Jay Rockefeller

Mr. ROCKEFELLER

Mr. ROCKEFELLER. We will see on all of this, because there is a very strong predilection on the part of the majority party to make--when you are talking about inheritance taxes, you know, that is pretty heavy stuff. That would raise questions. The Senator who is speaking knows something about that. The other thing I guess I want to say, if the Senator would further yield----

Mr. ROCKEFELLER. Of course.

Mr. ROCKEFELLER. General reminders, perhaps, would be more appropriate in terms of the phrasing. I certainly listened to what my distinguished friend said, and respect him. In fact, in all that he says, because he has a particularly articulate, modified way of saying things which I have long respected, which the Senator knows from our previous conversations. The Senator has brought up a number of points, such as wage and price controls, and this is something which is not necessarily totally accurate, but which I ask the Senator to contemplate. He talked about the evils of wage and price controls. Let us leave wages out for the moment--no, let us not leave wages out for the moment. I submit to the Senator what we are now seeing increasingly in private sector managed care--you made reference to the Clinton health care program which is long gone. It seems to me like the debate on health care reform was 10 years ago. Since it failed, there was this convulsion in the marketplace, an extraordinary explosion of activity, and managed care took off. We have health maintenance organizations, HMO's, which are wonderful in their concept of paying a doctor so much to keep a patient healthy. Therefore, the incentive was to keep the patient healthy, and the incentive was always on the relationship between the doctor and the patient. Then we see the introduction of for-profit HMO's, which are now sweeping the Nation. That introduces quite another concept, and that is the interest of the shareholder of the company as opposed to, perhaps, in contrast to, in contradiction with, perhaps, the relationship between the doctor and the patient. I just wonder out loud if what we have seen, therefore, and the resulting kind of caps and limits, and ``this will be allowed and that will not be allowed,'' is, in fact, a form of wage and price controls, but under the guise of the private sector, therefore, we do not think of calling it as such. I just raise that as something for the Senator to think about. Second, on the short-term basis aspect, the Senator expressed great concern about having to do this all the time. I am in total agreement. I am in total agreement, and I think the reason that we have had all of these short- term fixes is because we have not had to consider Medicare in a longer term context. The Senator made some correct observations. But that is why I think that a commission, never before entered into, on Medicare, which has grown enormously because Congress has added enormous new burdens on it, services to be paid for, as well as the cost of health care and everything else, that it is, in fact, a long-term commission approach which is the answer to solidifying patterns, making adjustments, and biting the bullet on some very difficult issues. I think that the deal, so to speak, would be that the commission would be so well balanced as to who was on it--experts, seniors, consumers, et cetera, it would be fairly done and expertly done--that it would be voted through by the House, voted through by the Senate and signed by the President almost without debate, like the Social Security Commission's recommendations were. It was an enormously controversial problem. Senator Dole and Senator Moynihan were on that commission. With respect to when the Senator talked about the old bromide, or whatever it was, of Democrats talking about tax cuts for the rich, I have to go by what people in the majority say, because we in the minority have to respond to that. The Senate budget resolution would, and I quote, ``accommodate further tax reform or tax reductions, to be offset by the extension of expired tax provisions or corporate and business tax reforms. Such tax reductions could include proposals such as economic growth, a capital gains tax reduction package, State tax reform, economic growth, fuel excise taxes * * *.'' And on to the end of the quote. So I have to believe that tax cuts for the wealthy are still very much in the mind of the Republicans. I cannot prove it, but I can point to the Republican budget resolution before us. What am I to think as I see this?

Mr. ROCKEFELLER. Mr. President, I would like to respond to the distinguished Senator from Michigan in his reference to treatment of home health care financing. I am addressing, in fact, the distinguished Senator from Michigan as the Presiding Officer. It is complicated, but it is very important. I would like to take just a couple of minutes, if that is all right, outlining why this change in home care financing does, in fact, make sense. And then also why, therefore, it is a legitimate way to improve the solvency of the part A trust fund. A little history: Before 1980, financing of the home health care benefit was divided between part A and part B, pre-1980. At that time only the first 100 days of home visits after a 3-day hospital stay were financed from the part A fund. All other visits were financed by part B. The policy behind this was that Medicare part A was designed to pay for short-term recuperative home care services. In 1980, Congress enacted legislation that improved Medicare's overall home health care benefit by removing the 100-day visit limit and the prior hospitalization requirement, the so-called 3-day requirement. As a result, financing of all home care services was shifted at that point to part A, even though part A was never intended to pay for long-term home health care services. That is the rationale, and it makes sense. The President's proposal restores financing of the home health care benefit back to the original intent of Medicare, and that is what happens in his proposal. It brings Medicare financing in line with use patterns that show home health care has evolved into two distinct benefits: Care to persons recovering from an acute care hospitalization and care where there is no hospitalization but long-term care services are required. This proposal extends the solvency of the part A trust fund by capping part A financing of Medicare's home health benefit and saves the trust fund almost $60 billion over 7 years. I just wanted to make that point. The Senator from Michigan, the Presiding Officer, had raised this point and I think it does bear explanation on a policy basis. I thank the Presiding Officer and yield the floor. Mr. BENNETT addressed the Chair.

Mr. ROCKEFELLER. I thank the Presiding Officer, and I yield the floor.

Mr. ROCKEFELLER. Mr. President, this letter is signed by the American Hospital Association, the Catholic Health Association, the Federation of American Health Systems, and seven or eight others, in which they say the budget drastically changes how the reductions would be allocated within the programs. They refer to: ``Not only are these unprecedented reductions, but they would have a disproportionate adverse impact on hospitals,'' and so on. It is a much more drastic cut for hospitals. That is something that we all need to worry about. The Prospective Payment Review Commission, ProPAC, a highly respected, nonpartisan commission that advises Congress on hospital payment issues, has warned us in their March report that severe reductions in hospital payments could have a severe impact on hospitals. They go on to say, ``The required restraint on cost growth may not be feasible, or desirable. Low updates over an extended period could affect a hospital's financial health and compromise access and compromise quality of care. They could also impede the diffusion of quality-enhancing technological advances.'' Mr. President, this is not a partisan conclusion reached by this Senator or the Clinton administration about the hospital cuts proposed in the Republican budget. This is a conclusion that has been reached by a group of health care experts who have been advising Congress on the financial health of hospitals since 1983. This budget truly ignores the heavy reliance of rural hospitals on the Medicare Program. Small rural hospitals may have to shut their doors. We have heard that before. But with this 20 percent greater impact, it is far more dangerous. Mr. President, in West Virginia one-half of all seniors live in rural areas. Well over half of our hospitals are rural and are, therefore, clearly and logically disproportionately dependent on the Medicare Program for their payments. Mr. President, my colleagues on the other side of the aisle will yet again claim that they are proposing these massive reductions in Medicare to save the trust fund from insolvency. Once again, I say this is nonsense. While the most recent Medicare trustees' report showed the trust fund in somewhat worse shape than last year, the variation falls within the typical margin of error. There is over $120 billion in that trust fund, and there is no imminent danger that claims cannot or will not be paid. During my almost 10 years' tenure on the Finance Committee, Mr. President, we have been faced with many of these situations, to be quite honest, with many scenarios of impending trust fund short-term insolvency crises. You have not heard very much about them. The reason you have not heard very much about them is that each time, except for the last time, Finance Committee members worked together to enact Medicare payment reforms to extend short-term solvency to that one and same trust fund. We have done it time and time again, maybe seven or eight times over a period of 15 years. We enacted major reforms in hospital payments in 1983 and followed up with physician payment reform, something that Senator Durenberger and I were closely involved in in 1989, as well, of course, as Senator Kennedy. We made countless payment and policy adjustments to rein in Medicare spending and extend trust fund solvency, but we did it together. It was bipartisan. You heard very little, if anything, about it. In fact, until very recently, the Medicare Program outperformed the private sector in containing its health care costs. The private sector is doing slightly better right now, but realize that the private sector is ensuring fewer and fewer people while Medicare's enrollment is increasing. Medicare pays for home care services and skilled nursing home care, types of services that are not normally covered by private insurance policies, and Medicare pays for an older and sicker population. So in spite of this, except for this year, they have held their costs below the rate of increase of the private sector. They have done very well. As everybody knows, or hopefully knows by now, their administrative costs are about 2 percent, which is virtually impossible to imagine but true. At the beginning of the Clinton administration, the trust fund was projected to be exhausted by 1999--not 2002 but 1999. The Democrats on the Finance Committee were forced to work single-handedly in 1993 to extend the solvency of the trust fund by 3 more years, and I am aware of that because I negotiated the Medicare part of that. I can tell you, Mr. President, that we did not have a single Republican vote. We did it, nevertheless. I did not hear one single concern expressed by the current congressional majority about the solvency of the trust fund back in 1993, which was not very long ago. The Congressional Budget Office has certified that the balanced budget proposed by the President would extend the solvency of the trust fund for 10 more years. That is about the same level of solvency achieved by the Republican budget. But the President's budget does so without damaging programmatic changes and drastic cuts that would eventually cause the Medicare Program to, as one noted public servant said, ``wither on the vine.'' We can address the short-term solvency needs of the trust fund without slashing and burning the Medicare Program. We can extend short-term solvency without shifting huge new costs to senior citizens. The President's budget proves that it can be done. The tougher issue, of course, is the long-term solvency of the trust fund, and about that we are all concerned. When the baby boomers begin to age into the Medicare Program, there will be a huge strain on the trust fund. None of the balanced budget proposals deal with the issue of long-term solvency. The Democratic proposal does not. The President's proposal does not. The Republican proposal does not do that. Last year, I introduced legislation--which I believe is strongly supported by Senator Dole; he said he strongly supports it--that would establish a bipartisan Medicare commission. When people hear the word ``commission,'' they say, ``Oh, yeah, one of those.'' Well, yes, one of those was what solved the Social Security problem for a great many years under President Reagan and Alan Greenspan back in 1981. The House and the Senate and the President, Republicans and Democrats, all went along with that. Tough decisions were made. Bullets were bitten. The bill was passed, and Social Security is not the concern that it was at that time. None of the balanced budget proposals, as I indicated, deal with this, and I think a Medicare commission to make recommendations to Congress on ways to deal with the long-term solvency of the Medicare Program is the intelligent, rational way to go. If we adopted the President's proposal on Medicare, we would have plenty of time, plenty of time, to adopt a bipartisan solution that addresses this long-term solvency. It has always been a matter of some amusement to me; if it is solvent until the year 2002--the Medicare HI trust fund--and this is 1996, that is called 6 years. The President could call this commission into being next year, if he is reelected, or, if Senator Dole is elected, then he could do it. He says he is for it. It would meet for a period of 6 months or a year or whatever it would be, and the problem, therefore, would be resolved and we could vote on it in 1998, 4 years before the crisis even hit us. Six years is ample time. Medicare is not in danger. Congress will not walk away from our responsibilities on Medicare. We simply will not do it. So from my point of view, in concluding, the Republican budget is designed to raid, not save, the Medicare Program. Medicare's money is going to be used to finance tax cuts for the wealthy. It is that simple. It has nothing to do with assuring long-term solvency of the Medicare trust fund. I find that abhorrent. It has nothing to do with making sure that Medicare programs continue to provide high-quality health care for our senior citizens and the disabled. It has everything to do with the Republican promises to balance the budget in 7 years and hand out tax cuts to the rich. Mr. President, I hope my colleagues will adopt my amendment. Mr. President, I send a modification of my amendment to the desk in that there was a small error.

Mr. ROCKEFELLER. Mr. President, I rise today in order to offer an amendment to restore $50 billion to the Medicare Program. This amendment restores $50 billion by closing corporate loopholes and by extending expired tax provisions already included in the Republican budget. Mr. President, we are back again trying to make sure that the Medicare Program is not gutted to pay for tax cuts for the wealthy. This is where we were a year ago. This is where we are again now. My colleagues on the other side of the aisle have tried to dress up their budget. They are proposing all kinds of fancy maneuvers and 3 separate budget packages. They are pretending their latest budget is somehow kinder and gentler. But there is really not much new here compared to what we had last year. They lost the budget battle last year with the American public when the public realized that the drastic cuts in the Medicare and Medicaid programs were going to be used to pay for tax breaks for the wealthy. Instead of going back, as I would have thought they would have done, to the drawing board and come up with some new ideas and better health policies, they have merely changed the rhetoric. Instead of proposing ways to strengthen the Medicare Program, they have come up with some complicated three-tiered reconciliation process so that they can send three different bills to the President in a desperate attempt to score some political points. Instead of working with Democrats and with President Clinton to actually enact a bipartisan balanced budget, the Republicans continue to work behind closed doors. The budget resolution before us has been preconferenced. I want my colleagues to understand this. It has already been preconferenced between the House and Senate Budget Committees. I have only been here 11\1/2\ years. I have never heard of that--a preconferenced bill involving something so massive as Medicare, for example. The deals have already been worked out and they have shut the door on any serious attempt to reach an agreement on a balanced budget. It is either their way, with massive Medicare cuts to finance tax cuts for the wealthy, or it is no way at all. Mr. President, last year the Finance Committee did not hold a single hearing on the so-called ``chairman's mark'' to cut Medicare by $270 billion; totally different approach than the one that Senator Kennedy and Senator Kassebaum in their respective minority-majority positions took in their committee. The Labor and Human Resources Committee has done their legislation in a bipartisan, open-to-all, way. We did not do that in Finance. We held hearings on the problems of the Medicare Program earlier in the year. But not a single hearing was held on the Republican's actual plan to cut $270 billion out of the Medicare Program. Not a single hearing was held to figure out what the impact of these really very radical cuts would be on the average Medicare beneficiary who already spends, let my colleagues understand this, 21 percent of their budget on health care. I wrote Dr. O'Neill, head of the Congressional Budget Office, last year asking for estimates of what she thought this $270 billion might have in the way of an impact on the average senior's pocketbook. Needless to say, I never got a response. It is no different this year, Mr. President. This year the Finance Committee has failed to hold a single hearing on any aspect whatsoever of the Medicare Program--not one hearing. This budget resolution assumes enactment of the same type of radical policy changes without even preserving current law financial protection for seniors. Mr. President, this debate is not about whether we should balance the budget but how we should balance the budget. This Republican budget still seeks the unprecedented cuts in the Medicare Program, just as it did last year. Just as that was rejected by the American people, here we are back again. The President's budget achieves balance with $50 billion, or 44 percent, less in Medicare cuts. If they both achieve balance, then it seems to me quite reasonable to take the President's approach and simply restore $50 billion knowing that the budget would then be in balance. Mr. President, even the Congressional Quarterly wrote, ``This year's Republican Medicare budget proposal looks a lot like last year's proposal.'' The same thing--a huge public outcry last year, and with a new year out it comes once again. On the surface, the Medicare cuts appear somewhat reduced. But a lot of the reduction can be attributed to CBO's revised Medicare baseline estimates and because this year's budget only includes 6 years worth of cuts rather than 7 years. For hospitals, though, this year's budget resolution is much, much worse than last year's. The American Hospital Association estimates that the projected hospital cuts in the budget are 20 percent greater than the cuts in last year's proposed hospital budget cuts. I have here a letter which I ask unanimous consent to have printed in the Record.

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

Mr. ROCKEFELLER. Mr. President, I send an amendment to the desk on behalf of myself, Mr. Dorgan, Mr. Kennedy, Mr. Dodd, Mrs. Boxer, Mr. Lautenberg, Mr. Daschle, Mr. Wellstone, Mr. Ford, and Mr. Exon.

Mr. ROCKEFELLER. I thank the Chair and the distinguished Senator from Nebraska, and also the chairman of the Budget Committee, for their courtesy. Amendment No. 3979 (Purpose: To restore $50 billion in excessive Medicare cuts designed to pay for new tax breaks for the wealthiest Americans, offset by the extension of expired tax provisions or corporate and business tax reforms; to protect seniors against unjustified increases in premiums and other out-of-pocket costs; to prevent the closing of rural hospitals and other excessive provider cuts that erode access to needed medical services; to prevent the implementation of policies designed to force seniors to give up their own doctors to join private health plans; and to protect Medicare against policies that will cause it to wither on the vine)

Mr. ROCKEFELLER

Mr. ROCKEFELLER. I thank the Presiding Officer.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, I want to follow on the comments that were made by Senator Bradley with respect to the Newborns' and Mothers' Health Protection Act of 1996. I think it is an absolutely classic example of what it is the American people do expect us to do in Congress and what they would like us to take on. It is a very real problem. As he indicated, they are very real families, very real people and they are in this situation, very helpless. I also join Senator Bradley in urging the majority leader, Senator Dole, to bring this bill to the floor as soon as possible. It did pass Labor and Human Resources by 14 to 2. That is not a close vote. That is virtually a unanimous vote. We are approaching Mother's Day. It would be nice to have this bill debated at that time. The legislation is absolutely vital in the turmoil which is now our health care system. It shifts the decisionmaking power of when a mother and her baby would be leaving a hospital, discharged home, so to speak, from an insurance company or an HMO, which has interesting missions in all of this, and then send it back to the doctor and to the patient. That is, the decision when to leave. That is why I signed on to this bill and became a cosponsor very, very early. Many large insurers are refusing to pay for more than 24 hours of maternity care. I do not know where managed care is going to take this country. I can tell you this, I am extremely worried about it, and I am even more worried about for-profit HMOs and managed care. Some HMOs even require discharge within 8 hours of delivery. I cannot imagine such a thing. I am sure that can happen from time to time, but I just cannot imagine that happening very often. These quick discharge practices can, in fact, enormously endanger the life of the mother and endanger greatly the life of the child. Newborns are prone to problems such as dehydration. They are prone to problems like jaundice that are not even detectable until they have been alive for 24 hours. So, by definition, how are doctors going to be able to determine infants' condition if they are already at home? New mothers are themselves very susceptible to pelvic infections, to breast infections. A new mom may be, probably is in most cases, too fatigued, just too tired, has been through too much in the delivery to properly care for an infant 24 hours after a normal but nonetheless exhausting delivery problem or experience. Quick discharges can result in devastating medical consequences, in devastating human consequences and, yes, they can result, and have resulted, in death, because new mothers and fathers are sometimes unable to detect these early symptoms of potentially life-threatening conditions. This is not ideological talk, this is medical talk. Right now, insurance companies start the 24-hour clock, or even the 8-hour clock or the 12-hour clock ticking the minute the child is born. The minute the child emerges, the minute of the first cry, the clock begins. The insurance companies do not distinguish between those mothers who have had a 2-hour birth and a mother who has been through 12 hours or 18 hours and had an extremely painful, exhausting, debilitating birth. They make no distinction whatsoever between the two; just out of here in 24 hours. Their rules do not distinguish between an experienced mother, a mother perhaps having her third or fourth child with a father or a grandmother at home ready to help, ready to help the mother, ready to help the child, on the one hand, and then on the other hand, a 16-year- old teenage mother with an exhausting birth process who is discharged after virtually no time. A teenage mother, who is terrified at the prospect and has no idea of how to care for a healthy baby, much less a baby showing some kinds of symptoms which that 16-year-old teenage mother cannot understand. It makes no difference to the insurance company. The circumstances make no difference: 24 hours, they must all be discharged from the hospital, period. How do we get here? I mean, this is the great debate. The Clinton health care bill did not pass, I understand that. It tried to bite off too much, I understand that. The free market is working, I understand that, but there are some very dangerous things going on. Some of the most unhappy people in America right now, and the ones most worried about quality of care, are physicians. Judith Bowman is a first-time mom from Fairmont, WV. She recently experienced one of these speedy discharges. She wrote to me: ``I was surprised by the almost drive-thru like approach put on bringing a precious new life into the world. The information concerning the baby and personal follow up care comes fast.'' ``I was,'' she said, ``exhausted. I couldn't understand it all. It was new to me. I couldn't take it all in. I was still recovering from the birth experience.'' ``The total length of my stay after delivery was approximately 20 hours.'' Mr. President, in concluding, I say that one would hope that the Congress would not need to legislate on this kind of matter. I mean, to be quite honest with you, I think it is rather shocking. It is the kind of thing that you think that the private sector would pick up immediately at the first sense of difficulties and simply stop. But, no--insurance companies are motivated by other things. I would think that we could trust insurance companies to do the right thing on an individual case-by-case basis. What is so strange about that? What is so radical about that? To let doctors make patient-care decisions without concern of financial or other penalties being imposed on them. Of course, what I am saying is, if doctors who belong to HMOs want to keep the mother more than 24 hours, they may be threatened, saying, ``You either start discharging after 24 hours or you're off our payroll.'' Do not think for a moment that is not happening. It is scary. It is scary. So this bill would require insurers to pay for a 48-hour stay following an uncomplicated vaginal delivery and 96 hours for an uncomplicated Caesarean section. The bill permits, as Senator Bradley said, shorter stays. But, again, it puts the decision in the hands of the physician of the mother to decide if that is appropriate. That is who should make this critical decision, not an insurance company driven by other considerations, including those of their stockholders. Mr. President, I conclude my remarks simply by thanking Senator Bradley and Senator Kassebaum for leading this effort. I again hope we will be able to take this matter up somewhere around Mother's Day. I thank the Chair, and I yield the floor. Mr. PELL addressed the Chair.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, I wish to draw the Senate's attention to a most important development that seems to have gone virtually unnoticed by a great many in the general public. As the co- chairman of the Senate Steel Caucus, I am pleased to report that the story of the resurgence of the American steel industry is a genuine American success story. In the April 16, 1996, edition of the New York Times, there was an extensive article which outlined many of the ways in which American steel companies have been able to rebound from huge losses and, in some cases, bankruptcy. Today the American steel industry is simply the most cost effective, and highest quality steel industry in the world. During the 1980's, as many of my colleagues will remember, the steel industry was confronted with many serious problems, not the least of which was the fact that foreign steel producers, with the approval of their governments, targeted our steel industry for extinction by means of dumping and other unfair trade practices. In response to the threat of our using our antidumping and countervailing duty laws, foreign governments negotiated voluntary restraint agreements [VRA's] with the United States that kept a lid on imports of unfairly traded steel. These VRA's were desperately needed medicine which gave our steel companies the extra boost they needed to rise from the ashes. In addition, Congress worked on a bipartisan basis to maintain the effectiveness of U.S. antidumping and countervailing duty laws. Effective use and administration of our trade laws were--and remain-- absolutely vital to the health of our steel industry. That is why I fought so hard, when we were negotiating the Uruguay round of the GATT, and when Congress was writing the legislation to implement the round, to make sure that the sanctity and effectiveness of our fair trade laws were maintained. Today, some are trying to undermine our trade laws through covert means, to find ways of getting around our trade laws. Mr. President, we can't afford to let that effort succeed. America's steel industry, the backbone of our economy, can't afford to let that effort succeed. However, our trade laws alone didn't bring about American steel's resurgence. Since 1980, U.S. steel producers have invested over $35 billion in modernization--a figure higher than the industry's total cash flow! But the revitalization of America's steel industry has been costly and painful. Between 1980 and 1992, the workforce was cut by 57 percent and 450 facilities were closed. Most of the 235,000 people whose jobs were lost in those down years won't benefit from the resurgence of America's steel industry, but the polishing-up of the rust belt will benefit thousands of other workers and their families. Today, the United States has a world class steel industry. American steel is the lowest cost producer for the U.S. market; U.S. labor productivity--man hours/ton--in the steel sector leads the world; the quality of American steel is second to none; and the United States is emerging as a center of innovative steelmaking technology. As we all know, successful competition in today's global marketplace requires a vigorous manufacturing base. Steel is fundamental to that base and continues to be essential to manufacturing, infrastructure and defense--mainstays of our economy. Mr. President, I ask that the New York Times article entitled, ``Big Steelmakers Shape Up,'' be printed in the Record. The article follows: [From the New York Times, Apr. 16, 1996] Big Steelmakers Shape Up--U.S. Mills Win Back Business at Home and Abroad (By John Holusha) Sparrows Point, MD.--Richard Moore was laid off from the Bethlehem Steel Corporation's sprawling mill here in 1981, one of tens of thousands of workers shed by the American steel industry as it fought to cut bloated costs and fend off surging imports. Now, after a nearly 15-year stint selling auto parts, Mr. Moore is back on the job, one of 400 production workers hired here last year, the first new arrivals since 1979. More are expected to be hired soon. ``The work here is dirtier, hotter, more dangerous and strenuous'' than the sales job, Mr. Moore said during a brief break. But, at $24 an hour in base pay and benefits, it is also ``much better than what I was doing,'' he added. The return of Mr. Moore and his colleagues--and others like them at steel plants around the country--marks the return as well of an industry that was nearly given up for dead in the United States a decade or so ago. Slimmer now and better run, American steelmakers are taking back more and more pieces of their domestic business from competitors in Japan and other countries. And at levels not seen for half a century, they are going abroad with a vengeance, more than holding their own on foreign turf in terms of quality and price, even with the added expense of shipping. Last year, they shipped 7.1 million tons of steel slabs, sheets and structural beams to foreign countries, nearly doubling the 3.8 million tons exported in 1994. It was the best export performance since 1940, according to the American Iron and Steel Institute, the principal industry trade group. And orders are booming this year. As explanation of why he expects to stay on this time around, Mr. Moore pointed to the fact that the tinplating line he works on had sold its full 1996 production capacity by mid-March. Last year, Bethlehem exported 500,000 tons of steel from the plant here, along the Chesapeake Bay about 12 miles southeast of Baltimore. That is up from just 50,000 tons the year before. All in all, the performance last year and the strong orders so far this year ``confirm that the U.S. steel industry has become competitive on a world basis,'' said Peter F. Marcus, a metals analyst at Paine Webber. To be sure, the United States still imports more steel than it exports, at least partly because so many outmoded mills have been closed that the domestic industry cannot fully supply the market. Imports totaled 24.4 million tons last year. And the bulk of the hiring here and at other plants is to replace retiring workers, not to add to the payroll. Still, in one basic category, hot rolled sheet steel, the United States has been a net exporter since last June. And overall employment in the industry--now thought to be around 170,000--has begun to increase as the first few of nearly a dozen new mills scheduled to open by the end of the decade have started production. Taken together, the numbers show just how far American steelmakers have come in changing their old ways, analysts and industry executives say. Those ways were marked by a full plate of inefficiencies: overstaffing, outmoded production processes and poor quality control. Foreign steelmakers, led by the Japanese and the Europeans, saw their chance and moved in. But there were domestic threats to the steel giants as well, from so-called mini-mills, upstart operators that turned out low-cost steel from scrap rather than from raw materials. And some foreign companies bought plants in the United States and began to revamp them. Eventually, the big American steelmakers got serious about survival. They slashed payrolls, shuttered the most antiquated of their hulking mills and spent billions on new technology and equipment. With costs down and quality up, the industry has been positioned of late to take advantage of currency swings that have made American products cheaper abroad. Besides making American steel itself more attractive to foreign markets, the relative weakness of the dollar has helped many domestically made products, from cars to appliances, that contain steel. And that, in turn, has given the American steelmakers a chance to retake at least some of their home ground. Noting that the Chrysler Corporation is exporting steel to Europe to make Jeeps there and that cars containing American steel are being exported in larger numbers than they used to be, Michelle Applebaum, an analyst with Salomon Brothers, said: ``The Rust Bowl in the United States has become competitive again. The steel market is the primary beneficiary of the new competitive heartland in the United States and is stronger than it has been in decades.'' The evidence of the shift is striking in sheet steel, the biggest category and a major component of cars, building materials and appliances. At the beginning of 1995, Ms. Applebaum said, imports accounted for a net market share (subtracting exports) of 17 percent. But by the end of the year that figure was down to 5 percent. ``That means that a full 12 percent share was given back to the U.S. market,'' she said, equaling twice the output of one large steelmaker, Inland Steel Industries. One measure of efficiency is the amount of labor it takes to produce a given quantity of steel. According to Mr. Marcus, the average integrated mill in the United States requires 4.42 hours of labor to produce a metric ton, or 2,200 pounds, of steel. That compares with 4.49 hours in Japan, 4.69 in Germany and 4.71 in Britain. Twenty years ago, when far more labor was required, Japan was the leader, at 11.36 hours, followed by the United States, at 12.49. Steel executives say exports provide a long-term opportunity, though shipments are likely to vary from year to year, depending on domestic demand. Because it costs about $50 a ton to ship steel overseas, the profit margin is less than in a domestic sale. But because blast furnaces must be run continuously, disgorging ton after ton of molten pig iron, manufacturers like having an alternative market if demand fails at home. ``Right now, the domestic market is more attractive, so our exports will probably be less this year than in 1995,'' said Paul Wilhelm, president of the U.S. Steel Group of the USX Corporation. U.S. Steel exported 1.5 million of the 11.4 million tons of steel it made last year. But the company is a permanent player in the export business, with long-term overseas accounts, Mr. Wilhelm said. John J. Connelly, the president of U.S. Steel International Inc., added, ``we see this as an ongoing 4 to 5 percent of our business through thick and thin.'' And while the cheap dollar helps keep that market open, industry experts say, there are other factors. ``Currency has an effect, but in the end if you are low- cost, high-quality and meet customer expectations, you will get business,'' said Curtis H. Barnette, Bethlehem Steel's chairman. This newfound efficiency and quality will have increasing importance in coming years as the new mills begin opening in this country. If products from the new mills can push out imports rather than cannibalize older mills, as has been the case in the past, jobs at places like Sparrows Point look like a better long-term bet. All the start-ups are patterned on mini-mills, which have small, highly efficient work forces. The Nucor Corporation, the mini-mill leader, can make steel at some of its mills with less than half an hour of labor a ton. But the mini-mills may no longer enjoy the big advantage over traditional mills that they had in the past, some experts say. In part, that is because the traditional mills have become so much more efficient. Another reason has to do with the production process of most mini-mills: They have to live with the impurities in the recycled materials they use, and the price of high-quality scrap has been rising. Integrated mills, because they work from raw materials, can better tune the chemistry of their products. Because the price of scrap is likely to keep rising as new mini-mills add to demand, many companies are investing in ways to separate iron from ore that do not involve blast furnaces, which are costly to build and operate. Nucor, for example, is converting ore into iron carbide, a form of the metal that can be added to scrap. As the mini-mills lose some of their edge, the slimmed-down integrated mills should be able to hold their own better on the domestic front, analysts predict. At Sparrows Point, the changes have been profound. In the 1950's and 60's, it was more like an independent empire than a factory. The mill employed about 30,000 people and there was a company town, complete with company-owned housing, stores and schools. There was even a police force and a semi- professional football team. In the late 60's, the company decided to end this paternalistic system and to gradually close down the town. New mill buildings swallowed the remains of the town, and the workers who stayed on the payroll moved to Baltimore and the surrounding area. ``There was a high school where the blast furnace is now,'' said Duane Dunham, the president of Bethlehem's Sparrows Point division. Over the last decade, Bethlehem poured in $1.6 billion for improvements. Everything in the mill is automated and run by computer, allowing only a few people to control the movement of vast amounts of material by watching wall-sized displays. Today the plant employs just 3,250 people and can make 3.5 million tons of steel a year, about one-third of its capacity in the old days. The attitude of the employees and their union, the United Steelworkers of America, has changed as well. At the tin plate plant to which Mr. Moore is assigned, for instance, the rigid union work rules of the past have become flexible. ``We are all cross-trained, so we can fill in for people who are not here,'' said Brenda Matthews, one of the new workers, adding that little distinction was made between men and women. ``Women do the same jobs as men,'' she said, with one exception: Only the men load the heavy bars of tin needed in the electroplating process. Even some of the veterans are whistling a new tune. James Henson has been at Sparrows Point for 25 years, mostly as an operator of a tractor that moves coils of sheet steel prior to shipment. ``In the old days, we had people chasing coils all over the place,'' he said, waving at a warehouse that is easily as long as three football fields. ``Now it is all on computer and we are shipping to our customers on a just-in-time basis. Every tractor operator has a computer and every coil is logged in. It's better this way.''

Mr. ROCKEFELLER

Mr. ROCKEFELLER. I thank the Senator. Change of Vote

Mr. ROCKEFELLER. Mr. President, I seek unanimous consent to change my vote on rollcall No. 82 from yesterday, April 24, 1996. At the time of the vote, I did not realize it was a tabling motion. Had I realized that, I would have voted ``no'', not to table it. This vote change, if I get unanimous consent, in no way would change the outcome of the vote. I, therefore, ask unanimous consent that the permanent Record be changed to reflect that I support the Dorgan amendment No. 3667 and that I oppose the motion to table the Dorgan amendment.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, I agree with the Senator from Oklahoma that this could be the most significant health care legislation that we have passed in a long time, which is why I think it is terribly important that we pass it. What has been made very clear, very distinct throughout this discussion, is that we are in an argument now on MSA. We have not been in an argument on anything else. We are in an argument on MSA. The agreement, from the very beginning, was to take the controversial stuff out; leave that for now, and do it later. It will probably pass on its own, but now is not the time. To back that up, I have a letter from the NFIB. This NFIB letter, signed by Dan Danner, says, ``The NFIB opposes the adoption of any amendment to S. 1028 which would draw a Presidential veto or cause the bill to be defeated in the Senate.'' I repeat the statement of administration policy from the White House, in which they indicated, as their first priority, that for the bill to include medical savings accounts would, as they say, ``create grave risks to the passage and enactment of this bipartisan legislation.'' I think those who are pushing the MSA, for whatever the various interesting reasons that have floated around here for the past several days, ought to bear very carefully in mind that they are putting the entire bill in jeopardy. If the amendment passes with MSA's, as the Senator from Massachusetts said, ``school is out.'' Everything else comes in. The bill is down. The bill is gone. An opportunity is finished. I hope people will take moral responsibility in considering the decision which they are making. In fact, every single serious health policy analyst--and you can laugh at them, except when you realize they are just about the whole gamut--they all say that giving a tax break for medical savings accounts is a very bad idea. I repeat--it is a very bad idea. Medical savings accounts, they say, would cherry pick the healthy people --yes--and drive up health care costs for the sick--yes. Medical savings accounts would further destabilize an already seriously fragmented insurance risk pool. And of course we understand what that means. The insurance risk pool gets fragmented when companies self-insure; many big companies do that now. They did not 25 years ago. That puts more pressure on the small business market where you have individual insurance. It is a very, very risky business in any event, without thrusting MSA into it. Another thought worries me. The Republicans put MSA's into reconciliation, with respect to Medicare. CBO has determined that only about 1 or 2 percent of Medicare beneficiaries would, in fact, select a medical savings account. But let there be no doubt in the mind of anyone here that what is hoped is that the MSA's would spread, indeed, to the whole concept of Medicare. This should represent to every one of my colleagues a very severe threat to the future of Medicare. That, I think, is what is in mind here. Furthermore, CBO concluded that healthy seniors would opt in and out of traditional Medicare based on whether they thought they would be using health services in that particular year. In other words, there would be no predictable pattern. Lewin-VHI, a well respected consulting firm, concluded that ``An optional health coverage program that promises potential cash benefits to persons who are able to keep their health spending low will experience extreme selection bias.'' The American Academy of Actuaries has also been quoted. This is an interesting quote from them. ``Those who have little or no health care expenditures. . .would save money on MSA's. The greatest losses will be for those employees with substantial health care expenditures. Those with high expenditures are primarily older employees and pregnant women. A report from the Congressional Research Office, written by the nonpartisan folks there says, ``If MSA's only attracted the healthy, the cost of insurance for everyone else would increase due to adverse selection.'' The Kaiser Family Foundation has concluded that, ``Enrollees who leave the traditional Medicare plan would be healthier on average than those who remain in the traditional plan.'' Again, notice that threat--the Medicare beneficiaries lost to MSA's would be healthier on average than those who remain in the traditional plan.'' That foreshadows an ominous future for Medicare. And you have this broad, broad coalition that is saying exactly the same thing. Mr. President, I do not think it is any secret that there have been special interests working very hard on this in the last several days, and those who are in the process of making up their mind at this point, I think, might consider that there is really one group that is especially interested in this particular medical savings account activity. Their president was working the entire Capitol yesterday and saw a number of people. In exchange, they are hoping to win approval of a special tax break that they hope will throw millions of dollars in new insurance business their way. Is that a crude thing to say? I do not know. I think it is a major part of this debate, and I think it is a major part of the reason that we are in a debate we should not be in at all. Debate on this bill was to be based on the clear premise that we agree that controversial stuff should be left out--so we can take, as the Senator from Oklahoma said, 25 million kids and adults and improve their lives substantially, in terms of health care. This is a bill which enjoys strong bipartisan support. MSA's do not enjoy strong bipartisan support. I have to conclude that the vote on this will be very close, and I hope as people vote, they will consider the pressures which have been brought, particularly by one single company, on Members on both sides of the House and the Senate. Are we really going to do their bidding, or are we going to help 25 million people in this country when we have a historic chance to do it? I think the answer is easy. I hope my colleagues will move to strike the MSA provision. I thank the Presiding Officer.

Mr. ROCKEFELLER. Mr. President, I ask unanimous consent that Greg Jones, a legislative fellow in my office, be allowed privileges of the Senate floor.

Mr. ROCKEFELLER. Mr. President, I want to congratulate the Senator from Tennessee for the remarks just made. There is really an extraordinary synergy between Senator Kassebaum and Senator Kennedy which has produced this legislation. It is interesting. I was home last week in my State, and I was talking about this bill. As I talked, a lot of the feelings that a lot of us had 2 or 3 years ago began to come back. When the larger comprehensive health legislation failed, it was just pulled to the ground by Harry and Louise, special interests, and other things, there may be a feeling out there in the land that, well, since that did not pass, I guess things must be going better. Of course, that is not true. Things are really worse. The system is in worse condition than it was at that time, and people, I think, increasingly know that. I think what we have to do is wait for a renewed demand, a broader demand, a broader anger on the part of the American people so that they will speak to us with more clarity than happened in the last go-around and we can respond. But in the meantime, Senator Kassebaum and Senator Kennedy saw an opportunity to take certain very specific and important parts of this problem and solve them, and they did so in a way which was so successful and so agreeable that the vote was unanimous from that committee. The Labor and Human Resources Committee has a reputation for having a good deal of bipartisanship. But it is also a committee where there are sharp differences of views and, therefore, the unanimity of the vote I think is a very, very good sign for the Health Insurance Reform Act of 1995. I think that we have to be fully aware that people in this country desperately want and thoroughly deserve the security that health insurance will not disappear the way it does now. The Senator from Tennessee was talking about how he could see that fear in people's faces. I am not a physician, but I hear that constantly in my State of West Virginia. When it disappears, it disappears cruelly. It disappears without warning. It disappears often because people are simply just laid off because of downsizing or because of other economic factors. It always affects, it seems, millions of hard-working men and women, people who are playing by the rules every day. I think today is our chance to really do something. I think we can do our job for the West Virginians, for the South Dakotans, the Kansans, and other Americans everywhere who are out there doing their job but still fear the loss of health insurance. Health insurance is a little bit like air. Sometimes you take it for granted. All of a sudden it is not there. You panic very quickly, and I think a lot more Americans are doing that. Some people, in fact, are estimating--a lot of people are--that by the year 2000, which is really only 3-plus years off, that 50 percent of Americans who work for a living--not 50 percent of Americans but 50 percent of Americans who work for a living--will not have health insurance. So, this problem just continues to get worse and worse. Yet, the Labor and Human Resources Committee has made a substantial improvement if we are able to pass this bill and if we can do it without controversial amendments. I will have more to say about that as the day goes along. I have, frankly, waited for this day for a long, long time, and I am filled with a sense of gratitude and a sense of relief that we are finally, as a body, going to do something which is meaningful. If everything really goes well, we may do this by the end of the night or tomorrow night. But the point is we really have a chance to do this. I do not know of a great deal of criticism about this bill on the part of my colleagues. Relatively few people on the outside are criticizing it, and, therefore, I have a good feeling about it. The so-called Kassebaum-Kennedy bill, the Health Insurance Reform Act, would establish some of the most fundamental and far-reaching changes in health insurance since the creation, in fact, of Medicare and Medicaid in 1965. I, therefore, again salute the two Senators, the chairman and the ranking member, for their really inspiring bipartisan partnership in crafting and advancing this very important legislation. I think we all remember, as I indicated--it seems like a long time ago, but it really was not--that there was a mighty debate in this body about guaranteeing health insurance for every man, woman, and child in this country. I believe that must still be the goal and the vision for America. I believe that as strongly as I did at the time. I believe in that even more strongly as I watch what is happening to more and more people as they lose their health insurance even though they are working. Mr. President, that comprehensive effort at that time to reform our country's health care system was stopped. But, again, the problems of losing health insurance continue. That is why in a sense we have won, through the good work of Senator Kassebaum and Senator Kennedy, we have won another chance to enact something which is really meaningful in the way of health care reform. The people of our States are still writing, calling, visiting, and asking for help. I am going to do whatever I can to make sure that we do not let this opportunity pass us by--that we will not fail on this and that we will make a real difference in people's day-to-day lives. That is why we simply have to also exercise restraint and not kill this bill with extra baggage. It is tempting, but it cannot happen. Amendments, whether they are well-intentioned or not, which are controversial will have the effect of bringing this bill down, and we all know that. We have to be very careful as we go through this exercise that we do not accept controversial amendments. I think this bill is going to solve some really horrible problems for real people. So why would we accept controversial amendments which we might otherwise support, as the Senator from Massachusetts said, when it could pull down the chance to do something really good for a lot of people? During debate on comprehensive health care reform several years ago, many of my colleagues--especially those on the other side of the aisle--said repeatedly that we should only enact those health reforms on which there is a strong bipartisan consensus and support. Well, here we have it. Here we have that piece of legislation. That is the precise description of this bill, S. 1028, which is before us today. It was so carefully crafted by the chairman and the ranking member; it came out of the committee by unanimous vote; it is a bill which should be sent to the President for his signature, and I am certain, although one never knows, that he would sign it. Loading up this bill with extraneous provisions which will please certain special interests but only delay enactment of health reform just does not make any sense at all. So, Mr. President, I intend to join the floor managers of this bill and Minority Leader Daschle in opposing any controversial amendment that will delay enactment of this bill--any controversial amendment, even if it means voting against amendments that, as I have indicated and so have others, have merit on their own and I would fight to enact in other terms and other circumstances. We cannot be distracted from the basic purposes of this bill, which are terribly important. Almost 40 million Americans lack basic health coverage today. It is going up about a million plus every year, Mr. President. It has been doing that regularly, and it will continue to do that, perhaps at an accelerating rate. One cannot be sure. Most of the people who are not lucky enough to have health insurance, with cards in their wallets or back pockets, are in fact the people we revere and honor in this body, and that is they are the hard-working, middle-class families who are victims of layoffs and downsizing or just plain profit gouging. This country offers the best health care in the world. Nobody has ever denied that. It is terribly true. Unfortunately, that health care continues to be beyond the reach of too many of our fellow citizens who do not deserve that lot in a country that is as outstanding and great as ours. As both Senator Kassebaum and Senator Kennedy said, this bill before us today will not solve all of the problems in the health care marketplace. I think it was Senator Kassebaum who said that the so- called guarantee issue, or guaranteed coverage, for that matter, for every man, woman and child in this country has not diminished. The bill is not going to solve it. I still believe it is a fundamental right for each and every one of us, not just for those who can afford it or are healthy enough to keep insurance companies profitable. But again, the machinery of our health care system is breaking down, and this bill helps substantially. If we cannot therefore enact a complete overhaul, if we are not going to be able to do that in this session, we must enact the individual fixes and the individual reforms that will at least keep the engine of this system running. Evidence of this need for an overhaul of our health care system is everywhere. It is found in the emergency rooms of our public hospitals, collapsing under the demand of the growing millions who need medical treatment but cannot pay for it. It is found in our schools where far too many children go without immunization and preventive care. It is found in the rooms of our nursing homes with so many residents being uprooted from their homes and neighborhoods because of their inability to afford community-based alternatives. They are forced onto Medicaid. They are institutionalized because their savings have been exhausted, and on and on. Mr. President, individuals and families go uninsured for several reasons. Often health insurance coverage is simply not available, or what is available is not affordable. The effect is the same. Health insurance often lapses after a worker is laid off and COBRA extensions that affect certain larger industries have expired. Entrepreneurs who leave their jobs to start their own businesses, which is what we glory in America--IBM used to have it all and then people started going out and creating all kinds of other things. That is what we do in America. We are a country of entrepreneurs. Entrepreneurs who have to leave their jobs or want to leave their jobs to start their own companies because they think they have a better idea are sometimes unable to convert their group health insurance policies to an individual health plan, and, even more tragic, insurance coverage is often terminated by an insurer just when that insurance policy is needed the most, when an individual or a family member experiences a really serious, devastating illness or disability. How reliable is a guarantee, so to speak, of health coverage when the health plan issuer acts in its own self-interest or cuts the safety line by either terminating a policy or increasing the premiums beyond the ability of the individual to pay, thus, in effect, accomplishing the same end--cutting that person off. The Health Insurance Reform Act of 1995 makes significant strides to address each of these two problems, and that is why it is such a good bill and needs to be passed. The Health Insurance Reform Act will strengthen the safety net for millions of Americans by improving portability and security of private health insurance, especially in the small group and the individual insurance markets. I support this bill because I personally have heard the stories of hundreds of West Virginians who have fallen between the cracks of our health care system. Mr. President, I wish to just give three personal examples that I know of and then end with a statement from the White House. Mr. President, I want to start--and these are all people who would be helped by this bill, and the examples are so many--with one Norma Schoppert, who lives in Piedmont, WV--not large, near the top of our State. Several years ago, she developed diabetes. Lots of people do. When her husband was working, Mrs. Schoppert was covered by the health plan offered by his employer. That is understandable. But then he retired in 1991 and became eligible for Medicare. When that happened, she was able to extend her own health insurance coverage for 3 years because of the COBRA provisions that affected his health insurance, and thus she was able to pay monthly premiums of $354 and continue full health insurance coverage under COBRA for 3 years. But that only lasted from 1991 to 1994, those 3 years. Mrs. Schoppert was offered an individual policy when her COBRA extension expired at a monthly premium, Mr. President, of $1,800. So you understand the effect, $354 in the COBRA extension, $1,800 without it. In effect, obviously, she could not pay that. She could not afford to pay this amount, so she has now no medical coverage at all. And unless the system is reformed, she will have to go without insurance until she qualifies for Medicare, which is still 3 years away. Now, Mr. President, that means, as the Senator from Tennessee indicated, 3 more years of anxiety, 3 more years of fear, worrying about the risk of losing everything that she and her husband worked all of their lives to build. And we say that sentence so easily; it just rolls off our tongue. But these are gigantic tragedies in the lives of real people. Second example. Juanita Taylor of Elkins, WV. Just a few years ago, she was a hard-working employee at Davis & Elkins, which is the local private college, but then she developed multiple sclerosis. She kept right on working, struggling to overcome the advancing weakness that her illness caused her. When she was, in fact, really too weak to meet the demands of her job, she lost her job and eventually the health insurance that had provided. Her neighbors and her friends pitched in to help her pay for a wheelchair, so that she could stay connected and involved with her community, so that her morale would be better. Those friends and neighbors told me that she was forced to pay out- of-pocket costs of $1,000 per treatment to help slow the advance of her multiple sclerosis. How many people can pay $1,000 per treatment? Although she now has Medicare, her medical expenses ate up all of her savings. Juanita Taylor courageously faced and fought a ravaging disease, only to be victimized by a system that cared more about how much money she had in her pocket than it did, quite honestly, about her health condition. But the final story, and the saddest one of all, it seems to me, comes from Falling Waters, WV, which is in Berkeley County. In 1990, Walter McPeak and his wife, Karen, were granted custody of Mr. McPeak's two sons, Anthony and Thomas. They wanted these boys. Both the boys have severe hemophilia and hepatitis, as well as the social and the emotional difficulties that come from living in constant fear that even the slightest injury could result in terrible trauma or instant death. At the time the boys came to live with them, both Walter and Karen McPeak were employed in high-paying management jobs. Together they earned a little over $80,000. But their employer's health plan would not issue coverage for Anthony or for Thomas. Their need for special clotting factors and other treatments means medical costs of several thousands of dollars each week. So it was not long before the McPeak family had used up all of their savings. They had to sell their house and then they sold their first car, and then they sold their second car, but still the costs climbed and there was no help in sight. When they tried to apply for Medicaid-- which you can imagine they did not want to have to do--because Medicaid would have helped pay for their sons' treatments, they were told that their family income was too high for the boys to be eligible for SSI, which would automatically make them eligible for Medicaid. So, what choice did Walter and Karen McPeak have to make? In order to qualify the boys for SSI, which was their moral and parental responsibility, they gave up their management jobs, both of them, over $80,000 a year, and took minimum wage, unskilled jobs so their income would not exceed allowable limits for them to qualify for SSI and hence Medicaid. This is a tragedy and this is a travesty. It should never happen in America. Anthony and Thomas got health insurance; yes, they did. But the McPeaks lost their savings, their home, their car, their jobs, probably a good deal of self-esteem--although not on a moral basis; and their employers, of course, lost two highly skilled managers. So we must pass health insurance reform in the form of this bill. The bill we are considering is not a perfect solution and nobody has made that claim. But it will go a long way toward ensuring that working Americans and their families are able to keep the health insurance that they have, if they lose or if they change jobs. This legislation will mean that families like the McPeak's, who have children with special needs, will have the protection and have the security of insurance coverage. And it will mean that talented and hard-working individuals with new and creative ideas, entrepreneurs, will be free to go out and start their own businesses, because of this reform bill, without the fear of losing their health insurance. Again, I thank and congratulate Senators Kassebaum and Kennedy for their enormous leadership that gives us this historic--and it is historic--chance to do something that Americans deserve and want so badly. I conclude with a statement of administration policy. This is just for the edification of the membership. I read from the administration's latest statement of administrative policy: Certain provisions included in the House-passed bill are so controversial and so potentially damaging to the health care system that they jeopardize enactment of the insurance reform that Americans want signed into law this year. Specifically, the inclusion of amendments that, one, provide for medical savings accounts, MSA's; two, deregulate multiple employer welfare arrangements--MEWA's; three, impose federally defined caps on punitive and noneconomic medical malpractice awards; four, undermine Medicare fraud and abuse efforts; and, five, weaken the ban on the sale of duplicative insurance policies to the Medicare beneficiaries, would call into question the seriousness of the commitment of the Senate to health insurance reform this year. The administration views such provisions as an effort to undermine a bipartisan consensus on health reform. If such amendments are adopted, they would create a grave risk to the passage and enactment of this bipartisan legislation. Mr. President, I yield the floor. Mr. KENNEDY addressed the Chair.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, the Senator from West Virginia would ask simply for 1 minute to make the following observation. Earlier this evening there was substantial nonpublic discussion as to nondiscrimination and long-term care. There was then a very helpful, constructive, and useful colloquy on the floor which agreed that in the tax preferential treatment of long-term care, that nondiscrimination would be completely treated. There was some disagreement as to what Treasury was saying constituted nondiscrimination and what the Finance Committee staff said constituted nondiscrimination. There seemed to be a difference. I simply, as a member of the Finance Committee, wanted to go on record as saying that the nondiscrimination aspect--this is not just racial, but we are talking just about the higher employer as opposed to the lowest employer--that nondiscrimination be done in the usual, customary, and effective manner for the tax preferential long-term care matters that we are now discussing. Amendment No. 3690

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, today, I would like to take a moment to recognize the 40 finalists in the 55th Annual Westinghouse Science Talent Search. These exceptional American youth--hailing from 13 States, including my home State of West Virginia--are being honored as the Nation's brightest high school math and science students. This program, sponsored by the Westinghouse Foundation, in partnership with Science Services Inc. since 1942, awards America's most prestigious and coveted high school scholarships in math and science. This year's finalists are among 1,869 high school seniors from 735 high schools located throughout the 50 States, the District of Columbia and Puerto Rico, including two West Virginia students, Namoi Sue Bates of Franklin and Bonnie Cedar Welcker of Parkersburg. Their independent science research project entries cover the full spectrum of scientific inquiry, from biology to solid state luminescence. The honor of being named to this group far exceeds the value of the scholarships and awards bestowed. Over the years, finalists have included five winners of the Nobel Prize as well as those who have achieved brilliant careers in science, medicine, and related fields. Mr. President, I want to commend each and every one of these outstanding American teenagers who truly embody the American dreams of discovering, curing, inventing, and changing the world.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, I am a proponent of responsibly reducing the deficit, as are many of my colleagues. I, too, want to eliminate wasteful spending. But this conference report on the line- item veto bill is not the right way to ensure deficit reduction or responsible fiscal management in my view. As articulated so poignantly by my colleague from West Virginia, Senator Byrd, the line-item veto legislation raises many constitutional problems and it substantially alters the balance of power devised by the Framers of our Constitution. Before supporting such a dramatic change in the balance of powers, we need to examine it in light of what it really offers our country. Giving a President broad power to cut discretionary spending concerns me in theory, but it troubles me even more to think about its potential effects in practice. A President may hastily veto substantive provisions of a spending bill, which he considers wasteful, but which really are essential programs for States or regions. One person's perception of waste or pork may be another person's funding for roads, schools, needed housing, or rural hospitals. Or a President could even wield a line-item veto as a political tool to intimidate a particular Member or groups of Members. A specific example is the recent history of funding for the Appalachian Regional Commission [ARC]. Recent Republican Presidents sought to eliminate the Appalachian Regional Commission [ARC] from the budget, but a bipartisan group within Congress maintained this important program to promote economic development in some of the poorest counties of our country. The ARC provides basic funding for infrastructure and economic development. In representing West Virginia's interest, I do not believe that Congress should give any President free range to cut discretionary spending. Under the line-item veto, a President could veto spending for the ARC, or other discretionary programs ranging from highway projects to housing programs. It is important to note that the present system already offers a way for the President to express his dissatisfaction with provisions in spending bills, known as the rescission process. Although this process might need to be streamlined and simplified, the President already has the ability to call for the rejection of specific programs within spending bills. Through the rescission process, the President can call on Congress to make more immediate cuts in areas which he thinks are wasting taxpayers' money. The President can single out items in spending bills that he opposes, and if Congress approves the budget cuts are made immediately. I agree that Congress needs to chart a careful course for deficit reduction and economic growth, and I continue to vote for cuts in specific programs where I believe Congress has wasted taxpayer money. I do not, however, want to risk the careless elimination of critical programs which benefit West Virginia and other States. And I do not want to irrevocably alter the balance of power between Congress and the executive branch which was enshrined in our constitution over 200 years ago. I think Congress has duty to be excruciatingly careful when fundamental rewriting of our Constitution is being considered. This conference report has not been given proper consideration and I disagree with its intent on principle. I oppose passage of this conference report.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. And would you agree with me that the ``product sellers'' provision, as it applies to rented or leased products (section 103(c)(2)) in the conference report which states that a `` `product liability action' means a civil action brought on any theory for harm caused by a product or product use,'' cannot be interpreted to mean use of alcohol, or use of a gun?

Mr. ROCKEFELLER. Mr. President, I thank the distinguished Senator from Washington. The debate now is about over, and we are about to vote. We are about to vote on a bill which I think is profoundly important, not only in the symbolism of it but in the reality. You cannot have an engine in a car that is invented by 51 separate people who do not communicate with each other and expect the engine to move the car forward. Similarly, you cannot protect and extend predictability and fairness and consumer protection--for example, as witness the statute of limitations--to help people in this country get justice from injury, from defective products if the engine that they have to depend upon is invented by 51 separate people who never talk to each other, and then somebody turns the key on and who knows where the system goes, or where the car goes. Probably nowhere. We have a system that works particularly well for a few. We have, however, a system that works particularly poorly for the most. It is the job, it seems to me, of the U.S. Senate and the U.S. Congress to try to improve the condition and the lot of our people in a fair and balanced manner. One cannot reasonably come into this Chamber all the time and say, ``I'm only going to do things which will help an injured person but pay no attention to other aspects of their life,'' for example, whether they are employed, whether they have a reasonable expectation of having a job. What we have tried to do in this product liability conference report is to make a fair, reasonable balance between the interests of consumers and business. We have done that. We have had asserted constantly against us that we have not, assertions which are made every year we discuss these things, which are wrong. So now we are prepared to do something, and I fully expect the Senate will adopt this conference report. It is an important bill. I repeat that I hope the President of the United States, who I think very much wants to sign a product liability reform bill--in fact, I am told very directly that he wants to sign a product liability bill. The question is what condition must it be in. I think we are presenting the President with a fair bill, one in which the Senate did not try to expand beyond products, one in which the Senate rejected virtually all other suggestions in which the only basic change was the statute of repose. It is a very good bill. There is no other way to say it than that. I also want to thank the Senator from Connecticut, Senator Lieberman, for his enormous role in all of this product liability debate, and his chief of staff, Bill Bonvillian, who is also an extraordinary person, who has been unbelievably kind and attentive to my legislative director, Tamera Stanton, to whom I referred earlier, who is going through a difficult situation just now. This is fair. This is the way America ought to work. The bill, I believe, will pass. I can only pray that the President will sign it. I thank the President and yield the floor.

Mr. ROCKEFELLER. Mr. President, section 103 of the bill, the so- called product sellers provision, imposes liability when a product seller fails to exercise reasonable care with respect to a product. If a tavern owner fails to exercise reasonable care in selling alcohol to an intoxicated person, would that case be subject to the bill?

Mr. ROCKEFELLER. Thank you for that discussion. I hope it will help counter some of the misinformation that has been circulating regarding this provision. Is there any special provision of the bill that emphasizes what you have said here today?