John McCain

Mr. McCAIN

Mr. McCAIN. Obviously, that is objected to. I ask unanimous consent that at 5:30 today the amendment be agreed to and that there be no further revenue or blue slip material amendments in order to this bill, except for three revenue amendments to be offered by each leader or his designee and that each be considered under the regular order with no points of order being waived; further, that when S. 1052 is read the third time, it be laid aside and the Senate immediately turn to the consideration of Calendar No. 69, H.R. 10; that all after the enacting clause be stricken and the text of S. 1052 be substituted in lieu thereof, the bill be read a third time, and the Senate proceed to vote on final passage of the bill; that the Senate request a conference with the House, and the Chair be authorized to appoint conferees.

Mr. McCAIN. Mr. President, of course not, because we----

Mr. McCAIN. We would not know how many bills--I think three revenue bills is reasonable. This is not a revenue bill, Mr. President. This is not a tax bill. This is a Patients' Bill of Rights bill. I think it is perfectly reasonable to say that three, as long as they fit under the window, would be appropriate. I went from one to three. I kept asking the Senator from New Hampshire if we could reach agreement on numbers of amendments. No. We have a lot of amendments. Well, that is not what the bill is all about. I am willing to agree to three. I think that is reasonable. So, obviously, I cannot agree to something which is basically open ended.

Mr. McCAIN. I thank the Senator. I hope we can reach agreement. In the meantime, so this doesn't become just a tax bill, I hope we can agree on three and they would fit under the window of the revenue that is generated according to this legislation, and, by the way, the Frist- Breaux proposal has no way of raising the money in their legislation for that. So I hope we can work this out because I think it is a worthwhile amendment that would be very helpful to low-income Americans. Mr. President, I ask unanimous consent that all first-degree amendments be filed by 2 p.m. this Monday.

Mr. McCAIN. Reserving the right to object.

Mr. McCAIN. Reserving the right to object.

Mr. McCAIN. I will not make my reservation long in deference to the Senator from New Hampshire. Mr. President, I will object. The point is, we need to have a finite number of amendments that we can accept, and we need to have it under the window of revenue that would be allowed according to the legislation. I hope we can work that out. But we cannot allow this simply to turn into a tax bill. We have already spent time on that. So I will object.

Mr. McCAIN. Madam President, on behalf of myself, I send an amendment to the desk and ask for its immediate consideration.

Mr. McCAIN. Mr. President, this amendment is not a complicated one. In fact, it is very simple and straightforward. It simply reiterates the Senate's strong support for providing strong patient protections to Americans who are battling deadly and life-threatening illnesses. The reason I offer this sense-of-the-Senate amendment is that there has been a great deal of discussion about the difference, according to the Congressional Budget Office, between the cost of the so-called Breaux-Frist proposal and the pending legislation. At the outset, so there is no misunderstanding, this sense of the Senate does not in any way tell the HMOs what they should cover and what they should not cover. That is not the point. The point is that when these are covered, there are obviously increased costs, but the reasons for covering them are compelling. The reason I just had the resolution read is the really compelling statistics: 182,800 women this year will be diagnosed with invasive breast cancer; 40,800 women will die from the disease; 1,500 children are expected to die from cancer this year; an estimated 198,100 American men will be diagnosed with prostate cancer; 31,500 men will die from prostate cancer this year. What I am trying to say is that we think there are additional costs associated with coverage for a disease that affects literally millions of Americans. The CBO, the Congressional Budget Office, scored the Frist-Breaux proposal as increasing premiums by 2.9 percent. They scored our proposal as being a 4.2-percent increase in premium cost. This is the estimated ultimate effect of the Bipartisan Patients' Bill of Rights on premiums for employer-sponsored health insurance in percent. I point out that the Congressional Budget Office costs out in lawsuits and damages an increase in premiums under the Breaux-Frist bill of .4 percent; our bill, .8 percent. So there is a .4 percent difference in their estimate--and we argue with that estimate--in costs associated with the provisions for litigation or remedies, lawsuits and damages, in this bill. I want to emphasize, .4 percent. The overall difference, according to CBO, is 1.3 percent, the difference between 2.9 and 4.2. But the difference associated with lawsuits and damages is .4 percent. Where do the other differences, according to CBO, occur? Well, timely access to specialists. They believe it would increase premiums by .1 percent and ours .3 percent. On charges for individuals participating in approved clinical trials, they say it would increase costs by .5 percent and ours by .8 percent. The right to hold health plans accountable--that is, the review of health care plans--the Breaux-Frist bill increases cost by .8 percent and ours by 1.2 percent, which is a difference of .4 percent--adding up to an overall additional cost in premiums, the Breaux-Frist proposal of 2.9 percent, and ours, the pending legislation, of 4.2 percent. My point is, as we have already seen, the majority of the debate has been centered around the allegation that there will be an explosion of litigation and lawsuits. That is not according to our view nor that of the former Governor, Senator Zell Miller, who spoke this morning of his experience as Governor of the State of Georgia, nor is it true in the CBO estimates. I happen to personally believe that clinical trials are important and should be part of health maintenance organization coverage, but that is up to the HMO. I happen to believe that treatment for breast cancer should be part of an HMO's coverage, but I also believe that that is up to the health maintenance organization. What I am trying to do here is put the Senate on record of being in favor of trying to address these illnesses which affect so many Americans, and it is our view, as a body, that these causes of death-- breast cancer is the second leading cause of cancer death among all women and the leading cause of cancer death among women between ages 40 and 55--that there are protections that all Americans should receive under HMOs. I stress again, we are not in any way mandating that those should be covered. We are entitled, as a body, to express our opinion and our sense. That is why it is a sense-of-the-Senate resolution and not any mandate that would be in the form of another amendment. This does not encourage excessive new mandates for health plans. It simply says that if the plan provides certain benefits, such as cancer care, then that plan cannot stop a qualified patient from participating in an approved or funded clinical trial. So I hope my colleagues will agree on this amendment. I have a letter from the American Cancer Society in support of increased access to clinical trials, prompt and direct access to medical specialists, and strong, independent, and timely external grievance and appeals procedures. I ask unanimous consent that the letter be printed in the Record.

Mr. McCAIN. I yield the floor.

Mr. McCAIN. Mr. President, I thank my friend from Illinois for the eloquent statement. I want to make a brief comment about the last vote. I believe we made a good-faith effort in order to see that we could circumscribe the number of tax amendments that would be on this bill. I thought it was a good-faith effort. Obviously, that offer was not accepted. I want to continue to work to see if we can work that out. In a larger sense, we had some pretty strong rhetoric on the floor after our first day of debate on this issue. But time after time, I hear the statement made by my colleagues on both sides of this legislation that we want a Patients' Bill of Rights. There is acknowledgement that we are in agreement on 90 percent of this issue. Well, then, let's really get serious about negotiating. Let's sit down together. I know I speak for the supporters of this legislation when I say there is nothing that we feel is not negotiable. We cannot betray principle, but it is interesting that we go over the President's principles and we find that we are not in any disagreement with the message that was sent over from the White House as far as the President's principles are concerned. If we are in agreement on the principles, then it seems to me there should be no reason why we can't reason together--whether it be on employer liability, or whether it be on the external appeals process, or whether it be in other areas that divide us. So I hope that we will take this opportunity after the vote tomorrow to contemplate it over the weekend, recognizing that the majority leader has stated that we will be on this bill until its conclusion, and take the opportunity to engage in serious negotiations because I don't think that we are that far apart on this issue. It is not our desire in any way, shape, or form to incur a veto. I was somewhat disappointed at the President's message today concerning the threat of veto because given the reasons listed, frankly, we believe that we are in compliance. So I hope that we can, tomorrow, and in the week ahead, have some meaningful negotiations and discussions so that we can reach an outcome that meets the goal that all of us state over and over and over again on the floor of the Senate, that we want an HMO Patients' Bill of Rights. I believe we can achieve it, and I hope today's debate--5 hours on an amendment that has to do with revenue--will not be the practice we continue here. Otherwise, it will be a long time before we complete consideration of this legislation. I, like 99 of my colleagues, do have plans for the Fourth of July. So I hope we can, not only because of the virtues and merits of the issues, but also for less noble reasons, try to get this issue resolved. I yield the floor.

Mr. McCAIN. Is it true that we have significant protections for employers with regard to liability, including the self-insured? But isn't it also true--because allegations will be made to the contrary-- that we are interested in actively pursuing further agreements with all parties to try to address and tighten this language so we can achieve the goal we seek; and that is, to remove employer liability where the employer had no voice in the medical decision and to make sure the self-insured are able to avoid unnecessary lawsuits and be protected as well?

Mr. McCAIN. For about a minute.

Mr. McCAIN. Madam President, I understand the amendment that is being proposed. It contains provisions, as I understand it, that were dropped in conference on the tax bill we passed not long ago. I think the Senator from Texas would confirm that. Is that right?

Mr. McCAIN. It was, I believe, not accepted in conference. Obviously, we would like to do everything we can to encourage employers and employees to be able to obtain health care plans. What I am concerned about is the possibility that this would open up other tax provisions that might be added to the bill. Also, there is the blue slip problem that would apply because it is a revenue issue that does not originate in the other body. Again, I think the Senator from Texas would recognize that is a problem that we face in this amendment. So I wonder if the proponents of the amendment would agree to a unanimous consent request, which I will state now and explain as follows: That the time between now and 5:30 be equally divided between Senator Hutchinson and Senator Kennedy, or their designees, for debate on the pending amendment; that no second-degree amendments be in order to the amendment; and that at 5:30 the amendment be agreed to, and that there be no further revenue or blue slip material amendments in order to this bill; further, that when S. 1052 is read a third time, it be laid aside and the Senate immediately turn to the consideration of Calendar No. 69, H.R. 10; that all after the enacting clause be stricken, and the text of S. 1052 be substituted in lieu thereof; the bill be read a third time, and the Senate proceed to vote on final passage of the bill; that the Senate insist on its amendment, request a conference with the House, and the Chair be authorized to appoint conferees. What I mean by this unanimous consent request is that in order to avoid the so-called ``blue slip'' problem, that this amendment would be adopted, but when the bill is laid aside for the first time, we would take up a House revenue bill which is pending here in the Senate on the calendar, and add that provision to the bill, thereby avoiding the problem of it being negated. I note the Senator from Oklahoma is in the Chamber as well. I would be glad to discuss this unanimous consent request with my colleagues to see if they would give it some consideration, so we could discuss getting it done.

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

Mr. McCAIN. Madam President, after years of delay--and I want to emphasize years of delay--and blocking of consideration of this legislation, this important issue, the Patients' Bill of Rights, we are now, finally, going to take up this issue. I am very pleased to hear of the new-found commitment on the part of those who had blocked consideration of this legislation to seeing this legislation through to its completion. I point out again, it is long overdue that we address this issue. I am glad we are going to address it in a format where amendments are offered, we have debate, and votes are taken without filibustering and without obfuscation of the issue. There are important issues, there are important negotiations, and important amendments that need to be discussed and debated. Again, I appreciate the commitment on the part of those who blocked--who blocked--consideration of this legislation for years on the floor of the Senate and am pleased to be bringing this issue to a conclusion. I applaud the majority leader who has stated we will not leave for the Fourth of July recess until we resolve this issue and have a final vote on it. I believe it deserves that attention. I hope all of my colleagues will devote their efforts and good-faith energies towards resolving it. Our personal health and the health of our loved ones is the most valuable thing we possess. Unfortunately, we often take good health for granted until tragedy strikes and the health or well-being of a family member is jeopardized by disease, accident, or infirmities associated with aging. When one of us or a loved one becomes ill, the obstacles of daily life become insignificant in comparison to ensuring the best health care services are available to our families. Unfortunately, too many Americans are powerless when faced with a health care crisis in their personal life. Too many Americans have had important, life-altering medical decisions micro-managed by business people rather than medical professionals. Too many Americans believe they have no access to quality care or cannot receive the necessary medical treatment recommended by their personal physician. Many Americans work hard and live on strict budgets so they can afford health insurance coverage for their family. But the moment they need it, they are confronted with obstacles limiting which services are available to them. They are confronted by frustrating bureaucratic hoops; and confronted by health plans that provide little, if any, opportunity for patients to redress grievances. This happens too often and can be attributed to several factors. Our health care system is very complicated and can be attributed to several factors. Our health care system is very complicated. Its language is comprised of thousands of acronyms and codes. Even its acronyms have acronyms. Our overly complex health insurance system intimidates and confuses many Americans. Many of us fail to fully examine the coverage provided by our health plans until we become ill, and then it is difficult to understand the plan's legalese. Health care has become increasingly depersonalized, focused more on profits than on proper patient care. I am not embarrassed to admit that I am often overwhelmed by the complexity of the health system. I can certainly relate to the majority of Americans who are overwhelmed by a system which does not meet their basic needs in a simple, efficient and affordable manner. Over the last few years I had an invaluable opportunity to travel around our great country; meeting and speaking with people from all sectors of life and regions of our nation. No matter how small or large a community I visited or where I held a town hall meeting, I repeatedly heard complaints that people's health plans denied or delayed the appropriate medical care, resulting in injury or even death to a loved one. This is why I began working with my colleagues on both sides of the aisle over a year ago to craft a bipartisan bill that truly protects the rights of patients in our nation's health care system. The following are the core principles I insisted be contained in our bipartisan bill: First, our bill is about getting patients the health care they need and not about promoting lawsuits. We have worked hard to ensure that our bill focuses on getting patients the medical care they need. This is not about promoting frivolous lawsuits that could drive up health care costs and increase the number of uninsured in our country. Our bill provides a fair and independent grievance process in the event an HMO denies or delays medical care. A mother should have options when she is told her son or daughter's cancer treatment is not necessary and will not be covered by her insurance. She must have access to both internal and external appeals processes which are fair and readily available and which use neutral experts who are not selected, or otherwise beholden to the HMO. In life-threatening cases, there must be an expedited process. Our bipartisan bill puts Americans in charge of their own health care. Patients and their doctors should control health care decisions, not HMOs or Washington bureaucrats. Physicians utilizing the best medical data must make the medical decisions, not insurance companies or trial lawyers. We need to put in place a balanced system that allows managed care companies to reduce costs but also reinvigorates the patient-doctor relationship, the essence of quality health care. This bill protects employers from liability. We protect employers from being exposed to any liability unless they are directly participating in medical decisions. This bill will not make employers vulnerable for health care decisions they are not directly making and will not cause them to drop health care coverage for their employees out of fear of exposure to frivolous and unlimited liability. Our bipartisan bill provides all Americans with patient protections. Our compromise includes strong patient protections that will ensure timely access to high quality health care for the millions of Americans with private health insurance coverage either through their employer or through the individual market place. The protections include: access to emergency care, access to specialty care, access to non-formulary drugs, access to clinical trials, direct access to pediatricians and ob-gyns, continuity of care for those with ongoing health care needs, and access to important health plan information. The bill also protects the doctor-patient relationship by ensuring health professionals are free to provide information about a patient's medical treatment options. Our bipartisan bill empowers states. It allows states to develop their own patient protection laws, and empowers the Governors to certify that they are comparable to federal law. If the State law is comparable to those at the Federal level, the State law will remain in effect. We allow States to enforce their own laws for their citizens while ensuring that a minimum level of protections are available for all Americans. We want to ensure that a mother in Arizona can take her son directly to a pediatrician in the same way a mom in Texas can. Our bill allows Americans to seek reasonable relief once all options to receive medical care have been exhausted. I find it incredible that HMOs and their employees are able to avoid responsibility for negligent or harmful medical care. Americans covered by ERISA health plans should have the same right of redress in the courts as those who are enrolled in non-ERISA plans if they are unable to receive a fair resolution through an unbiased appeals process. We must ensure that patients receive the benefits for which they have paid and rightfully deserve. We must also ensure that unscrupulous health plans not go unpunished when they act negligently, resulting in harm or death to a patient. Out bill protects state laws that allow patients who have been harmed or killed due to the medical decisions of an HMO to seek redress in state court. However, we worked hard to strike a compromise and help employers by allowing contract disputes to be handled in federal court. This will help employers and insurance companies have that offer multi- state plans have uniformity without obviating state laws. Finally, we must improve access to affordable health care. It is simply disgraceful that 44 million Americans cannot afford health care coverage. This is the largest number of uninsured citizens in over a decade, despite our solid economy and past actions to provide greater access to medical care. We must continue building upon already enacted reforms by expanding medical savings accounts, providing full tax deductibility for self-employed health insurance costs, and allowing tax credits for helping small businesses provide access to health care coverage for their employees. These provisions continue to be a crucial component of the bipartisan compromise I reached with Senators Edwards and Kennedy. I am working with both of them and my colleagues on both sides of the aisle, including Finance Chairman Baucus to ensure that these provisions are addressed as a part of this bill or in the next legislative vehicle that the Senate deliberates. America has been patiently waiting for far too long for Congress to pass a Patients' Bill of Rights that will grant American families enrolled in health maintenance organizations the health care protections they deserve, including the right to remedy insurance disputes through the courts if all other means are exhausted. For far too long, this vital reform has been frustrated by political gridlock, principally by trial lawyers who insist on the ability to sue everyone for everything, and by the insurance companies who want to protect their bottom line at the expense of fairness. If I have ever seen a more living, breathing argument for campaign finance reform, it is in the failure to act on this legislation. Both sides hope to continue affecting their agenda with ``soft money'' contributions they hand over to the political parties, while neither represents the hopes, expectations, and best interests of the American people. I have always found the American people to be reliable counsel when Congress attempts to assess the gravity and urgency of a problem affecting the entire nation. I have listened to countless thousands of Americans demand immediate action on a Patients' Bill of Rights. I have heard countless thousands demand a reasonable standard of accountability for health insurers who have too long and too often escaped virtually all accountability. I have heard countless thousands demand, what any American recognizes as basic fairness, that their most precious possession, their health, not be subordinate to profits for insurers or lawyers, or to political advantage of one part or another. I have heard from very few people who claim that HMOs should continue to be the sole decisionmakers for who gets decent health care and who does not, for who lives and who dies. I have heard very few people defend an HMO's right to escape all accountability for those decisions. I have heard from very few people except those starring in radio and television ads underwritten by insurers who say HMO reform is unnecessary. I have heard from very few people who have claimed that their health, or their child's health is less important to them than the amount of damages they can recover from negligent health insurers. But in every reliable public survey, and in every conversation I have had with the American people, in groups of ten or crowds of a thousand, everyone recognizes that a Patients' Bill of Rights is an urgent, necessary improvement if America is to have the kind of health care that befits a great and prosperous nation. Men and women of good will, on both sides of the aisle, in Congress and in the administration, are working to bridge differences between our different remedies to this problem. I am encouraged by that, and pledge my cooperation in any sincere effort to reach fair compromises on the outstanding issues that still divide us. Whether in the amendment process or in discussions with colleagues and members of the administration, the sponsors of this bill want to reach agreement on genuine reform that will be enacted into law. But we cannot compromise on our resolve to return control of health care to medical professionals, and to hold insurers to the same standard of accountability that doctors and nurses are held to. That is all we seek today and all that the American people expect from us, a fair and effective remedy to a grave national problem. I urge all my colleagues to join us. I yield the floor.

Mr. McCAIN. I ask unanimous consent.

Mr. McCAIN. I don't agree. I don't agree. We will be glad to debate that and have a parliamentary decision on it.

Mr. McCAIN

Mr. McCAIN. Mr. President, I yield the floor.

Mr. McCAIN. Mr. President, I reiterate my support for the majority leader's unanimous-consent request. I believe it is fair and also crucial for allowing us to finally engage in a real and meaningful debate that will get Americans the protections they need and want. This unanimous-consent request is exactly along the lines of that which governed the campaign finance reform debate. Most Americans, no matter how they felt on that issue, believed that it was a fair, open, and honest debate in which the issues were ventilated and the majority of the Senate worked its will. That is how most Americans think we should function and, unfortunately, all too often we do not. Under this unanimous-consent agreement, unlimited amendments can be offered, and each one will be provided a significant period of time, 2 hours, and after debate the amendment would be voted on by the full Senate. I am struggling to understand why we can't agree that this is not only a fair proposal but truly it affords each and every one of us with an opportunity for engaging in a free and spirited debate. This format embodies the full spirit of the traditional Senate and should not be ignored or misconstrued as anything but a reasonable and honest proposal. I think Americans are watching us to see if we can come together on an issue of great importance to everyone across our Nation. I don't think delay is warranted. We should not obstruct. I am confident that engaging in a truly open debate on this issue, without stringent time restraints or limits on amendments, will result in the passage of a strong bipartisan patients' protection bill that can be signed into law by President Bush. I want to reiterate, it is my sincere and profound commitment to see that we enact a bill that the President of the United States can sign. It would serve no one's purpose to go through the debate and amending process in the Senate and in the other body and conference and then have a bill the President will not sign. I will make a couple of additional comments. There has been some debate as to who supports and who does not support this legislation. I have a list of over 300 organizations that are in support of this legislation--not only the nurses and doctors of America but traditional consumer advocacy groups, including health groups such as the American Cancer Society, the American Dental Association, the American Nurses Association, a long list of organizations that have traditionally advocated for the health of Americans either in a specialized or general way. We have a clear division here between the health maintenance organizations, which according to a CNN USA Today poll enjoy the approval of some 15 percent of the American people, and the nurses and doctors and those who are required to and do commit their lives to taking care of the health of our citizens. I have been asked many times why is it that I am involved in this issue, why is it that I have worked very hard to try to fashion a bipartisan agreement that we could use as a base for amending and perfecting a bill that we can have signed by the President. In my Presidential campaign, in hundreds of town hall meetings attended by thousands and thousands of Americans, time after time after time after time, average citizens stood up and talked about the fact that they have been denied reasonable and fair health care and attention they believe they deserve and need. This is an issue of importance to some 170 million Americans who would be covered by this legislation. This is an issue to average Americans who are members of health maintenance organizations. This is a challenge and a problem. These Americans want the decisions made by a doctor and not an accountant. These Americans want and need and deserve a review process that is fair. These Americans are not receiving the fundamental health care they deserve as members of health maintenance organizations and, frankly, that is available to other Americans who have larger incomes. Mr. President, this is not something we should delay any longer. This is an issue we should take up and address, amend, debate, and then come to a reasonable conclusion. I want to repeat my commitment to working with the White House, to working with all opponents of the legislation in its present form. For us to do nothing, as has been the case over the last several years, as time after time this issue has been brought up and blocked through parliamentary procedures, is not fair. It is not fair and honest to the American people to refuse to address the issue. As I said with campaign finance reform, if the result of the debates and amendments is not to my liking and I don't agree with the result, I will respectfully vote against it. But I will not try to block it. I hope Members on both sides of the aisle will make that commitment as well because of the importance of the issue to the American people. It deserves a full and complete debate and vote. I want to work together with my colleagues on both sides of the aisle. We have had meaningful negotiations. We have had good discussions. As a result of amendments, we will have further discussions. I hope that over time we will be able to reach an agreement. I again express my support for the unanimous consent request the majority leader propounded because I think it is a fair and honest way, providing no advantage to either side on this debate. Again, I thank my colleagues for their commitment and involvement in this issue, but most of all I want to thank these 300-some organizations--the nurses and the doctors of America, in particular-- who have committed themselves to addressing this issue so that all Americans can receive the health care they deserve. I ask unanimous consent that a list of organizations supporting the bill be printed in the Record.

Mr. McCAIN

Mr. McCAIN. Mr. President, I join my colleagues in support of renewing the Iran-Libya Sanctions Act to protect American interests in the Middle East. Despite promising changes within Iranian society, Iran's external behavior remains provocative and destabilizing. Iran continues to aggressively foment terrorism beyond its borders and develop weapons of mass destruction as a matter of national policy. Consistent calls from its leaders for Israel's destruction, and the Iranian government's bankrolling of murderous behavior by Hezbollah, Hamas, and other terrorist groups, should make clear to all friends of peace where Iran stands, and what role it has played, in the conflagration that threatens to consume an entire region. Of grave concern are recent revelations that implicate Iran's most senior leaders in the 1996 terrorist attack on Khobar Towers, which took the lives of 19 U.S. service men. If true, America's response should extend far beyond renewing ILSA. The successful conclusion of the Lockerbie trial, which explicitly implicated Libya's intelligence services in the attack, does not absolve Libya of its obligations to meet fully the terms of the U.N. Security Council resolutions governing the multilateral sanctions regime against it. Libya has not done so. Libya's support for state terrorism, as certified again this year by our State Department, and its aggressive efforts to develop chemical and potentially nuclear weapons, exclude Libya from the ranks of law-abiding nations. Lifting sanctions on Iran and Libya at this time would be premature and would unjustly reward their continuing hostility to basic international norms of behavior. Overwhelming Congressional support for renewing the Iran-Libya Sanctions Act reflects a clear, majority consensus on U.S. relations with these rogue regimes. Were the foreign and national security policies of Iran and Libya truly responsive to the will of their people, our relationship with their nations would be far different. But Libya's Qaddafi and Iran's ruling clerics hold their citizens hostage by their iron grip on power. Supporting their replacement by leaders elected by and accountable to their people should be a priority of American policy.

Mr. McCAIN

Mr. McCAIN. Mr. President, I join my colleagues in support of renewing the Iran-Libya Sanctions Act to protect American interests in the Middle East. Despite promising changes within Iranian society, Iran's external behavior remains provocative and destabilizing. Iran continues to aggressively foment terrorism beyond its borders and develop weapons of mass destruction as a matter of national policy. Consistent calls from its leaders for Israel's destruction, and the Iranian government's bankrolling of murderous behavior by Hezbollah, Hamas, and other terrorist groups, should make clear to all friends of peace where Iran stands, and what role it has played, in the conflagration that threatens to consume an entire region. Of grave concern are recent revelations that implicate Iran's most senior leaders in the 1996 terrorist attack on Khobar Towers, which took the lives of 19 U.S. service men. If true, America's response should extend far beyond renewing ILSA. The successful conclusion of the Lockerbie trial, which explicitly implicated Libya's intelligence services in the attack, does not absolve Libya of its obligations to meet fully the terms of the U.N. Security Council resolutions governing the multilateral sanctions regime against it. Libya has not done so. Libya's support for state terrorism, as certified again this year by our State Department, and its aggressive efforts to develop chemical and potentially nuclear weapons, exclude Libya from the ranks of law-abiding nations. Lifting sanctions on Iran and Libya at this time would be premature and would unjustly reward their continuing hostility to basic international norms of behavior. Overwhelming Congressional support for renewing the Iran-Libya Sanctions Act reflects a clear, majority consensus on U.S. relations with these rogue regimes. Were the foreign and national security policies of Iran and Libya truly responsive to the will of their people, our relationship with their nations would be far different. But Libya's Qaddafi and Iran's ruling clerics hold their citizens hostage by their iron grip on power. Supporting their replacement by leaders elected by and accountable to their people should be a priority of American policy.

Mr. McCAIN

Mr. McCAIN. Mr. President, I rise to oppose the Conference Report on the Reconciliation bill. I do so after having expressed hope that the progress we made in the Senate bill to scale back the benefits going to the top rate taxpayers to make room for more tax relief to lower income Americans would prevail in the final tax bill. During the debate on the Senate version of the tax reconciliation bill, I had urged my colleagues that substantial tax relief to middle income Americans should be our top priority. While I regret that my amendment to cut the top rate by one percent to 38.6 percent so millions more middle class Americans would fall into the 15 percent tax bracket failed on a tie vote, Senator Grassley did move in that direction in the Senate bill by insisting that the top rate should be cut to only 36 percent. As a result, I reluctantly voted for the bill but pledged to vote against the Conference Report should further reductions in the top tax rate be made at the expense of the majority of Americans who are in much greater need of tax relief. Unfortunately, the Conference Report did just that by jettisoning the commendable work both Senators Grassley and Baucus did in crafting a Senate reconciliation bill that provided more tax relief to middle income Americans. This Conference Report lowers the top rate cut to 35 percent, at the cost of delaying, for several years, much needed tax relief for married couples unfairly penalized by our tax code. I regret having to vote against this Conference Report. We had an opportunity to provide much more tax relief to millions of hard-working Americans. I supported a $1.35 trillion tax cut despite my concern that a tax cut of that size would restrict our ability to fund necessary increases in defense spending. But I cannot in good conscience support a tax cut in which so many of the benefits go to the most fortunate among us, at the expense of middle class Americans who most need tax relief.

Mr. McCAIN

Mr. McCAIN. Mr. President, one of the few benefits of growing old is watching young people you've been privileged to know grow, both personally and professionally. We would like to think that members of younger generations who have become important and compassionate people have done so because of us, that our wisdom has rubbed off on them, and that the world is better off for it. The world is better off for having Lorne Craner in it, but the credit is all Lorne's. I am happy that my former staff member and the President of the International Republican Institute, which I chair, now moves to the State Department, where he will serve as Assistant Secretary for Democracy, Human Rights, and Labor. More importantly, persecuted masses around the world who are deprived of their rights and freedoms, the right to choose what government represents them, the right to live and speak freely, and the right to organize for safe and decent working conditions, have an important ally in Lorne. America's foreign relations rightly reflect our belief that our most basic values as a nation are universal values; and that citizens in dictatorships cherish these values as much as we do, despite what tyrannical leaders may do to subjugate them. Our values are contagious, which is why autocrats fear them so. Lorne has dedicated his career to promoting these values and advancing our national interest worldwide, to the benefit of many of its citizens. Lorne served on my staff for 6 years in both the House and Senate and was a wonderful asset to me. He was such a wonderful asset that President Bush and Secretary of State Baker tapped him to be Deputy Assistant Secretary of State for Legislative Affairs when they took office. Lorne served with distinction in that job, and as Director for Asian Affairs on President Bush's National Security Council. As Vice President and then President of the International Republican Institute from 1993 until today, Lorne invigorated an organization created by President Reagan to shine the light of freedom upon the darkest corners of the Earth. Lorne's vision and management of the Institute, which operates in over 30 countries under sometimes trying conditions, have earned IRI the respect and gratitude of democrats from Serbia to South Africa, Cuba to Cambodia, and Azerbaijan to Zimbabwe. In many countries, the struggle continues, while in others, ruling democrats speak glowingly of how IRI helped them set their people free. Lorne and the IRI staff have been integral to these democratic advances. We have much to do yet as a country to improve human rights, labor rights, and political freedom overseas. As Secretary Powell's point man on these critical issues, Lorne has his work cut out for him. But he is ready. I am very proud of him, and I know his late father, my dear friend, would be also.