needed to guarantee that Americans suffering from mental illness are not forced to pay more for the services they need, do not face harsher limitations on treatment, and are not denied access to care. This bill is a chance to take the actions needed to end the longstanding discrimination against persons with mental illness. The late Senator Paul Wellstone and Senator Pete Domenici deserve great credit for their bipartisan leadership on mental health parity. If it were not for them, we would not be here today. The bill prohibits group health plans from imposing treatment limitations or financial requirements on the coverage of mental health conditions that do not also apply to physical conditions. That means no limits on days or treatment visits, and no exorbitant co-payments or deductibles. The bill was negotiated by and has the support of the mental health community, the business community, and the insurance industry. The need is clear. One in five Americans will suffer some form of mental illness this year--but only a third of them will receive treatment. Millions of our fellow citizens are unnecessarily enduring the pain and sadness of seeing a family member, friend, or loved one suffer illnesses that seize the mind and break the spirit. Battling mental illness is itself a painful process, but discrimination against persons with such illnesses is especially cruel, since the success rates for treatment often equal or surpass those for physical conditions. According to the National Institute of Mental Health, clinical depression treatment can be 70 percent successful, and treatment for schizophrenia can be 60 percent successful. Over the years we've heard compelling testimony from experts, activists, and patients about the need to equalize coverage of physical and mental illnesses. The Office of Personnel Management talks us that providing full parity to 8.5 million federal employees has led to minimal premium increases. We heard dramatic testimony about the economic and social advantages of parity, including a healthier, more productive workforce. Some of the most compelling testimony came several years ago from Lisa Cohen, a hardworking American from New Jersey, who suffers from both physical and mental illnesses, and is forced to pay exorbitant costs for treating her mental disorder, while paying little for her physical disorder. She is typical of millions of Americans who not only face the cruel burden of mental illness, but also the cruel burden of discriminatory treatment. No Americans should be denied equal treatment of an illness because it starts in the brain instead of the heart, lungs, or other parts of their body. No patients should be denied access to the treatment that can cure their illness because of where they live or work. A number of States have already enacted mental health parity laws, but 86 million workers under ERISA have no protection under state mental health statutes. Mental health parity is a good investment for the Nation. The costs from lost worker productivity and extra physical care outweigh the costs of implementing parity for mental health treatment. Over the years study after study has shown that parity makes good financial sense. An analysis of more than 46,000 workers at major companies showed that employees who report being depressed or under stress are likely to have substantially higher health costs than co- workers without such conditions. Employees who reported being depressed had health bills 70 percent higher than those who did not suffer from depression. Those reporting high stress had 46 percent higher health costs. McDonnell Douglas found a 4 to 1 return on investment after accounting for lower medical claims, reduced absenteeism, and smaller turnover. Mental illness also imposes a huge financial burden on the Nation. It costs us $300 billion each year in treatment expenses, lost worker productivity, and crime. This country can afford mental health parity. What we can't afford is to continue denying persons with mental disorders the care they need. Today is a turning point. We are finally moving toward ending this shameful form of discrimination in our society--discrimination against mental illness. This bill has been seven years in the making, and brings first class medicine to millions of Americans who have been second class patients for too long. Today, we begin to right that wrong, by guaranteeing equal treatment to the 11 million people receiving mental health services, and promising equal treatment to the remaining 100 million insured workers and their families who never know the day they may need their mental health benefit. The 1996 Act, was an important step towards ending health insurance discrimination against mental illness. This bill will take another large step forward by closing the loopholes that remain. It guarantees co-payments, deductibles, coinsurance, out of pocket expenses and annual and lifetime limits that apply to mental health benefits are no different than those applied to medical and surgical benefits. It guarantees that the frequency of treatment, number of visits, days of coverage and other limits on scope and duration of treatment for mental health services are no different than those applied to medical and surgical benefits. This equal treatment and financial equity is also applied to substance abuse. Features of State law that require coverage of mental disorders are protected, to assure those currently protected by state parity laws that their needs will be met. The medical management strategies needed to prevent denial of medically needed services for patients remain intact. Finally, the bill is modeled on the parity that is already guaranteed to the 8.5 million persons, including Members of Congress, under the Federal Employee Benefits Program, Equal treatment of those affected by mental illness is not just an insurance issue. It's a civil rights issue. At its heart, mental health parity is a question of simple justice. It is long past time to end insurance discrimination and guarantee all people with mental illness the coverage they deserve. I urge my colleagues to support this important principle, and end the unacceptable double standards that have unfairly plagued our health care systems for so long.

Mr. KENNEDY

Mr. KENNEDY. Mr. President, it is a privilege to join Senator Snowe in introducing ``The Preservation of Antibiotics for Medical Treatment Act of 2007.'' I am also pleased that this year we are joined by Senator Sherrod Brown, who championed this legislation so ably as a member of the House of Representatives. Our goal in this important initiative is to take needed action to preserve the effectiveness of antibiotics in treating diseases. These drugs are truly modern medical miracles. During World War II, the newly developed ``wonder drug'' penicillin revolutionized care for our soldiers wounded in battle. Since then, such drugs have become indispensable in modern medicine, protecting all of us from deadly infections. They are even more valuable today, safeguarding the Nation from the threat of bioterrorism. Unfortunately, in recent years, we have done too little to prevent the emergence of antibiotic-resistant strains of bacteria and other germs, and many of our most powerful drugs are no longer effective. Partly, the resistance is the result of over-prescribing such drugs in routine medical care. Mounting evidence shows that indiscriminate use of such drugs in animal feed is also a major factor in the development of antibiotic resistant germs. Obviously, if animals are sick, whether as pets or livestock, they should be treated with the best veterinary medications available. That is not the problem. The problem is the widespread use of antibiotics to promote growth and fatten healthy livestock. Such nontherapeutic use clearly undermines the effectiveness of these important drugs, because it leads to greater development of antibiotic-resistant bacteria that can make infections in humans difficult or impossible to treat. In 1998--nine years ago--a report prepared at the request of the Department of Agriculture and the Food and Drug Administration by the National Academy of Sciences, concluded: ``There is a link between the use of antibiotics in food animals, the development of bacterial resistance to these drugs, and human disease.'' The World Health Organization has specifically recommended that antibiotics used to treat humans should not be used to promote animal growth, although they could still be used to treat sick animals. In 2001, a Federal interagency task force on antibiotic resistance concluded that ``drug-resistant pathogens are a growing menace to all people, regardless of age, gender, or socio-economic background. If we do not act to address the problem . . . [d]rug choices for the treatment of common infections will become increasingly limited and expensive--and, in some cases, nonexistent.'' The Union of Concerned Scientists estimates that 70 percent of all U.S. antibiotics are used nontherapeutically in animal agriculture--8 times more than are used in all of human medicine. This indiscriminate use clearly reduces their potency. Major medical associations have been increasingly concerned, and have taken strong stands against antibiotic use in animal agriculture. In June 2001, the American Medical Association adopted a resolution opposing nontherapeutic use of antibiotics in animals. Other professional medical organizations that have taken similar stands include the American College of Preventive Medicine, the American Public Health Association, and the Council of State and Territorial Epidemiologists. The legislation we are offering has been strongly endorsed by the American Public Health Association and numerous other groups and independent experts in the field. Ending the current detrimental practice is feasible and cost- effective. Last month an economic study by researchers at Johns Hopkins University examined data from the poultry producer Perdue. In this study of 7 million chickens, the slight benefit from the nontherapeutic use of antibiotics was more than offset by the cost of purchasing antibiotics. In fact, most of the developed countries in the world, except for the United States and Canada, already restrict the use of antibiotics to promote growth in raising livestock. In 1999, the European Union banned such use, and funds saved on drugs have been invested in improving hygiene and animal husbandry practices. Researchers in Denmark found a dramatic decline in the number of drug-resistant organisms in animals-- and no significant increase in animal diseases or consumer prices. These results have encouraged clinicians and researchers to call for a similar ban in the United States. The title of an editorial in the New England Journal of Medicine 6 years ago said it all: ``Antimicrobial Use in Animal Feed--Time to Stop.'' In the last Congress, over 350 organizations representing scientific and medical associations, consumer and environmental groups as well as animal rights and religious groups endorsed this legislation and called for an end to the reckless and irresponsible use of these critically important medicines. The Nation is clearly at risk of an epidemic outbreak of food poisoning caused by drug-resistant bacteria or other germs. In recent years, many nations, including the United States, have been plagued by outbreaks of food-borne illnesses. Imagine the consequences of an outbreak caused by a strain of bacteria immune to any drugs we have. It is time to put public safety first and stop this promiscuous use of drugs essential for protecting human health. The bill we are introducing will phase out the non-therapeutic use in livestock of medically important antibiotics, unless manufacturers can demonstrate that such use is no danger to public health. The Act applies this same strict standard to applications for approval of new animal antibiotics. Such use is not restricted if the animals are sick, or if they are pets or are animals not used for food. In addition, FDA is also given authority to restrict the use of important drugs to treat such animals, if risk to humans is in question. According to the National Academy of Sciences, eliminating the use of antibiotics as feed additives in agriculture will cost each American consumer not more than five to ten dollars a year. The legislation recognizes, however, that economic costs to farmers in making the transition to antibiotic-free practices may be substantial. In such cases, the Act provides for Federal payments to defray the cost of shifting to antibiotic-free practices, with special preference for family farms. Antibiotics are one of the great miracles of modem medicine. Yet today, we are destroying them faster than the pharmaceutical industry can replace them with new discoveries. If doctors lose these vital medications, the most vulnerable Americans will suffer the most-- children, the elderly, persons with HIV/AIDS, and others who are most in danger of drug resistant infections. I urge my colleagues to support this clearly needed legislation to protect the health of all Americans from the reckless and unjustified use of antibiotics.

Mr. KENNEDY

Mr. KENNEDY. Mr. President, it is a privilege to join Senators Enzi, Dodd, and Alexander in introducing the Head Start for School Readiness Act. Our goal is to reauthorize Head Start and continue our bipartisan support for this very successful program to prepare low-income children for school. For over forty years, Head Start has given disadvantaged children the assistance they need to arrive at school ready to learn. It's comprehensive services guarantee balanced meals for children, and a well-defined curriculum to see that children develop early skills in reading, writing, and math, and positive social skills as well. It provides visits to doctors and dentists, and outreach to parents to encourage them to participate actively in their child's early development. It is clear that Head Start works. A federal evaluation found that Head Start children make gains during the program itself, and the gains continue when the children enter kindergarten. Once Head Start children complete their kindergarten year, they are near the national average of 100 in key areas, with scores of 93 in vocabulary, 96 in early writing, and 92 in early math. We've made tremendous, bipartisan progress this year in our effort to reauthorize Head Start and build upon a program that serves as a lifeline for the neediest families and children across the Nation. In this legislation, we build on Head Start's proven track record and expand it to include thousands of low-income children who are not yet served by the program. We provide for better coordination of Head Start with state programs for low-income children. We strengthen Head Start's focus on school readiness and early literacy. We enhance the educational goals for Head Start teachers. And we provide greater accountability for the program, including new policies to ensure improved monitoring visits and new policies to address programs with serious deficiencies. To strengthen Head Start, we have to begin by providing more resources for it. The need for Head Start is greater than ever. Child poverty is on the rise again. Today, less than 50 percent of children eligible for Head Start participate in the program. Hundreds of thousands of three- and four-year-olds are left out because of the inadequate funding level of the program. Early Head Start serves only 3 percent of eligible infants and toddlers. It is shameful that 97 percent of the children eligible for Early Head Start have no access to it. It's long past time for Congress to expand access to Head Start to serve as many infants, toddlers, and preschool children as possible. The bill that we introduce today will set a goal to expand Head Start over the next several years. We call for increases in funding, from $6.9 billion in the current fiscal year, to $7.3 billion in FY 2008, $7.5 billion in FY 2009, and $7.9 billion in 2010. These funding levels are critical to advance the essential reforms in this legislation, and to serve thousands of additional children in the Head Start program. Early Head Start is an especially important program for needy infants and toddlers. Research clearly shows its benefit to infants and toddlers and their families. Early Head Start children have larger vocabularies, lower levels of aggressive behavior, and higher levels of sustained attention than children not enrolled in the program. Parents are more likely to play with their children and read to them. This bill will double the size of Early Head Start over the course of this authorization, and deliver services to over 56,000 additional children over the course of this authorization. Our bill establishes a Head Start Collaboration Office in every state to maximize services to Head Start children, align Head Start with kindergarten classrooms, and strengthen its local partnerships with other agencies. These offices will work hand in hand with the Head Start network of training and technical assistance to support Head Start grantees in better meeting the goals of preparing children for school. States will also have an active role in coordinating their system of early childhood programs, and increasing the quality of those programs. Our bill designates an Early Care and Education Council in each State to conduct an inventory of children's needs, develop plans for data collection and for supporting early childhood educators, review and upgrade early learning standards, and make recommendations on technical assistance and training. For those States ready to move forward and implement their statewide plan, our bill will offer a one-time incentive grant to implement these important efforts. Over the past four decades, Head Start has built up quality and performance standards to guarantee a full range of services, so that children are educated in the basics about letters and numbers and books, and are also healthy, well-fed, and supported in stable and nurturing relationships. Head Start is a model program, and we can enhance its quality even more. One way to do that is to strengthen Head Start's current literacy initiative. We know the key to later reading success is to get young children excited about letters and books and numbers. Our bill emphasizes language and literacy, by enhancing the literacy training required of Head Start teachers, by continuing to promote parent literacy, and by working to put more books into Head Start classrooms and into children's homes. We also make a commitment in this bill to upgrade all of the educational components of Head Start, and ensure that services are aligned with expectations for children's kindergarten year and continue to be driven by the effective Head Start Child Outcomes Framework. At the heart of Head Start's success are its teachers and staff. They are caring, committed persons who know the children they serve and are dedicated to improving their lives. They help children learn to identify letters of the alphabet and arrange the pieces of puzzles. They teach them to brush their teeth, wash their hands, make friends and follow rules. Yet their salary is still half the salary of kindergarten teachers, and turnover is high--11 percent a year. Because a teacher's quality is directly related to a child's outcome, our bill establishes a goal to ensue that every Head Start teacher have their A.A. degree and 50 percent earn their B.A. degree over the course of this authorization. Head Start teachers and staff are the greatest resource to children and families in the program, and we must match these ambitious reforms and improvements with the funding needed to see that Head Start programs can meet these goals. We have also granted additional flexibility in this bill for Head Start programs to serve families and children that need services at the local level. We've lifted the eligibility requirements so that families living below 130 percent of the federal poverty rate can qualify and participate in Head Start. Often, these are the neighbors of Head Start children with similar needs, but currently remain barred from participating in the program. Under this bill, Head Start programs will be empowered with greater authority to determine the needs of families in their local communities and define services to meet those needs. If programs determine that there is a greater share infants and toddlers in need of services, our bill allows them to apply to the Secretary to convert and expand Head Start to serve those youngest children, consistent with Early Head Start standards. If programs identify a need to provide full-day or full-year care for children and families, they can take steps to do so. Accountability is a cornerstone of excellence in education and should start early. Head Start should be accountable for its promise to provide safe and healthy learning environments, to support each child's individual pattern of development and learning, to cement community partnerships in services for children, and to involve parents in their child's growth. Head Start reviews are already among the most extensive in the field. Every 3 years, a federal and local team spends a week thoroughly examining every aspect of every Head Start program. They check everything from batteries in flashlights to how parents feel about the program. Our bill takes a further step to improve the monitoring of Head Start programs, ensures that programs receive useful and timely feedback and information, and strengthens annual reviews and plans for improvement. Our bill also takes an important step to suspend the Head Start National Reporting System. Four years ago, I insisted that instead of rushing forward with a national assessment for every four- and five- year-old in Head Start, this Administration should instead move more deliberately to develop and implement an assessment tool that would help guide and improve Head Start programs. Unfortunately, they rejected that call and proceeded with an assessment--absent sufficient authorization or oversight from Congress--that was later proven by a GAO study to be flawed and inconsistent with professional standards for testing and measurement. Any assessment used in Head Start must be held to the highest standard. It must be valid and reliable, fair to children from all backgrounds, balanced in what it measures, and address the development of the whole child. Our bill calls on the National Academy of Sciences to continue their work in surveying assessments and outcomes appropriate for early childhood programs, and to make recommendations to the Secretary and to Congress on the use of assessments and outcomes in Head Start programs. I hope the National Academy's work will be helpful as we consider future improvements in the Head Start program. Finally, this bill appropriately rejects earlier calls to block grant Head Start services, preserving the community-based structure of the program. It makes no sense to turn Head Start into a block grant to the states. To do so would have dismantled the program and undermined Head Start's guarantees that children can see doctors and dentists, eat nutritious meals, and learn early academic and social skills. The current Federal-to-local structure of Head Start enables it to tailor its services to meet local community needs. Performance standards guarantee a high level of quality across all programs. Yet each program is unique and specifically adapted to the local community. Head Start is successful in serving Inuit children in Alaska, migrant-workers' children in Tennessee, and inner-city children in Boston. It is essential to maintain the ability of local Head Start programs to tailor their services to meet the needs of local neighborhoods and their children. The Head Start for School Readiness Act we are introducing today will keep Head Start on its successful path, and enable this vital program to continue to thrive and improve. I urge our colleagues on both sides of the aisle to join us in advancing and strengthening this program, and give children the head start they need and deserve to prepare for school and for life.

Mr. KENNEDY

Mr. KENNEDY. Access to mental health services is one of the most important and most neglected civil rights issues facing the Nation. For too long, persons living with mental disorders have suffered discriminatory treatment at all levels of society. They have been forced to pay more for the services they need and to worry about their job security if their employer finds out about their condition. Sadly, in America today, patients with biochemical problems in their liver are treated with better care and greater compassion than patients with biochemical problems in their brain. That kind of discrimination must end. No one questions the need for affordable treatment of physical illnesses. But those who suffer from mental illnesses face serious barriers in obtaining the care they need at a cost they can afford. Like those suffering from physical illnesses, persons with mental disorders deserve the opportunity for quality care. The failure to obtain treatment can mean years of shattered dreams and unfulfilled potential. Eleven years ago, Congress passed the first Mental Health Parity Act. That legislation was an important first step in bringing attention to discriminatory practices against the mentally ill, but it did little to correct the injustices that so many Americans continue to face. The 1996 legislation required that annual and lifetime dollar limits for mental health coverage must be no less than the limits for medical and surgical coverage. But more steps are clearly needed to guarantee that Americans suffering from mental illness are not forced to pay more for the services they need, do not face harsher limitations on treatment, and are not denied access to care. This bill is a chance to take the actions needed to end the longstanding discrimination against persons with mental illness. The late Senator Paul Wellstone and Senator Pete Domenici deserve great credit for their bipartisan leadership on mental health parity. If it were not for them, we would not be here today. The bill prohibits group health plans from imposing treatment limitations or financial requirements on the coverage of mental health conditions that do not also apply to physical conditions. That means no limits on days or treatment visits, and no exorbitant co-payments or deductibles. The bill was negotiated by and has the support of the mental health community, the business community, and the insurance industry. The need is clear. One in five Americans will suffer some form of mental illness this year--but only a third of them will receive treatment. Millions of our fellow citizens are unnecessarily enduring the pain and sadness of seeing a family member, friend, or loved one suffer illnesses that seize the mind and break the spirit. Battling mental illness is itself a painful process, but discrimination against persons with such illnesses is especially cruel, since the success rates for treatment often equal or surpass those for physical conditions. According to the National Institute of Mental Health, clinical depression treatment can be 70 percent successful, and treatment for schizophrenia can be 60 percent successful. Over the years we've heard compelling testimony from experts, activists, and patients about the need to equalize coverage of physical and mental illnesses. The Office of Personnel Management talks us that providing full parity to 8.5 million federal employees has led to minimal premium increases. We heard dramatic testimony about the economic and social advantages of parity, including a healthier, more productive workforce. Some of the most compelling testimony came several years ago from Lisa Cohen, a hardworking American from New Jersey, who suffers from both physical and mental illnesses, and is forced to pay exorbitant costs for treating her mental disorder, while paying little for her physical disorder. She is typical of millions of Americans who not only face the cruel burden of mental illness, but also the cruel burden of discriminatory treatment. No Americans should be denied equal treatment of an illness because it starts in the brain instead of the heart, lungs, or other parts of their body. No patients should be denied access to the treatment that can cure their illness because of where they live or work. A number of States have already enacted mental health parity laws, but 86 million workers under ERISA have no protection under state mental health statutes. Mental health parity is a good investment for the Nation. The costs from lost worker productivity and extra physical care outweigh the costs of implementing parity for mental health treatment. Over the years study after study has shown that parity makes good financial sense. An analysis of more than 46,000 workers at major companies showed that employees who report being depressed or under stress are likely to have substantially higher health costs than co- workers without such conditions. Employees who reported being depressed had health bills 70 percent higher than those who did not suffer from depression. Those reporting high stress had 46 percent higher health costs. McDonnell Douglas found a 4 to 1 return on investment after accounting for lower medical claims, reduced absenteeism, and smaller turnover. Mental illness also imposes a huge financial burden on the Nation. It costs us $300 billion each year in treatment expenses, lost worker productivity, and crime. This country can afford mental health parity. What we can't afford is to continue denying persons with mental disorders the care they need. Today is a turning point. We are finally moving toward ending this shameful form of discrimination in our society--discrimination against mental illness. This bill has been seven years in the making, and brings first class medicine to millions of Americans who have been second class patients for too long. Today, we begin to right that wrong, by guaranteeing equal treatment to the 11 million people receiving mental health services, and promising equal treatment to the remaining 100 million insured workers and their families who never know the day they may need their mental health benefit. The 1996 Act, was an important step towards ending health insurance discrimination against mental illness. This bill will take another large step forward by closing the loopholes that remain. It guarantees co-payments, deductibles, coinsurance, out of pocket expenses and annual and lifetime limits that apply to mental health benefits are no different than those applied to medical and surgical benefits. It guarantees that the frequency of treatment, number of visits, days of coverage and other limits on scope and duration of treatment for mental health services are no different than those applied to medical and surgical benefits. This equal treatment and financial equity is also applied to substance abuse. Features of State law that require coverage of mental disorders are protected, to assure those currently protected by state parity laws that their needs will be met. The medical management strategies needed to prevent denial of medically needed services for patients remain intact. Finally, the bill is modeled on the parity that is already guaranteed to the 8.5 million persons, including Members of Congress, under the Federal Employee Benefits Program, Equal treatment of those affected by mental illness is not just an insurance issue. It's a civil rights issue. At its heart, mental health parity is a question of simple justice. It is long past time to end insurance discrimination and guarantee all people with mental illness the coverage they deserve. I urge my colleagues to support this important principle, and end the unacceptable double standards that have unfairly plagued our health care systems for so long.

Mr. KENNEDY

Mr. KENNEDY. Mr. President, I know the Senator from West Virginia wants to make his comments. I wonder if I could just have one moment as well.

Mr. KENNEDY. Mr. President, I had the good fortune of meeting Thad Cochran before he was even a Senator. This was when he was wearing the uniform of the U.S. Navy and he was stationed up in the New England area in the late 1950s and early 1960s. I didn't know at that time, when I was about to become a freshman Senator and he was in the service of our military, that our paths would cross again in this wonderful Chamber, or that he would go on to have the kind of career he has had in the Senate. But it was evident then, so many years ago, that this impressive young naval officer possessed the same qualities we all see today. Then as now, Thad Cochran possessed a deep sense of fairness and compassion, a great commitment to this country we all love, and, above all, good judgment and good humor. Thad and I don't always agree on policy matters--and more often than not we find ourselves on the opposite side of the issues--but those disagreements never diminish my respect for his thoughtfulness, and nor do they diminish the friendship I feel toward him. So I, too, want to join my colleagues in paying tribute to an extraordinary Senator and a great patriot as he marks this wonderful milestone. The people of Mississippi are fortunate indeed to have him fighting for them every day in the U.S. Senate, and all of us are lucky as well to call Thad Cochran our colleague and friend. He is a Senator of great integrity, and we congratulate you Thad on this extraordinary day.

Mr. KENNEDY

Mr. KENNEDY. Will the Senator yield for a question?

Mr. KENNEDY. First of all, I commend the Senator from New York for an excellent presentation. As I understand it from his comments, the principal question before the country now is the whole issue of a surge and the certain timeliness of it. We know that the President was able to extend, for example, marines in place over there and get a certain number of troops over there, but we know this is something that is going to happen in the future. A chunk of the troops are going over in February, another group in March, and another group in April. In the Armed Services Committee yesterday, we learned it is not just the 20,000 the President talked about, but that number is going to be exceeded. We heard from General Pace. As I understand what the good Senator has said, we have had four surges previously over there. This concept, this idea, has been utilized previously and none were successful. Secondly, as I understand what the Senator has said, the leading generals, General Abizaid and General Casey, previously suggested that this concept did not make sense; it only inflamed the insurgency. Is that the Senator's understanding?

Mr. KENNEDY. The third part of the Senator's speech, which I hope our colleagues will listen to, is the reference to the independent study by Baker and Hamilton, where a bipartisan recommendation said that such an activity would not make sense. So does it make sense when we have that kind of lineup, so to speak, where we have the military, the background of surges, the independent study made by Republicans and Democrats alike--we are faced now with a surge, so we have to take action and express ourselves. Doesn't it make sense for this body to express itself on that particular policy issue? Isn't that the responsible thing to do?

Mr. KENNEDY. Just a final point. Madam President, the Senator has stated it well. Basically, the recommendations of those generals I mentioned--and General Abizaid said he had inquired of all the combat commanders--all of the combat commanders--whether there should be an enhanced presence in Baghdad, and he testified before the Armed Services Committee that we should not. But isn't the point the Senator is making is to underline what all of the generals have said and Maliki has said; that is, it is a political resolution, it is a political decision? What we are seeing now is resorting to a military solution when the independent study commission, the generals on the ground, and the political leaders in that country have said what is necessary now is a political resolution, a political decision, and we find an administration that has effectively discarded that as an option and is going to the military option. As I understand, the Senator believes we ought to have a political resolution, political courage by the parties in power there; that we here and the U.S. troops can't care more about the freedom of the Iraqis than the Iraqi people and they have to stand up, step up, and be willing to make their judgments.

Mr. KENNEDY. Madam President, will the Senator yield for a final point?