Don Nickles

Mr. NICKLES

Mr. NICKLES. I announce that the Senator from North Carolina (Mr. Helms) and the Senator from Oklahoma (Mr. Inhofe) are necessarily absent. I further announce that, if present and voting, the Senator from North Carolina (Mr. Helms) would vote ``nay.''

Mr. NICKLES. I announce that the Senator from North Carolina (Mr. Helms) is necessarily absent. I further announce that, if present and voting, the Senator from North Carolina (Mr. Helms) would vote ``yea.''

Mr. NICKLES. Mr. President, these are not insurers. They are providers of care saying that more regulation will do just the opposite--it will increase costs. Experts are saying the Kennedy proposal will increase costs and therefore increase the uninsured and add a lot of money being expended for defensive purposes in litigation, not for improving quality of care. That is a mistake. I urge my colleagues to vote in favor of my amendment, cosponsored by Senators Jeffords, Frist, Collins, and others. I thank them for their comments. I urge my colleagues to vote no on the Kennedy amendment. Mr. KENNEDY addressed the Chair.

Mr. NICKLES. I appreciate the fact that my colleagues on the Democratic side say they will support our amendment, but I want to inform them that our amendment is in direct contradiction with their amendment. Our amendment says we shouldn't do anything to increase health care costs. My colleagues want to say that the proposal by the Senator from Massachusetts doesn't increase costs. They can say it, but it is not true. The facts are the Lewin Group, for example, did a study on the so- called PARCA bill and said it increased costs 23 percent. Granted, the bill that the Senator introduced 2 days ago and is calling upon the Senate to pass may not be exactly the same thing, but it has a lot of common elements, and it will increase costs. The Nickles resolution says we shouldn't increase costs because that increases uninsured. Common sense. And it says we shouldn't require health care providers to spend a lot of money defending themselves instead of providing quality care. The proposal by my colleague from Massachusetts refers to the patient bill of rights. His bill of rights says we should pass legislation. I mention that the President's commission did not say we should pass legislation. They are not consistent. Should we try to improve quality care? Sure. Should we pass legislation mandating a fixed definition of quality care? I don't think so. To give an example, a letter from Bob Waller of Mayo Clinic says, ``Providers of care are in the unique position based on the personal commitment to the well-being of the individual patient to drive quality improvement initiatives. Nothing could stifle innovation quicker than external mandatory standards.'' Now, that is not from some insurance carrier. That is the director of the Mayo Clinic, one of the top providers of quality health care in the world. The Cleveland Clinic states: We are already subject to extensive Federal, State and private regulations through oversight by private payors and accrediting bodies. Adding yet another layer of regulation will only further complicate matters, add administrative costs to our organization, and in all likelihood have little or no effect on the actual quality of care provided. I ask unanimous consent to have these statements printed in the Record.

Mr. NICKLES. I yield the Senator from Maine 4 minutes.

Mr. NICKLES. I yield to the Senator from Tennessee 4 minutes. How much time remains on our side?

Mr. NICKLES. I reserve the remainder of my time.

Mr. NICKLES. I reserve the remainder of my time, because I have a couple of colleagues who wish to speak on this. I ask that the second-degree amendment No. 2281 be withdrawn.

Mr. NICKLES. Mr. President, how much time do I have remaining?

Mr. NICKLES. Mr. President, I have sent my amendment to the desk for various reasons, one of which is, my colleague from Massachusetts has an amendment which he calls a Patients' Bill of Rights. It sounds like a good title, but, frankly, I am concerned it will increase costs, I am concerned it will increase regulation, and because it will increase costs, the number of uninsured will rise, and without question it will increase regulation. The bill that he refers to, the bill that he recently introduced--it also has the same title--called the Patients' Bill of Rights Act of 1998, is 68 pages long and has a lot of details in it. It has a lot of things that every health care plan in America would have to provide. That would cost a lot. It has a lot of the same language that is in the so-called PARCA, the Patients Access to Responsible Care Act. Estimates were made on that bill that it would increase costs 23 percent. That is a big increase. If you increase health care costs 23 percent, you are going to put a lot of people who had insurance in the uninsured category. I think that would be a serious mistake. People who have done their homework on this legislation, and maybe are experts in it, have come out and said, ``We have reviewed this Patients' Bill of Rights and find it severely lacking.'' Here is a quote from the Health Care Leadership Council. They said, ``a vote for the Kennedy amendment is a vote for greater involvement by lawyers and bureaucrats in our health care system. To improve American health care we need to empower individuals, not government. We need every medical dollar to go to medical services, not to lawyers and legal fees.'' One of the reasons for the reference to lawyers and legal fees is that it would allow insurers and businesses to be sued for not providing coverage; not just for the coverage, but also for pain and suffering, for punitive damages. So you would have health care insurers as well as businesses, who would be worried more about litigation than consumer care. I think that would be an enormously expensive provision, and people need to know it. I will continue with the Health Care Leadership Council. They said: The bureaucratic regulations that would result from the Democrats' patient bill of rights legislation would add unnecessary complexity to the health care system. Complexity steals time from patients and forces health care providers to focus on regulatory compliance instead of improving the quality of care. The Chamber of Commerce of the United States, which represents companies throughout the country says: We urge your opposition to an amendment expected to be offered by Senator Kennedy to the budget resolution today expressing the sense of the Senate that a patient bill of rights proposal should be enacted this session . . . The goal of improving health care quality can be better achieved through the power of the marketplace. The National Federation of Independent Business says: The Kennedy amendment would dangerously place the Senate on record in support of health care mandates prior to carefully examining the issues of cost, coverage, regulation and litigation. Additionally, it is premature given the work of respective health care task force groups in the Senate and House and private-sector efforts. Thus, we hope you will not rush to legislate on the basis of antidotes rather than sound decisionmaking. Big Government mandates substitute Government intervention for quality innovations currently taking place in the private health care market are the wrong prescriptions for America's health care system. Also, I have a letter from the Council on Affordable Health Insurance: Bill of rights is a cruel hoax when the cost of those rights will result in health insurance which is unaffordable for those privately purchasing or causes employers to drop health insurance coverage altogether. Both Congress and the States have enacted laws to make health insurance accessible to almost every American who seeks coverage. Access to health insurance is meaningless if Congress makes it unattainable because of regulations placing it financially out of reach for many Americans. I ask unanimous consent that these letters be printed in the Record.

Mr. NICKLES. Mr. President, this is a first-degree amendment and now has 30 minutes equally divided?

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

Mr. NICKLES. That is correct.

Mr. NICKLES. Mr. President, I send an amendment to the desk and ask for its immediate consideration.

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

Mr. NICKLES. Mr. President, I suggest the absence of a quorum.

Mr. NICKLES. I send an amendment to the desk and ask for its immediate consideration.

Mr. NICKLES. Parliamentary inquiry. I believe time has to expire before the Senator can send a second-degree amendment to the desk.

Mr. NICKLES. No, not on my time. I only have a minute left. So I just make the comment that people can talk about these goals. I will agree with the goals. But when you try to mandate them by legislation, saying that we know better, that we are going to dictate to the Mayo Clinic, here is what you must do, we are going to dictate to the Cleveland clinic; we know better, Congress knows better, the Senator from Massachusetts knows better, we are going to dictate it by legislation, I disagree. I do not think that will improve quality. I think it would be a serious mistake. I urge my colleagues at the appropriate time to vote no on the Kennedy amendment, and I will offer a second-degree amendment shortly.

Mr. NICKLES. Just a couple of comments. My colleague said that the President's Commission on Quality endorses these proposals, but they specifically did not endorse legislation. There is a big difference. Do we want to encourage the private sector to improve quality and access and information? You bet. But when you come up with a 68-page bill and say here is what you must do, there is a difference. The President's commission did not say legislate. The Senator's sense-of-the-Senate says legislate. The underlying sense-of- the-Senate resolution provides for enactment of legislation to establish a patients' bill of rights which was just introduced 2 days ago that will increase health care costs. I think that is a serious mistake.

Mr. NICKLES. Mr. President, I will be happy to go. We generally alternate back and forth. It doesn't make any difference. Mr. President, I rise in strong opposition to the Kennedy amendment. At a certain point I will be offering a second-degree amendment. Senator Kennedy's amendment--maybe I should read from it. It is a sense of the Senate that Congress should pass the bill called the ``Consumer Bill of Rights,'' I believe. Now, I might mention the Senator introduced this bill 2 nights ago. I have a copy of the bill which was introduced, the companion bill which is in the House. It is 68 pages. It is the Federal Government getting involved in many areas that possibly my colleagues haven't had a chance to examine. I know this bill has only been introduced for a couple days, but it is a pretty far-reaching bill. It is a bill that treats private plans differently than union plans. It is a bill that says we in Government know best. It is a bill that has lots and lots of mandates. It is a bill that will increase the cost of health care. It is a bill that does not track the President's Commission on Quality Care. I met with some of the Commission on Quality Care just recently. They didn't have a consensus to legislate. As a matter of fact, there was a push by the administration and others that we need to legislate a patients' bill of rights. But that was not the consensus of the commission. As a matter of fact, the commission did not recommend legislation. Yet even though the commission, which studied this issue for 10 months, didn't recommend legislation, here comes a bill, 68 pages, and now, without even having the ink dry on the bill, we have people saying let's pass this. It has a great title. I agree it is a great title. I compliment my colleague from Massachusetts. Boy, any time you say something has a bill of rights, it has to be good. Unfortunately, the closer you look at this legislation, it is not good. I don't think it is good if you increase costs for patients. I don't think it is good if you increase Federal mandates. I don't think it is good if you increase costs to where a lot of people cannot afford insurance. And I don't think there is a relationship between increasing regulations and increasing quality. As a matter of fact, it may be inversely related; you may have more Federal regulations and more money and resources that health care providers have, and instead of using those for providing quality, they are going to be using them to provide for compliance and health care quality goes down. So while I compliment my colleague from Massachusetts for having a great title on this proposal that is only 2 days old, I don't think the Congress should be committing itself to passing it. I think it would be a serious mistake. I might mention, this is not just the Senator from Oklahoma saying this. I am looking at health care providers who have serious reservations. I will just give you one example. This is a quote from the American Hospital Association regarding the bill which was recently introduced: However, the President's quality commission confirmed there is no consensus that Federal legislation introduced today by House and Senate Democrats is the way to achieve these best objectives. The AHA believes the private sector can and must meet the challenge to protect consumers and improving the quality of care. Federal legislation should be considered only if all private sector efforts fail. We have not even given them a chance. We are saying we know best and we are going to mandate it. We are going to dictate it. Mr. President, I will reserve the remainder of my time.

Mr. NICKLES. Mr. President, how much time remains on both sides?

Mr. NICKLES. I announce that the Senator from North Carolina (Mr. Helms) is necessarily absent. I further announce that, if present and voting, the Senator from North Carolina (Mr. Helms) would vote ``yea.''

Mr. NICKLES. I announce that the Senator from North Carolina (Mr. Helms) is necessarily absent. I further announce that, if present and voting, the Senator from North Carolina (Mr. Helms) would vote ``yea.''

Mr. NICKLES. I announce that the Senator from North Carolina (Mr. Helms) is necessarily absent. I further announce that, if present and voting, the Senator from North Carolina (Mr. Helms) would vote ``nay.''