Jay Rockefeller

Mr. ROCKEFELLER

Mr. ROCKEFELLER. I ask unanimous consent that the Senator from West Virginia be allowed to speak for 5 minutes as if in morning business.

Mr. ROCKEFELLER. Will the majority leader yield? The Senator was just interested in when the Medicare Select conference report will take place?

Mr. ROCKEFELLER. I thank the majority leader. Vote on Amendment No. 1473

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, because I know a lost cause when I see one, I concede that the majority leader is succeeding in passing what is known as the Medicare select legislation tonight. The conference report will pass tonight. Nobody else will comment on it, but I will. I just hope I will not be tempted into saying, ``I told you so'' a year from now if some troubling signs turn out to be an omen of serious problems. For some reason, many of my colleagues on the other side of the aisle are adamant about rushing to expand a pilot project limited to 15 states into one for all 50 States. The conference report is an agreement to make this extension, but only for 3 years instead of the 5 years that had been passed by the House. I still think 3 years is too long, but I have assurances from the chairman of the Finance Committee that we will have a hearing or hearings, and a good faith process, to consider whether any changes are warranted. What is Medicare select? Medicare select is a managed care insurance policy that is sold to senior citizens to fill in the gaps of Medicare coverage, of which there are many. It differs from other MediGap policies because it only pays Medicare's cost sharing amounts if the senior citizen receives his or her medical care from an insurer's selected network of health care providers. What bothers me is the rush to expand this limited program before an evaluation of this demonstration project, done at the direction of Congress is completed and reviewed in oversight hearings. As the proponents of this push to expand the program know, the independent researchers evaluating the pilots will have their analyses completed by mid-August and a draft final report submitted by October. Leapfrogging over a careful effort to review a demonstration project, in order to decide if and how to expand the approach, is not the way to do business with Medicare and its beneficiaries. I think it is a mistake. I think it is bad precedent. I have to wonder whether it has to do with special interests eager to see this program quickly expanded. I think it is a mistake to ignore emerging signs that this approach to the marketing of medigap policies may be costing Medicare rather than achieving savings. When the majority of this body has just told senior citizens of America they want to cut Medicare by $270 billion, where is the sense in also extending a program for 3 years that might drain Medicare even more. Just in recent days, another yellow line started flashing. Based on reports routinely submitted to the Government from the top notch research firms conducting the Medicare select study for HCFA, some startling findings have been reported on how the Medicare select program is operating. They are finding that Medicare select enrollees had significantly higher Medicare costs in comparison to seniors with regular medigap insurance. The Congressional Budget Office agrees that the new study raises serious questions about the operation of the Medicare select program. On average, Medicare's costs have increased 17\1/2\ percent--higher-- under Medicare select, which we are expanding to all 50 States. Only one State, Missouri, experienced lower Medicare costs for its Medicare select enrollees. Mr. President, 8 States had higher Medicare costs for its Medicare select. Alabama, 12 percent higher; Arizona, 23 percent; Florida, 8 percent; Indiana, 57 percent higher; almost 6 percent in Kentucky; 7.5 percent in Minnesota; 12 percent higher in Texas; and 14 percent higher in Wisconsin. And so it goes. Researchers believe the bulk of these cost increases were a result of greater hospital costs. This information was not available to the Congressional Budget Office when it did its cost estimate of the original Medicare select legislation. At that time, CBO was forced to rely on very preliminary research that was done by these same researchers. The information then was limited to case-study information and did not include actual analyses or a comparison of utilization data. Mr. President, this is why I remain troubled about this legislation, this conference report, which will be passed tonight and then become the law of the land. Serious questions have been raised about the operation of the Medicare select program, yet a conference report is about to be passed that gives the green light to 3 years of taking this program to every single State. It is maddening that just when there is all the railing about the Medicare trust fund and its solvency, some of my colleagues are so anxious to expand this program with a disregard for its potential drain on the part A trust fund. There are all kinds of questions to answer before I would be comfortable expanding or extending this program. That is why Congress for this evaluation. That is why I believe we wait for the final report and take 3 hours out of our day in the Finance Committee to hold a hearing on what was learned. Instead, we are seeing this rush to pass a bill. The independent researchers have a full year of data from 1994 and are currently in the process of analyzing this data. It will take them about a month to complete their analysis of this insurance data. The data cited previously mostly reflects Medicare's cost experience in 1993. While the researchers have already controlled form many variables, they plan to try to better pinpoint the reason for these very significant Medicare cost increases. This additional information-- which will be available in only 1 month--would provide Congress with much better information and will tell us if the Medicare cost increases of Select enrollees are a one-time phenomena or a continuing trend. It would also help us figure out the reasons for the higher Medicare costs of beneficiaries enrolled in Medicare select plans. It would provide us with information which would make sure we didn't enact a major new expansion that primarily benefits insurance companies without making sure the Part A trust fund was not going to be drained of funds. Are sick seniors merely signing up for Medicare select managed care products in record numbers? This would be an unexpected finding since people with serious health care problems normally avoid managed care plans, if they can. Or, are sick seniors somehow being steered into Medicare-select plans by insurance companies and away from risk-based HMO's? In addition to analyzing 1994 utilization data, the research team is also completing work on beneficiary survey which will include beneficiaries' own stated reasons for signing up with the Medicare select plan. Mr. President, it is not often that legislators are able to have research of this caliber available on a Medicare legislative initiative. Yet, we are choosing to ignore the red flag that these research findings have raised. According to the Congressional Budget Office, the Medicare Program is currently overpaying HMO's by about 5.7 percent per person because of Medicare's payment methodology which does not take into account the tendency of healthier seniors to sign up with HMO plans. This legislation before us today could--because of the special advantages Medicare select insurers have been granted in obtaining discounts from hospitals--have a similar effect. Insurance companies make money while the Medicare Program loses money. Mr. President, the legislation before us today is preferable to the House bill that was originally brought to the Senate floor. Instead of extending the Medicare select program to 50 States for 5 years, this legislation expands it to 50 States for 3 years. This is still longer than I would have liked. It is longer than the original Senate bill which was the result of a compromise reached between myself and the majority leader, Senator Dole, and Senators Packwood and Chafee. The legislation will also allow the HHS Secretary to discontinue the program if the Secretary determines that the Medicare select programs is resulting in higher premium costs to beneficiaries or in higher program costs to the Medicare Program. Mr. President, I look forward to an oversight hearing in the Finance Committee on the Medicare select program which--under a prior agreement with Senators Dole and Pakcwood--will be held once the final evaluation study has been completed. And I am committed to working with the chairman of the Medicare Subcommittee, Senator Dole, on any legislative modifications that may be necessary based on the committee's oversight hearing, the RTI study, or from the results of a GAO study--that was added to the Senate bill and retained in the conference agreement--that requires a study of the medical underwriting practices of Medigap insurance policies. Again, I hope I will never have to say ``I told you so'' on behalf of the Medicare Program and the senior citizens who count on us to look before we act. Mr. President, I yield the floor.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, I am very pleased to be here with my colleagues from Montana and Iowa, Senators Baucus and Grassley, to introduce a bill for rural America. The point of our bill is to help make sure that the people living in rural areas--who are disproportionately elderly--will be assured access to vital health care services, especially primary care and emergency care services. Our legislation is an effort to make sure that senior citizens are not forced to travel long distances in emergency situations or for simple, but life-saving reasons like getting certain tests. Getting reliable access to health care services has always been a struggle for the people of rural West Virginia and the rest of the country. Now, as major changes are unfolding in the delivery of health care and throughout the health care system, many rural hospitals are being forced to re-examine and re-focus their mission and their capabilities. Our bill steps in by giving rural hospitals across the country an important option that rural hospitals in West Virginia and 7 other States already have to be more responsive to the people in their areas. Under this bill, rural hospitals will be relieved of burdensome regulations that may interfere with their ability to meet the most critical health needs of their local community. Currently, most rural hospitals have only one choice when faced with declining occupancy rates, declining Medicare and Medicaid reimbursement rates, and intense market pressures to lower their costs: closing their doors. Small, rural hospitals are simply not able to take advantage of the ``law of large numbers'' and economize like larger hospitals can. Under our legislation, when a full-service hospital is no longer sustainable, critical access hospitals will assure rural residents basic access to essential primary care and emergency health care services. This legislation is modeled on two separate, ongoing rural hospital demonstration projects. It is modeled after a demonstration project in Montana, called the Medical Assistance Facilities or MAF Program which has been in existence since 1990 and the Essential Access Community Hospital and Rural Primary Care Hospital Program, more commonly referred to as the EACH/RPCH Program which exists in seven States. Under these demonstration programs, limits are placed on the number of licensed beds and patient length of stays in the participating rural hospitals. In exchange, hospitals receive slightly higher Medicare payments to cover the important services they do provide--along with relief from Federal regulations that are intended for full-scale, acute care hospitals. We believe, based on new cost information collected by the General Accounting Office, that our legislation will actually save the Medicare Program money. By giving hospitals some flexibility on staffing and other Federal regulations, hospitals can staff-up based on their patients' need, not just to meet regulations meant for completely different situations. We want to encourage the development of rural health networks, to help small, rural hospitals save money and improve quality by tapping into the resources of larger, full-service hospitals. The labors of health care should be divided according to who can do what best, but there absolutely is a role for rural hospitals and a reason for Congress to help them survive. Mr. President, this legislation will make sure that rural residents will have immediate access to emergency care, and that they and their families won't be forced to travel long distances for routine medical care. Rural residents who need just a short stay in the hospital can stay and receive their care at the local hospital rather than traveling to a usually more expensive medical center. The magnitude of Medicare cuts that are included in this year's budget resolution make this legislation especially critical. We must make sure that rural hospitals have the ability to react to huge Medicare cuts by becoming more efficient and closing down unused beds rather than by simply closing their doors. I am very proud to note that West Virginia has been a leader in helping small, rural hospitals figure out how to adapt and cope with rapidly changing economic circumstances. Webster County Memorial Hospital and Broaddus Hospital in Philippi were two of the first few hospitals to be designated rural primary care hospitals nationwide. Seven other West Virginia hospitals are currently considering making the transition. According to Steve Gavalchik, the administrator of the Webster County Memorial Hospital, if they had not been able to take advantage of the EACH/RPCH Program, the hospital might have been able to hang on for only about 16 to 18 months more before being forced to shut its doors. Now, Webster County hospital can focus on doing a few things well. Networking with an essential access community hospital has been invaluable as Webster County has made the transition to a rural primary care hospital. United Hospital Center, their hospital partner, has provided technical assistance, financial advice, quality assurance and quality improvement support. For the people of Webster County, access to basic and emergency health care services would have been severely curtailed if Webster County Hospital had been forced to close. The nearest hospital is 43 minutes away--in the summer. In the winter, the drive is much more treacherous and takes up to 1\1/2\ hours or more. Patients with chronic obstructive pulmonary disease [COPD], diabetes, pneumonia, and congestive heart failure are the most common diagnoses of patients admitted for short term stays. Just imagine if these patients, most of them elderly were forced to travel an hour or so to get routine hospital care, not to mentioned the extra costs that would be involved for them and their families. Family practice services are now available on site at the hospital because the doctors in the town moved into unused space. The doctors' practice have benefited from sharing resources, and the local health department has moved its headquarters to the hospital complex. As a result, the hospital and the local health department are now working together in ways they would have never thought of before. More important, patients benefit from the ease of having a central place to go to take care of their routine health care needs. According to the hospital administrator at Broaddus Hospital, Susannah Higgins, Broaddus Hospital was also faced with possible closure prior to being designated an RPCH hospital. Now, Broaddus can function as a mini-hospital. Through its relationships with partner hospitals, Broaddus offers oncology, general surgery, ob-gyn clinic services on-site on a weekly basis. Family practice and internal medicine services are available on a daily basis. Lifesaving emergency services are on-site. Just recently a local resident severed his leg in a logging accident. He was transported to Broaddus Hospital in a private car. By the time he arrived at the emergency room he was in extremely, extremely critical condition. Fortunately, he was able to be stabilized and was later transported to a medical center. If emergency services had not been available in the area, there is a very good chance that man would not be alive today. When minutes and seconds literally count, a helicopter landing pad cannot take the place of having highly trained and qualified emergency doctors and nurses available immediately to stabilize and begin emergency care. Webster County Memorial Hospital and Broaddus Hospital are examples of how rural communities can adapt to a changing health care marketplace. This legislation builds on the strengths of the current EACH/RPCH program and the Montana MAF program; improves them; and expands them to all 50 States so that rural hospitals all across America will have the same opportunities. Mr. President, under our bill, newly designated critical access hospitals would be limited to 15 inpatient days and patient stays would have to be the kind involving limited duration--up to 96 hours, although exceptions are allowed in special circumstances, such as inclement weather or a patient's medical condition. In this bill, we ease up on hospital regulations so that critical access hospitals can meet the needs of their community and not the needs of a Federal bureaucracy. We are not easing up on quality standards but have rather allowed hospitals to use common sense when it comes to staffing and certain other Federal standards. For instance, if there are no inpatient beds occupied, hospitals do not have to have a full complement of hospital staff on duty. Medicare reimbursement would take into account a small, rural hospital's fixed costs and the inability of small, rural hospitals to take advantage of some of the cost-saving measures that larger hospitals can implement. Our legislation is targeted at the 1,186 rural hospitals nationwide with fewer than 50 beds. While these hospitals are essential to assuring access to health care services in their local communities, these hospitals account for only 2 percent of total Medicare payments to hospitals. Our country's small rural hospitals needs special attention. This legislation gives them that attention and the ability to adapt to a rapidly changing health care world. Finally, this legislation would require the Secretary of HHS to submit a report by next January on a methodology for Medicare reimbursement of telemedicine services. I recently, along with my colleague from Maine, Senator Snowe, included an amendment in the telecommunications bill--that was passed by the Senate just last week-- that will guarantee rural health care providers affordable transmission costs when it comes to telemedicine and other telecommunications technology. The provision in the bill we are introducing today is another important step to improving access to specialty and state-of- the-art medical care for rural residents. Mr. President, I believe this legislation is critically important and, if enacted, will have an important difference on the health of rural residents across America. I am honored to be part of this effort, and intent on continuing to respond to the health care needs of the people in my State and rural America.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, I am pleased and honored to wish the great State of West Virginia, and my fellow Mountaineers, a happy birthday. On this 20th of June we celebrate not only the courage our ancestors possessed in order to separate from Virginia, a powerful mother State, but also the heritage and sense of independence they left behind. The State of West Virginia has always represented a place of great uniqueness. Our colors are blue and gold. Blue characterizes our bold ability to stand up for the freedom and the equal opportunities that we all deserve. Gold is the dignity of Mountaineers that shines throughout the world. The pride that the people of West Virginia have in their surrounding environment is one that can be found no where else. West Virginia's mountainous terrain offers attractions annually. The white water rafting and golf courses are considered among the finest anywhere. Plus, the 33 State parks include abundant wildlife. Tourists have rave remarks about our historic Blennerhassett Island, Harpers Ferry, and the Greenbrier Hotel. Loyalty is a splendid quality of all the people in this magnificent State. Mountaineers have always supported the education and athletics of their colleges and universities. Through continuous hard work the men and women of West Virginia have attracted numerous industries to the area. Their strong work ethic has helped West Virginia's manufacturing sector to prosper. However, the pride and loyalty of our people extends out from our own boundaries. The people of West Virginia know the importance of freedom; therefore, many have dedicated their lives to serving our Nation. Mr. President, the people of West Virginia share a special bond. Therefore, on this day let us all join together in recognizing and celebrating a very special birthday. Happy Birthday West Virginia.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, I wish to recognize an outstanding woman whose hard work and dedication have touched the lives of many individuals. Indeed, it is rare to discover a character so willing to offer one's talents solely to serve and improve the lives of others. Thus, I would like to take this time to express appreciation for an extraordinary citizen of Nicholas County, Summersville, WV, Helen Cole. Recently, Helen was honored at the Muddlety-Glade Creek Ruritan Club where she received numerous awards, including the prestigious Clara Barton Award, which is known to be the highest award given to volunteer workers. Currently, Helen is employed by Love, Inc., where she helps counsel financial management. Helen, born in Ansted, WV, located in Fayette County, has been a lifelong resident of West Virginia. Helen has received a bachelor of science degree in home economics as well as a master's degree in extension education. In time, she became employed by WVU and USDA extension agents in Nicholas [[Page S 8628]] County, where she taught home economics in the field and in the home. In addition, Helen conducted radio educational programs in Nicholas and Fayette Counties and performed ``Friends and Neighbors,'' an educational television program. Furthermore, Helen assisted as eastern regional director for the National Home Demonstration Agents Association [HDAA], and also served as State president of the West Virginia chapter of HDAA. However, Helen's true colors are revealed through her in-depth involvement with the Nicholas County chapter of the American Red Cross. In the past, Helen has been a Red Cross volunteer for many years and has primarily been responsible for locating volunteers to manage crucial programs, such as blood services, first aid and CPR educational programs, service to military families, and disaster relief assistance. From 1976 to 1981, Helen served as the volunteer executive secretary of the American Red Cross. In December 1980, Helen retired after 34 years of teaching home economics to extension homemakers and soon after accepted the dual positions of full-time chapter managers and treasurer. Although Helen recently retired in December 1994 from her office of chapter manager of the American Red Cross in Summersville, she still remains involved in various volunteer activities in addition to her employment by Love, Inc. For example, Helen continues to volunteer at the Nicholas County chapter of the American Red Cross, where she holds the position of executive secretary and is a member of the board of directors. Also, she occasionally still teaches classes through programs under the WVU extension service concerning lesson leader training. Helen, since 1981, has volunteered with the Food Pantry of the Summersville Ministerial Association, where she organizes food supplies for the pantry. Furthermore, Helen reviews applications for emergency assistance at the Federal Emergency Management Agency program in Summersville. Also, since 1942, Helen has been a Sunday school teacher and continues to teach an adult women's class at Memorial United Methodist Church in addition to a weekly Bible study class. Helen Cole's accomplishments deserve notice and praise. Her enthusiasm and concern for humankind provide a model we should all strive to follow.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, I want to take a few moments to talk about how the Snowe-Rockefeller provision in the bill before us today will assure rural residents that when it comes to their health care they will have the same advantages as urban residents. A shortage of family doctors, pediatricians, nurse practitioners, and other primary care providers has been a chronic problem in rural areas. Access to a medical specialist has been practically nonexistent unless a rural citizen was willing and able to travel, sometimes a very long distance, to be treated. Telemedicine is a telecommunications technology that can address both these problems, and at the same time, save money for both patients and health care facilities. Patients save because they can be treated in their own hometown rather than being referred to an out-of-town specialist. This saves them transportation and overnight accommodation costs. Patient cost-sharing payments will also be less if a patient can be treated locally rather than transported to a referral or specialty center. The costs of a local, rural hospital are generally lower than a teaching or specialty hospital. In those cases when a patient must be transferred for specialty care, the availability of telemedicine consultations can speed up when a patient can be transferred safely back home. Mr. President, a major difficulty in recruiting doctors and other health care providers to rural areas is the professional isolation, the heavy workload, and little or no back-up medical support. Telemedicine can provide lifesaving back-up support for medical emergencies which eases the minds of patients and their families and the doctor taking care of the patient. Telecommunication hookups can reduce the sense of professional isolation and provide for continuing education opportunities. And, over the long run telemedicine can increase training opportunities for health care professionals at rural sites, increasing the chances a doctor or nurse will return to practice in a rural community. Mr. President, in West Virginia and all across the country, rural hospitals are finding it increasingly difficult to retain patients in the community because specialty physicians have a hard time diagnosing a patient's condition over the phone based only on a verbal description of the problem by the rural physician. Now with telemedicine, many of those rural hospitals can safely and effectively care for their patients instead of referring them elsewhere. For example in West Virginia, a medical student and a primary care doctor consulted with the chief of neurology at West Virginia University about an elderly Medicare patient. The chief neurologist was able to diagnose the patient's medical condition through telemedicine technology. This saved the patient a 138-mile trip over mountainous terrain to West Virginia University Hospital. The patient instead was able to be treated at the rural hospital and ended up saving the Medicare Program $2,500. And, of course, when minutes, even seconds, count, having the instant availability of emergency consultations can literally mean the difference between life and death. Just last week in West Virginia, an emergency medical resident staffing a rural hospital emergency room had to treat a patient with a broken neck. The medical resident had never treated a broken neck before, but because the rural hospital had telemedicine capabilities, Dr. John Prescott, the chief of emergency medicine at West Virginia University was able to immediately consult with the doctor on the appropriate treatment protocol. The patient was stabilized and later transferred to a referral hospital. Our amendment will help bring down a significant financial barrier to the development of telecommunications technology in rural areas: the costs of transmission. While the basic start-up costs for acquiring telemedicine technologies are coming down, transmission costs remain unaffordable. A small, rural hospital in West Virginia reported that the estimated charge for a T1 line to allow them to hook up with a larger hospital for administrative and quality assurance support was an unaffordable $4,300 a month. The West Virginia University which started a pilot telemedicine project 5 years ago, recently solicited bids for carrier services; three companies bid for the service. The winning bid's monthly charges ranged from $475 a month to $2,200 a month. The highest monthly charge of $2,200 was for a telecommunications hookup with a small rural health center in Greenbrier County, WV with the closest teaching hospital in the area. The cost of transmission must be lowered if telemedicine is to become economically feasible for many rural communities. Right now the West Virginia telemedicine project is funded by Federal grant dollars. This is true for hundreds of telemedicine projects all across the country. Congress with enthusiastic bipartisan support has encouraged the development of telemedicine technologies all across the country. The Government has provided seed money for telemedicine, but unless we make sure that telecommunication transmission costs are affordable over the long run, many rural health care providers won't be able to continue with these very important projects. Tommy Mullins, a hospital administrator for a small rural hospital in West Virginia, recently told my staff that ``the $2,000 per month service charge for the T1 is more than I spend for educational programs for my entire staff of 150 employees. If we did not have the grant money to pay for the monthly charge we could not maintain the hookup.'' Mr. President, our amendment is carefully targeted to health care facilities that are providing health care services in rural areas. We have also specifically included academic health centers, teaching hospitals, and medical schools in our amendment. These institutions have been essential partners with rural health providers in planning and creating rural health telemedicine networks and have been leaders in initiating rural health networks. Rural health care providers are generally so overloaded with patient care demands that it is difficult for them to spend the time planning and coming up with the resources to implement a telemedicine program. In addition, academic health centers bring health professions training programs and continuing education programs to the rural health network which reduce professional isolation for the rural health care providers. Finally, it promotes an increased understanding and sensitivity on the part of the academic health center to many aspects of rural health care. Mr. President, I am extremely pleased and relieved that the amendment I sponsored with the Senator from Maine, Senator Snowe, was not stricken from the telecommunications bill. I believe that our provision will have a tremendous positive effect on rural health care. We are already seeing amazing results in terms of quality of care and in improving access to primary and specialty care in rural areas as a result of telemedicine. This amendment will make sure that the important progress we have made in rural health care will continue and expand. limiting access by children to inappropriate materials on the internet

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Madam President, I rise also to support the Race for the Cure. I do not have the same personal experience that Senator Bradley and Senator Mack have, but I am profoundly moved by the experiences they have gone through. As they communicated to all of us about much more devastating experiences that their wives have been through and to some extent are still going through, it is interesting that both men, in my judgment, both Senators are reticent about personal matters. That is their nature. But when it comes to something like this, where there is so much that they can do to help so many people, and where they know that as Senators people will at least from time to time listen to what they have to say, they know they have a duty, and I think we all do, to make people aware of what can happen through early detection and through public awareness. America is a very interesting country. We battle about whether we are going to reform health care or whether we are going to increase or decrease Government spending on research, but Americans are very unique in the way that they sometimes can just galvanize themselves to make things known, and this Race for the Cure is a very dramatic example. The numbers have grown over the years. This year the international community will be involved for the first time on Saturday, June 17. I really was interested in what Senator Mack had to say about fear. I think that is true. I have seen that in my own work as a Senator, even going back to the time I was a VISTA volunteer in West Virginia, the fear that people sometimes have either because there is enough that is going to be wrong in their lives they do not want to take a test to find out something which might tell them there is something much more seriously going wrong in their lives or simply because Americans often are generically optimistic; they figure ``it will not happen to me.'' Of course, it does. And the figures about how you can cut down through mammograms, through self-testing, the spread of this disease and mortality of this disease are really just staggering. I am impressed by the difference between the 95 percent cure rate upon early detection and then over a 5-year period, that a 5-year survival rate goes all the way down to 18 percent. If there has not been early detection and there has been such a spread on a more general basis, that argues so totally for prevention, for self-examination, for mammograms, for doing everything we possibly can. So I think it is very important; the statement that more women die from this disease than any other is something that we have to understand and something that we have to talk about so that people will be strong in their response and that a husband and wife and friend, all of us feel a responsibility to each other about problems with diseases like this which are difficult for women in this case and others for men in other cases; that we have to be able to talk openly, publicly, freely, and instructively about this to each other and to the American public. It is one of our roles I think as public officials. So that I congratulate Senator Bradley and Senator Mack, both for their own combination of privacy in the way they handled this ordinarily but, on the other hand, when it comes to helping others, the way they are determined to be more public so as to broaden public education and thus increase the possibility for a better cure rate. And symbolically, here we come to the Race for the Cure on Saturday, and I hope that it is the largest one ever. I thank the Presiding Officer and I yield the floor. Several Senators addressed the Chair.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. I thank the Chair.

Mr. ROCKEFELLER. Yes. 1292.

Mr. ROCKEFELLER. I thank the Senator. Amendment No. 1292 (Purpose: To eliminate any possible jurisdictional question arising from universal service references in the health care providers for rural areas provision)

Mr. ROCKEFELLER. Just for the sake of the hour of 7:30, I simply ask unanimous consent, Mr. President, for 10 seconds to call up amendment No. 1292.

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

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, I have a question to address to the majority leader or the minority leader. Mr. President, I would be very pleased to ask my question to the Democratic leader, if that would be acceptable to him. We are confronted with a situation here, the present posture, as I understand it, is that we are going to vote on a very complex series of aspects of this bill, and after we have voted time for debate. What I think I have a real problem with is the fact that debate honestly changes people's minds, a good debate. I think as a result of the debate last night on one of our amendments a number of minds were changed. In this case, where we are dealing with cable rates, where there are less than 35,000 people within the system, and those would be completely regulated, that has enormous effect. And it may be that a lot of Senators do not know that this is in that legislation. So the question I would have to the Democratic leader, is there anything inherently wrong in not trying to have the vote now but have the debate now, to try to debate this with our colleagues and then have the vote laid over until Monday? It just strikes me that in a democratic body having a debate after you have already cast your vote is not the way democracy usually works.

Mr. ROCKEFELLER. That would be entirely satisfactory with this Senator. I thank the Chair.

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

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, I want to try to give a sense of a little bit of the overview of this, and do it within a relatively short amount of time. I want to also say that there have been some very constructive conversations that have been taking place, which reflect themselves in the managers' amendment. For example, there was a very constructive conversation yesterday afternoon involving the Senator from Maine, the Senator from Nebraska, Senator Kerrey, myself, and others with, for example, Bell Atlantic, which represents my State, Ameritech, NYNEX. We were able to reach accommodation in a very constructive, positive way, in ways which are reflected in the managers' amendment. So I do not want people to think this is kind of a pitched battle only. There have been some people who have been trying to do some good work on this, on both the corporate and senatorial side. I have to say we have heard some absolutely amazing statements from the Senator from Arizona and some of his allies. Make no mistake about what they are trying to do. They are trying to say to all of these telecommunications giants: Go ahead and charge exorbitant rates on the backs of America's schools and libraries and rural health institutions, and keep those community institutions off the ramps of learning and telemedicine. Or go ahead, in the alternative, and milk schools and libraries for as much money as you can get. I can fly, under airline deregulation, from Huntington, WV, to Washington, DC, in 1 hour. But it is cheaper to fly from Washington, DC, to Los Angeles. I think you understand the point. Where people think they can put it to you and they are in a profitmaking business and they do not have a sense of corporate responsibility or a broader picture, as some that I have mentioned do have, they will do it. And they have done it. And it hurts. We should reject that kind of thinking out of hand in this Chamber. Private telecommunications companies [[Page S7980]] are being given an open ticket in this bill to get into new businesses, exciting businesses, important businesses, making all kinds of profits and reaping incredible dividends. And I do not object to that. I do not object to that. I think what we are looking at is an extraordinary excitement. I had dinner with the President of a computer company last night-- with six of them, in fact. He said within a very few years any citizen of the world will be able to talk with any other citizen of the world directly, through e-mail or some such, based upon the name of the person, the service that the person provides, be it a business or a location. There will be worldwide direct person-to-person communication in as fast a time and with as much clarity as you pick up your local telephone to dial your mother-in-law. All we are doing in our provision is to say, in return for this explosion of excitement and opportunity and profits, which create, indeed, more opportunity for all of that growth, for all of those profits that you will now be able to get your hands on, make sure that you bring libraries, schools, and hospitals along with you. That is called a fair deal. Mr. President, let us be clear about what the Senator from Arizona is trying to do also with this amendment. This amendment strikes a dagger into the heart of Main Street U.S.A. Just about every issue associated with the telecommunications industry sounds incredibly complicated and confusing. As soon as you start talking about it, the jargon and the terms are from a world of their own--cyberspace, internet, on-line, you name it. The Snowe-Rockefeller-Exon-Kerrey amendment in this bill--and the one that the Senator from Arizona wants to strip from this bill--has an extremely simple, basic mission. It is the way to make absolutely sure that America's schools, elementary and secondary, libraries and rural health care institutions are part of this information superhighway that is unfolding before our eyes. I do not think anyone is confused about what we mean when we say that schools, libraries, and rural hospitals should be one of this country's and this body's highest priorities. Without a doubt, I can say that is how the people of West Virginia feel--that our schools, our libraries, and our rural hospitals and clinics are a lifeline that we hold most dear. And that is true for all States. The provision in this bill, and the one being attacked by the McCain amendment, which we hope loses, designates these vital institutions-- again, schools, libraries, rural health facilities, and hospitals--as community users and then requires communications companies to charge this category of community user affordable rates for universal service. Through this part of the bill, we guarantee that America's children and library users and health care providers in rural communities can take advantage of the exciting range of technologies that are in fact the new roads, the new interstates, to education and lifesaving medical information. I applaud the Senator from Maine, Olympia Snowe, for her work in incorporating this provision into the telecommunications bill. It is her amendment. Together we presented this idea to our colleagues in the Commerce Committee, and her commitment to this idea helped win the day when we had the vote on our provision. Both Senators from Nebraska, Senators Kerrey and Exon, have been stalwart partners in this work. This provision, section 3010 of the bill, is a major reason to enact telecommunications reform. Looking at it from my State's perspective, it is the major reason. This is a historic chance to ensure that schools, libraries, and rural health care providers will acquire affordable access to advanced communications services, not only now but in the future, and all kinds of possibilities that we can only begin to imagine today. The telecommunications bill before us, carefully crafted by Senators Hollings and Pressler, presents us with an opportunity that will not come again. It is time to unleash an industry into the realm of competition, innovation, job creation, product creation and profit. But in return, Mr. President, we should make sure that the most basic institutions of our community and our society can hitch a ride onto this great journey. Once a few of the kinks and other parts of this bill are worked out-- by that I mean things that are being worked on by the leadership as I talk--the passage of this bill will be good news for business, good news for workers and consumers, and good news for our country as a whole. And it will be great news for our basic institutions, the institutions through which all of us have to pass in order to achieve adulthood--schools, libraries, in this case rural health facilities-- because they know they will not be left behind. If the McCain amendment passes, they will be left behind. If it is defeated, those schools, libraries, and rural health facilities will not be left behind. The Senator from Arizona thinks this is a part of the bill that can be amputated or weakened. If that is what he thinks, let me be very, very clear about what that means to schools, libraries, and rural health institutions. You are telling the organizations that are the bedrock of America that they will just have to stay on the back roads of communications. The organizations with the big money and clout can speed their way onto that information superhighway as fast as they want. But the institutions that educate our children and our adults, that serve Americans with the keys to knowledge, that treat and cure the people of rural communities will have to settle for the back road. Mr. President, I do not want anybody to be at all unclear about this. One of the things that we have learned in the Commerce Committee and in our own conversations is, if we think the world has begun to change in terms of telecommunications up until this point, we have not seen anything yet. Remember, I said a moment ago that every 18 months the capacity of computers has doubled for the last 30 years. That is going to speed up. So what we are talking about now is going to be far greater in the future. Therefore, what we deprive people of now will hurt much more in the future than we can possibly imagine. Our provision in the bill says to these institutions that they will have their place on the modern roads of telecommunications--schools, libraries, rural health clinics, and hospitals. We intend to open the new worlds of knowledge and learning and education to all Americans, rich and poor, rural and urban. Browsing a Presidential library, reviewing the collections of the Smithsonian, studying science or finding new information on the treatment of an illness are becoming available to all Americans through new technologies in their homes or at their schools, libraries and rural hospitals. And our provision, the one that the Senator from Arizona wants to strike, is designed to make sure that these links do get made to our children and citizens. Mr. President, our provision is targeted. It promises affordable rates to institutions that are the heart and soul of the communities of the United States of America, and we all know it. Our provision deals with the new realities and opportunities that face schools and libraries and rural health institutions in the towns and States that we all represent--every single one of us--rural or urban. We hear a lot about the explosion of computers in America's homes. But let us keep in mind that a lot of families cannot afford their own computers and equipment for their children. They cannot afford that. This Senator can. Some other Senators here can. Most people cannot. We are talking, Mr. President, about thousands of dollars that many, many families in my State of West Virginia and elsewhere simply do not have for this kind of purchase. The Presiding Officer may be aware that in 1994, for the first time, the purchase of personal computers surpassed the sale of television sets in this country. The Presiding Officer may be aware that those who are on Internet are now 30 million, and that that number is growing at 10 percent per month, but it is not growing in Welch, WV. It is not growing in Alderson, WV, and it is not growing in the Presiding Officer's rural areas and some of his urban areas because the people do not have the capacity to get on line to join up with that information highway. [[Page S7981]] Schools and libraries are the institutions that serve our communities and that serve our children, no matter what. That is why we want to make sure that these institutions can count on affordable rates to get on line, to tap into telecommunications services and to bring in the learning and the information from distant places for our children and adults and other users to learn from. No matter where one lives, we want every citizen to have a chance to go to the local library and visit a world of information available as a result of these new technologies. I am very sorry to hear some talk of different ways to achieve our basic goal. Let us face it. Some communications companies do not want to be forced to offer rates to even the most basic institutions serving our communities. But let me be clear. Our approach is the simplest way to achieve the simplest goal I believe that all of us support-- affordable access to communications that these community institutions in fact do need. The Snowe-Rockefeller-Exon-Kerrey part of this bill provides the way to ensure that elementary and secondary schools and libraries have access to essential universal telecommunications services, which will be defined, incidentally, by the universal service board described in this bill, at rates that are affordable. The affordable rate will be determined by the FCC and the State commission, depending upon whether you are talking interstate or intrastate. What does this mean for thousands of elementary and secondary schools in America? A 1995 study by the National Center for Education Statistics discovered, to my shock, that only 3 percent of classrooms in public schools in America were connected to something called Internet, which is the whole future, a large part of the future--only 3 percent. Why? One reason has to be the lack of funds to even buy the equipment. But another reason, which becomes more serious as schools do scrape together the money for the one-time expense of buying equipment, is their inability to pay excessive rates to hook into those services. It is one thing to have the computer on the table or the desk. It is another to have that hooked up to the wall and then through that wall to the other wall. That is expensive. Look at the study of the U.S. National Commission on Libraries. They found that 21 percent of public libraries are connected to the Internet. And I thought that was pretty good news. But that figure then suddenly drops to 13 percent when it comes to public libraries in rural areas and small communities. Why does it drop? Because there are libraries that do not have the money and will not have the money to pay commercial rates to be on- line. And therefore you just count them out of it. I described in Pocahontas County--and I see my senior colleague from West Virginia here--the small, octagonal library that was barely scraped together, the only library in the county. It is one of the largest counties east of the Mississippi and it has about 7,000 people in it. And we scraped together the money to put that octagonal building up, all made of wood and put solar panels on the outside because fuel is expensive. Now, of course, there is a problem; it rains 45 inches every year in Pocahontas County so the solar panels do not work, so they have to spend money on fuel. But that is typical of a rural community, of a library trying to make it. And then you ask them on top of that to have to pay money to hook up to these information systems. It cannot work and it will not work, and it is not fair to those people. Why is somebody born in a big city any better than somebody born in a small rural area? The answer is he or she is not. But I refuse to be a part of creating a two-tier society. We appear to be on our way to doing that in other ways. I do not want it to be done in terms of the ability to learn and to grow. In West Virginia, our schools are determined, by hook or crook, to get computers into every one of our 900 elementary and secondary schools because our Governor has made it a priority and so has our Bell Atlantic company. They have made a special project of West Virginia. Classrooms in 50 different places already can connect to Internet. But this is not the way most of it works, Mr. President. This is a special set of circumstances. Let us be clear. If the schools of West Virginia cannot count on affordable rates--and that is what this part of the bill is about--many of them are never going to be a part of the world that telecommunications offers regardless of what they have. Teachers in West Virginia cannot wait to use these computers, Mr. President, and their links to distant places. They are excited about it. It transforms them as it transforms us as we get into the business of learning computers. They want to get into libraries. They want to get into colleges, to courses on every topic imaginable, to art collections, to whatever for their students. They have come before the Commerce Committee and boasted about what they can do for their children in schools when they have computers. Think of what this means for children of small schools in remote towns in West Virginia or South Dakota or Alaska or South Carolina or Maine. Through their computers, students can take a language class that is being given in Texas, visit a museum's collection on Fifth Avenue in New York, communicate with a computer pen pal in Asia or Russia or South America, and explore the jungles and the rivers and the plains of distant places to learn about science and biology and nature. Extraordinary opportunities, if it will be provided for them. Most classrooms in America still look the same as they did 60 years ago when we wrote the first telecommunications act. They have chalk and blackboards, desks and chairs. Yet, with the tools of our modern-day office, how can we possibly expect our children to become productive, informed, innovative contributors to the economy out there, beyond the schools, when they learn with a blackboard and they do not have a computer? It will not work. If our children are to use technology thoughtfully and appropriately, they must have access to it in their formative years. Our bill also has a special provision to guarantee access to the health care providers in rural communities, like rural hospitals and clinics, by promising them universal telecommunications services at rates reasonably comparable to the rates charged urban health care providers, language carefully worked out. Why do we single out our health care providers in rural areas? Why do we do that? Because their remoteness makes it far more likely that they cannot afford the cost of telecommunications that are now being used to save lives and help train health care professionals and provide other critical services. Most of this is known as telemedicine. It is the wave of the future. It is what is going to hold down the cost of health care. My own home State of West Virginia is a pioneer, as Senator Byrd well knows, in the frontier of telemedicine. Our mountaineer doctor television program that we are struggling as best as we can to make work has created a network using interactive video and other telecommunications services that hooks up two of our academic health centers to our large teaching hospitals, two veterans hospitals--two veterans hospitals are involved in this--and six hospitals in rural areas, all hooked up and linked together through this network. Senior medical professors and practitioners are guiding and training physicians at hospitals hundreds of miles away. Just about a week ago, a resident in one of West Virginia's rural hospitals was confronted with a broken neck. He had never treated this resident, obviously, and had never treated a broken neck before. Thanks to that mountaineer doctor program, called telemedicine, the chief of emergency medicine at West Virginia University helped that resident through the steps of stabilizing that patient and preparing a transfer of that patient to a more sophisticated medical facility. Through this telecommunications network, West Virginia's chief of neurology helped a medical student and primary care doctor in a Grant County hospital determine if a Medicare patient was suffering from Lou Gehrig's disease. This consultation by interactive video saved that patient a brutal [[Page S7982]] 140-mile trip, allowed him to remain comfortable in his own community's rural hospital, and saved Medicare about $2,500 in extra costs. Examples like this go on and on and on just in West Virginia. I know from listening to statements made by Majority Leader Dole, by the chairman of our committee, Senator Pressler, and my good friend, the Senator from Montana, Senator Burns, that they are among many in this body who know all too well what telemedicine means to their States. Talk about being rural, you better talk about Montana, as well as West Virginia and Maine. Again, the Snowe-Rockefeller part of this bill simply ensures that these institutions can count on affordable rates to take advantage of telemedicine and other unfolding communications technologies. Affordable telemedicine will allow patients in rural America to receive in their own communities the care they need. They will not have to suffer the costs and the hardship of travel, and they will be able to receive care at their local hospital, thus helping to preserve that hospital. The Snowe-Rockefeller language is an economic development tool and it is an empowerment vehicle. It ensures that our children will become productive members in a world that is growing more technological and competitive every single hour. It ensures that our citizens in rural America will be able to stay in their communities and receive quality health care. It ensures that we will not create information haves and have-nots in our country. I will close, Mr. President, and I apologize to my colleagues for the length of what I have said, but I wanted to lay this out. One of our colleagues who is opposed to this bill and who supports the McCain amendment, which I hope will be defeated or tabled, said on this floor earlier that rural hospitals and rural clinics already have access to affordable rates. That is absolutely without any merit or basis in truth whatsoever. The lack of adequate telecommunications infrastructure is a major barrier to the development of telemedicine and those systems in our rural communities. Let not that statement get by. Rural areas have the equivalent of a dirt road when it comes to telecommunications. When Texas implemented one of the very first telemedicine projects in the country, they found that people still had party lines in west Texas--party lines. They had to install dedicated T-1 lines at very significant costs because T-1 lines are powerful instruments. Basic startup costs are coming down, but according to all the experts in this field, transmission costs must be lowered to make telemedicine economically feasible. The small rural hospital in West Virginia was told that it would cost $4,300 a month to hook up with a major, larger hospital for administrative and quality assurance support. They decided they could not afford the technology, and so they did not do it. And there you have it. The University of Arizona, not a small rural hospital, established the Arizona international telemedicine internetwork in 1993. They used straight telephone lines and they used compression to transmit static images. They say cost is a barrier to upgrading. According to them, their carrier--in this case U.S. West--has been inflexible in making any sort of cost concessions. Mr. President, I have said what I want. There are many others on the floor who want to speak. I was determined to try and give a broad overlay of what the Hollings-Pressler bill does, and I have done my best to do so. I yield the floor. Mr. ROBB addressed the Chair.

Mr. ROCKEFELLER. Mr. President, there are times when I wish I had never offered an amendment in the Commerce Committee having to do with perimeters for flights, 1,250 miles, because the doing of that and the winning of that in the Commerce Committee has, I think, fundamentally angered my very good friend, the distinguished Senator from Arizona. I think it has caused a whole series of things to happen as a result. The hearing with respect to United Airlines, a hearing with respect to-- well, no other hearings, but then I think this amendment. I think he was very deeply disturbed by that. I just want to say one thing. As I walked in the door over there I heard him mention that $100 billion had been saved in terms of cost of deregulation of airlines. I want to inform the Senator from Arizona that--sure, a lot of that must have been saved in West Virginia. Because you do not get to West Virginia now by jet airplane. Yes, there are one or two. Corporations have theirs. But when I go it is by propeller. I remember when we had American and Eastern and United, and they came in regularly into our airports. That was years and years ago. Within two or three months of deregulation it was gone. I am talking about this amendment when I am talking about airlines; that is what happens when the free market is allowed to entirely set what the rules of the game will be. West Virginia has suffered substantially. West Virginia has suffered profoundly because of deregulation of airlines which is glorified by the Senator from Arizona and which is very deeply hurtful to the livelihoods of the people of the State of West Virginia who have to move to other States, often, because there is not enough work because businesses have to be able to count on reliable air service and they do not want it to be some small propeller plane where your chin is resting on your knees--as is the case in the seated position of the junior Senator from West Virginia. It is incredibly important, not just to West Virginia but to every single State that has any part of it which is rural, that the amendment of the Senator from Arizona be defeated and be defeated soundly. We are dealing with some very, very fundamental principles here. For example, as we build on this information superhighway we must include an on-ramp for students and adults to ensure that every American has the opportunity to plug in and be part of this technology. The bill before us, ably shepherded through by Senator Hollings and Senator Pressler, includes this amendment. I think this amendment--I said this a couple of times in the last few days--I think it is so important that this language stay that schools, elementary schools, secondary schools, no matter where they are, be included as part of the information process, that they be wired up, that public libraries be included as part of this process, which in many cases in rural areas and other areas they may not be and will not be, because, like airline deregulation, you go where the population is. And, terribly important particularly for rural areas, that the telemedicine be available through rural health centers and through rural hospitals. And they will not be if the amendment of the Senator from Arizona prevails. They will not be because the market will not allocate the resources to make that available. I am as certain of that as I am of having to take a propeller airplane whenever I go to West Virginia. In fact, the only time that I do not take a propeller airplane when I go to West Virginia is if I go to Pittsburgh first. And the principle is exactly the same. The market will seek out where it is profitable to go as they are deregulated, as we will do and we will do profitable for them to go they will not go. I want every Senator from every one of the 50 States--I do not care if it is New York State, which is thought of as being urban but has an enormous rural section, that people who live in Binghamton, NY, or Oneida or other places outside of that, they are not going to get service. Their elementary and secondary schools, their rural hospitals, their rural health clinics are not going to get service. They are not going to be wired up. They are not going to be part of this information highway. It is not going to happen because the market will make other choices. As a result of that, I have said what I think is probably a hyperbole in listening to myself say it, but I find believing myself saying it so compelling that I need to say it on the floor of the Senate, that if this language is allowed to stay in the bill and, thus, if the amendment of the Senator from Arizona is defeated, this Senator as an individual junior Senator from West Virginia will probably have done more in one series of paragraphs of sentences in a bill to help his State than anything he has done in his public career. I feel so strongly about that amendment. The amendment to strike this language is so wrong. It is so wrong for rural America. It is so wrong for places that cannot defend themselves. It is so wrong for choices that will be made by the marketplace to avoid elementary schools, secondary schools, libraries, rural health clinics, and rural hospitals. If you are not there with the technology, you might as well not be there. If you are a kid, if we want to create in this country a first-tier and a second-tier society--and I am not talking about rich and poor in financial terms. I am talking about even more important terms; that is, having a future. If you want to have a two-class society in this country, those who know and those who do not, then you vote with the Senator from Arizona because that is what you will have. You will have people that go on-line, with America-On-Line, that can search and have their home pager and do all kinds of things, and they will make 15 percent more in salaries than people that do not have those abilities; probably 30 percent more. I remind you that in the computer business, the productivity, the technology, has been doubling for the last 30 years every 18 months. So what are these rural schools, what are these rural hospitals to do when they are not wired up? I cannot imagine anything that affects the future of this Senator's State, of the State of the Senator from North Dakota or the Senator from Nebraska in a more fundamental way in terms of its young people finding a chance to take their place in America as citizens with possibilities and pride and confidence than how this amendment is disposed of. Senator Pressler and Senator Hollings have worked together and have kept this as a part of the bill. They deserve praise for that. I want to share one story. Then I will sit down and yield to the others. I will have more to say about my home State of West Virginia and this amendment, which I feel is just--I feel so strongly that it has to be defeated for the sake not just of my State, but of every State, the rural and the out-of-the-way parts of every State. Let me share one story about West Virginia. It has to do with the West Virginia Library Commission, which is a very aggressive group. They have very aggressively worked for years to develop the network, and they recently won a Federal grant to provide computers for over 150 libraries in our State. Our State commission is currently investing in that equipment and training for every library to be linked to the internet. But each library must pay for its own telecommunication link, and they cannot. My wife Sharon and I have our farm in Pocahontas County. That is one of those little public libraries--when I was a Governor I was there--a little octagonal building that uses solar ray because they cannot afford the fuel. And it is interesting to use solar panels in that part of the State because the sun does not shine that often. It rains 45 inches every of year. There is no way they can possibly match. So that is taking the students of Pocahontas County, WV, and condemning them to second-class citizenship in terms of going into a library or the adults who want to improve themselves through library services. They are struggling financially. They cannot match. They cannot pay what they would be required to pay. We have something in this law called ``public interest.'' If there is ever a case of public interest, it is that people who are born in poor circumstances, in rich circumstances, in rural areas, in urban areas, or somewhere in between on either of those fronts have an equal chance in terms of the education system and the computer system and the health system of this country. No, we did not pass health care last year. Maybe we bit off too much. But here is something we can bite off which will really help. It is called telemedicine. It will only affect those parts of the State which are rural, and they will never get it unless the amendment of the Senator from Arizona is defeated and defeated soundly. Our part of the bill on this is not intended to give something away for nothing. It merely assures financially strapped public institutions like libraries and schools will get affordable rates for access. There are many others who want to speak. I will speak more on this subject. But I say again that the defeat of this amendment, I think, is central to the bill. I think it is central to the future of the young people and adults of my State. I have rarely felt so strongly about anything in my public life. I yield the floor. Mr. ASHCROFT addressed the Chair.

Mr. ROCKEFELLER. Reserving the right to object.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, I join with my colleagues, Senators Lautenberg, Daschle, Mikulski, Wellstone, Murray, Harkin, and Reid, in cosponsoring an amendment to the budget resolution, Senate Concurrent Resolution 13. This amendment--known as the ``Ex-Patriots to Patriots'' amendment-- would assume the repeal of the tax loophole that enables U.S. citizens to renounce their citizenship to avoid paying U.S. taxes. This would generate $3.633 billion in revenues for the Treasury over 10 years, from 1995 to 2005. Our amendment would restore funds from this revenue--$1.7 billion over the 7 years covered by the resolution--to Function 700, veterans programs, so as to offset some of the $15.4 billion in reductions contained in the budget resolution. Mr. President, emigration and expatriation are fundamental rights of all Americans. They are guaranteed by the American Constitution and international human rights laws. Expatriation to avoid taxation is permitted by the Internal Revenue Code of 1986. We believe this provision in the Tax Code should be repealed for several reasons. First, it is unfair to all Americans who work hard every day to support their families and who pay taxes to support their country. It offends our sense of justice that some of the wealthiest Americans--who can afford to pay taxes, whose fortunes blossomed in the freedom and bounty of our Nation--can take such a drastic measure to avoid paying their fair share. Second, at a time when we are all committed to reducing the Federal deficit, the Treasury losses significant revenue because of the actions of the approximately 25 individuals a year who choose expatriation to take advantage of this tax loophole. And finally, if these funds were available, they could be targeted toward needed programs and services which are in jeopardy--and which benefit far more than 25 people. Mr. President, the matter of this ``Ex-Patriots'' tax loophole has come before the Senate earlier in this session of Congress and is on the table again. We passed the ``Ex-Patriots'' provision as part of the small business health care deduction bill in March, but it was dropped in the House-Senate conference in April. Later, the Senate voted again to repeal this tax loophole, this time by a vote of 96-4 in a sense-of- the-Senate resolution. And on May 15, Senate Concurrent Resolution 13, as passed by the Budget Committee, does repeal this tax loophole for wealthy Americans. However, it does not go far enough, it does not target any of the revenue for veterans' programs. On May 11, Senate Lautenberg wisely linked the two issues--repeal of the expatriates' tax break and restoration and funding to America's true patriots--in Budget Committee action. The tie vote of 11-11 demonstrated the bipartisan support for changing the tax code and helping maintain veterans' programs. Our amendment links the repeal of the tax loophole for expatriates to the restoration of funds for America's true patriots--her veterans. It does so because approximately $15 billion in reductions for veterans programs--including health care services for service-connected veterans and poor veterans--are on the chopping block. As ranking minority member of the Senate Committee on Veterans' Affairs, I believe the patriotism demonstrated by the men and women who have worn our country's uniform--those who put themselves in harm's way, those whose lives have been irrevocably changed by injuries sustained in the line of duty, those who lost comrades in the heat of battle--speaks for itself. The repeal of the expatriates' tax loophole makes sense, and our veterans deserve no less. Let us remember once again, in this 50th anniversary year of the end of World War II, the persons who enlisted in service to their country when tyranny threatened to obliterate peace and prosperity for generations to come. Science fiction writers and filmmakers have conjured up images of the unimaginable--what the world would have been like had our soldiers and sailors not made the world safe for democracy, safe for their children and grandchildren. Thankfully, many of these men and women are alive and well. But while many have their memories, their honor, and their dignity, they may not have their health or the material wealth with which to purchase the care they need. Mr. President, I want my colleagues to understand some of the ways the underlying budget resolution, as reported by the Budget Committee, will affect the people who use the VA health care system. Under the resolution, VA would be forced to operate at a level below current services. In human terms, almost 150,000 eligible veterans would be denied inpatient and outpatient care in 1996 alone, and almost 1 million veterans would be denied care in 2002. In terms of VA's capacity to provide a full range of health care services nationwide, the equivalent of 5 VA hospitals would have to be shut down in 1996, and 35 VA hospitals would have to close their doors in 2002. In the first year of implementation, 8,200 VA health care professionals would lose their jobs, and by the end of this 7-year period, 53,000 VA medical facility employees would lose theirs. Another equally disturbing effect of the Budget Committee's action would be the cut in VA research programs of $15 million and 142 FTEE. This amounts to 10 percent of all VA research projects, or 150 fewer medical research projects each year. VA research is geared toward some of the special illnesses and disabilities which affect veterans, among them blindness, posttraumatic stress, and spinal cord injury. These and other subjects of VA research endeavors--everything from Alzheimer's disease to heart disease to women's health--also benefit the general population by finding the causes of disease and aiding in developing the best diagnostic, treatment, and preventive methods. Today's research results are tomorrow's cures. By eliminating the opportunity for our Nation's medical professionals--VA research is conducted by VA clinicians and researchers and also by those from our Nation's medical schools which are affiliated with VA medical centers--we cut off a source of knowledge that is crucial to the health of our Nation's citizens. Last, Mr. President, under the resolution, VA's construction program would be affected beyond repair. In [[Page S7452]] fact, the program would be decimated. This program, which upgrades and maintains VA's $25 billion physical plant infrastructure, should cease to exist. All 200 pending projects, totaling $3.4 billion, would have to be canceled. These are not new projects, new hospitals, or new buildings. These are essential modernization projects. They are essential because 65 percent of VA medical centers, or 114 hospitals, are at least 30 years old. And 73 percent of VA hospital, domiciliary, and nursing home beds, that is more than 74,000 beds, do not comply with patient privacy standards. In this day and age, no hospital should have more than two beds per room, congregate bathing facilities, or inadequate space. If we suspend all work on these projects, VA's plans to upgrade its patient environment will never be realized. Mr. President, because this amendment is budget neutral, there is every reason why we should use these new funds to minimize the negative impact on veterans' programs of the Budget Resolution. The link between the two, thoughtfully and rightfully, proposed by Senator Lautenberg should be adopted by the full Senate. It is within our power to do so, and it is the right to do. As ranking minority member of the Veterans Affairs Committee, I urge my colleagues to support our amendment. (The following statement was inadvertently omitted from the Record of May 24, and appears here at the request of Ms. Mikulski.) amendment no. 1166

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President. I would like to submit for the Record, a recent Washington Post article on the Agency for Health Care Policy and Research (AHCPR). Before submitting the article, I would like to say a few words about the AHCPR. The Agency for Health Care Policy and Research (AHCPR) was established as the eighth agency in the Public Health Service by the Omnibus Budget Reconciliation Act of 1989. I was pleased to work on a bi-partisan basis--with Senators Mitchell, Hatch, Durenberger and Kennedy, and Representatives Gradison, Stark, and Waxman--to help establish AHCPR. In creating the agency, Congress gave increased visibility and stature to the only broad-based, general health services research entity in the Federal Government--one of the most important sources of information for policymakers and private sector decisionmakers as they seek to resolve the difficult issues facing the Nation's health care system. Congress gave AHCPR the following mission: ``to enhance the quality, appropriateness, and effectiveness of health care service and access to such services, through a broad base of scientific research and the promotion of improved clinical practice and in the organization, financing and delivery of health services. The Members of Congress who supported the creation of AHCPR did so because of their concern that while the Nation was spending at that time some $800 billion on health care, it is now more than a trillion dollars, we had little information on what works in the delivery or financing of care. We wanted to encourage support for research to find the best ways to finance and provide health care at the lowest cost and the highest quality. We believed then that for a relatively low expenditure we could find ways to save health care money without sacrificing quality. The AHCPR's work has proven us right. The 1989 Reconciliation Act authorized AHCPR to conduct research in three basic areas: Cost, Quality, and Access (CQA) and medical effectiveness research and outcomes research. Cost, Quality and Access research funding has provided: The fundamental research that led to the development of the Diagnosis Related Groups (DRG) system; The basic research that first documented major variation in physician practice patterns; A landmark study, called the Medical Outcomes Study (MOS) which will help understand the impact of financial incentives and practice setting (e.g. Health Maintenance Organizations vs. fee- for-service) on practice style and, in turn, on health outcomes; Research that documented that utilization review can significantly cut utilization costs of health care; and The most comprehensive survey on the costs and utilization patterns of AIDS patients, which will help target treatment programs, more effectively. Part of AHCPR's work is in technology assessment and this effort has made a significant contribution to saving federal funds. For example, according to the Institute of Medicine, at least $200 million a year in medicare expenditures are saved through AHCPR's technology assessment program. Again, AHCPR is helping us as policymakers understand what works. Congress greatly expanded the federal effort to support research on the outcomes, appropriateness and effectiveness of health care services. The ultimate goal of this program is to provide information to health care providers and patients that will improve the health of the population and optimize the use of scarce health care resources. This program includes research, data development and development of clinical practice guidelines. It was our hope that the guidelines, which are just that, not requirements, would lead us to find ways to save money without compromising care. It is now apparent that our modest investment in the process has paid off. For example, AHCPR, research has found that some 90% of low back pain problems--a condition estimated to cost more than $20 billion a year in health expenditures--disappear on their own in about one month. This finding has enormous cost savings implications. One hospital in Utah found that after six months of using an AHCPR guideline on prevention of pressure ulcers that it saved close to $250,000. That hospital is part of the Intermountain Health Care system which has now implemented the guideline in its 23 other hospitals. Use of this guideline has reduced the incidence of bed sores by 50% at savings of $4,200 per patient. [[Page S7576]] I cite the cost savings aspects of AHCPR research because of a recommendation by the Budget Committee to cut AHCPR research by 75%. The committee report also indicates that AHCPR was established to manage health care reform. That assertion is just plain wrong. AHCPR is an important agency for its research, but it was not envisioned to be a health care implementation agency. We may save a few Federal dollars by cutting AHCPR's funding, but we will lose far more in potential savings in our health care system. The budget resolution also proposes deep reduction cuts in Medicaid and Medicare spending. I oppose those harsh cuts because the people of West Virginia will have health care benefits taken away from them as a result. It seems to me that the only way to rationally reduce costs and not hurt people by reducing their access to care or their quality of care, is to know what works and what does not work. That is precisely the point of the research of AHCPR. The current budget of AHCPR is about $160 million. This modest investment is just now paying off in research and guidelines which have the potential to reduce cost and without a reduction in quality of care. It is my hope that the Appropriations Committee will continue to provide adequate appropriations for AHCPR and I will do my best to support the agency as the Congress makes its decisions on authorizations and funding for the coming fiscal year. I ask that the article from the Washington Post be printed in the Record.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, I rise in strong support of this amendment to preserve funding for the Appalachian Regional Commission, and I thank the Senator from Kentucky for offering it. Without his amendment, the budget proposal before us includes a plan to wipe out a very small and valuable agency over the next 5 years. This amendment is the Senate's chance to reject the idea of eliminating the tools dedicated to the economic development and future of 13 Appalachian States, including West Virginia. Senators listening to this debate may think this is an amendment that only deserves the votes of those of us representing those States. I hope our case will be heard so that won't be the conclusion of our colleagues. The people of every State have a stake in the economic strength of the rest of the country. When floods ravage the Mid-West or the Gulf States; when a major defense installation or space center is located in a State like Texas or Alabama; when payments are made to farmers for crop losses; when billions are spent to shore up S&L institutions in certain States; when special aid is given to cities or to California after its riots or earthquakes; when research labs get special funds in New Mexico or Massachusetts--when any of this support and assistance is extended, it is the country's way of investing in each region and in the futures of Americans everywhere. The Appalachian Regional Commission is the Nation's effort to help a part of this country overcome tremendous barriers. In many parts of the region, major progress has been achieved. But the ARC's job is not finished, and the agency should not be abolished until it is. Like so much else in this budget debate, this amendment is about priorities. For me, this represents a choice between two programs that affect the people of West Virginia. It calls for a little less support for the Office of Surface Mining, in order to put more into the ARC. The key message in this amendment is its call for continuing the ARC's partnership with West Virginia and the Appalachian region to finish the foundation we need for more growth, more jobs, and more hope for our people. To that end, I accept the idea that the Office of Surface Mining should reduce its bureaucracy and excessive regulatory activity in order to finish ARC's work for families and businesses in Appalachia. This amendment will not add to the deficit or prevent us from reaching a balanced budget in 2002--it will simply redirect funding from certain activities at OSM so that the ARC can continue its mission for the people of Appalachia. This amendment accepts a fair share of responsibility for deficit reduction. But instead of saying wipe out the ARC, it charts a course of gradual reductions, starting with a 35 percent cut in ARC funding for 1996, with continued reductions through 2002. Overall, it would be a 47 percent cut in ARC funding if the commission were frozen at its 1995 level. This is going to require changes and further streamlining at the ARC, which should be tough but doable. Under the McConnell amendment, ARC is still contributing its fair share to deficit reduction. Without it, one region of the country is asked to suffer more than is fair and to a point that will hurt the region. As a former Governor, and now as a U.S. Senator from West Virginia, I know--vividly--the value of the ARC and how it improves the lives of many hard-working citizens. Whether the funding is used for new water and sewer systems, physician recruitment, adult literacy programs or the Appalachian corridor highways, it has made the difference in West Virginia, Kentucky, and the other Appalachian States. The highways are the most visible and best known investments made by the ARC for the people of Appalachia. As of today, over two-thirds of the ARC highway system has been completed. But if the ARC is simply abolished, the job will not be completed. What a waste of money to pull out before a road system is finished. At this very moment, some of these highways are called highways halfway to nowhere, because they are just that--half built, and only halfway to their destination. The job has to be completed, so these highways become highways the whole way to somewhere. And that somewhere is called jobs and prosperity that will benefit the rest of the country, too. Appalachia simply wants to be connected to our national grid of highways. Parts of the region weren't lucky enough to come out as flat land, so the job takes longer and costs more. But it is essential in giving the people and families in this part of the United States of America a shot--a chance to be rewarded for a work ethic and commitment with real economic opportunity and a decent quality of life. I won't speak for my colleagues from other Appalachian States, but West Virginia was not exactly the winner in the original Interstate Highway System. And Senators here represent many States that were. As a result, areas of my State have suffered, economically and in human terms. Without roads, people are shut off from jobs. That's obvious. But without roads, people also cannot get decent health care. Dropping out of school is easier sometimes than taking a 2-hour bus ride because the roads are not there. The structure of the ARC makes it more efficient and effective than many other agencies. The ARC is a working, true partnership between Federal, State, and local governments. This structure expects responsibility from citizens and local leaders, Federal funding is designed to leverage State and local money for any activity. Accordingly to the ARC, throughout its lifetime, it has contributed less than half of the total amount of project funds. Administrative costs have accounted for less than 4 percent of total costs over ARC's lifetime. Long before it was fashionable, ARC used a from the bottom up approach to addressing local needs, rather than a top down, one-size- fits-all mandate of the type that has become all too familiar to citizens dealing with Federal agencies. It works, too. I urge everyone in this body to keep a promise made to a region that has been short shrifted. Each region is unique. Solutions have to differ, depending on our circumstances. When it comes to Appalachia, a small agency called the Appalachian Regional Commission should finish its work. Abolishing it overnight will only create more problems and more costs that can be avoided. I urge my colleagues to vote in favor of the McConnell amendment.

Mr. ROCKEFELLER. Mr. President, I rise to, in the strongest terms, support this amendment which I am pleased to cosponsor. I congratulate the Senator from New Mexico, Mr. Bingaman, for his continued leadership on behalf of the Nation's economic needs and potential, and join Senator Lieberman in helping to make this case to our colleagues. The proposal to eliminate the U.S. Department of Commerce is incredibly short-sighted and will be extremely harmful to the competitive position of the United States. The Commerce Department's responsibility for trade enforcement, export promotion, manufacturing, and technology is a focused mission for American jobs and growth, and quite simply, its elimination is tantamount to economic surrender. To begin with, the Commerce Department acts as the cop on the beat, enforcing U.S. trade laws against internationally recognized unfair trading practices. Domestic industry is a huge fan of the Department's Import Administration, and a move to eliminate it, or roll it into another agency with a very different mandate, is only going to be red meat for our competitors. I know this from painful experience. Those of us who represent industries such as steel have seen what unfair trade, dumping and subsidized imports, can mean to local economies and our Nation's overall economy. The Import Administration does yeomen's work enforcing our domestic trade laws--which look out for American businesses and American jobs--and to move it somewhere else is not only thoughtless, it is dangerous. Mr. President, I will not sit by while the one agency that is looking out for American business, at home and abroad, is dismantled for political gain. The Department of Commerce's trade promotion arm is the matchmaker for thousands of businesses promoting products made in the United States--by American workers--in markets all over the world. I speak from experience here. In January, I led a trade mission of West Virginia businesses to Japan and Taiwan, we called it Project Harvest because that is what we were trying to do, sow the seeds of relationships that would reap tangible benefits for small and large West Virginia companies and their workers. In all this we worked closely with the Department of Commerce's Foreign Commercial Service, and in less than 6 months, these companies have already secured millions of dollars' worth of contracts. I know what my friends across the aisle are saying about their so- called mandate, but I challenge any one of them to tell me that they have one company in their State such as Precision Samplers, that want to see the Department of Commerce eliminated. As a result of our trade mission, and with the help of the Department of Commerce, Precision Samplers has already signed contracts worth half a million dollars. And the list doesn't end there, West Virginia companies such as the Dean Co., and FCX Systems and Precision Coil have all signed lucrative contracts since our trade mission, and a big thanks goes to the experts at the Department of Commerce who helped make these deals happen. Small companies such as these owe a great deal to Department of Commerce export promotion programs, and I doubt they would want to see that support network eliminated. I also want to make a special note of the role played by the Bureau of Export Administration [BXA]. BXA evaluates national security interests when American companies seek applications for the export of dual use goods and technology; those are products that could have military applications. There are a lot of things that need to be considered in these applications, but as a Commerce entity, BXA has longstanding close relations with exporters and the business community that other agencies simply don't have. However, BXA has to work with all those other agencies in making its evaluations. Export licensing has foreign policy implications, so involves the State Department; it has national security implications, so works with DOD; it has to clear the sale of nuclear equipment that DOE is expert in, or other things that the Arms Control and Disarmament Agency has a role to play. And BXA coordinates all this while always looking out for the needs of American businesses. We need to maintain an umbrella organization that looks out for America's business interests at home and across the globe. Creating a Department of Trade would be better than breaking up all the trade functions of the Department of Commerce and moving them all over the Government, to Justice, DOD, Treasury, the ITC, USTR, wherever. But why reinvent the wheel? The Department of Commerce works. This idea of making a Department of Trade or expanding USTR is merely moving around the deck chairs. And maybe it is even worse. This particular ship is standing tall and sailing true. Breaking it down and moving it around is a bad idea. I also want to discuss a related set of proposed cuts--support for new breakthrough technologies. It is an astounding proposal, and one that shows how soon some forget what it takes for America to win in the new global economy. We should remember the lessons of the 1970's and early 1980's. During those years, America led in science and new ideas, only to see American inventions such as the VCR commercialized first by other countries. Other governments [[Page S7331]] have long used research consortia and other aid to help their firms overcome the technical hurdles associated with critical but risky new ideas. And time after time, we found our competitors taking our ideas and sending them back to us in the form of VCRs and other new products. Over the past 10 years, both American industry and the U.S. Government have taken steps to make sure Americans profit more from our new inventions and discoveries. Industry and the venture capital industry have focused their attention sharply on getting the next generation of products out the door. Both competitive pressures and Wall Street's push for short-term results have led our firms to focus their limited R&D dollars on developing new products. That is good in the short term, but it also means that even our largest firms have been forced to cut longer-term research that is essential for the future but which will not pay off for 10 years. In the real world, as opposed to some theoretical world, American companies--both large and small--increasingly have turned to cost- shared projects with the Government and each other to develop these risky but vital longer-term technologies. These are the breakthrough technologies that will create new industries and jobs in the future-- technologies such as next-generation electronics, low-cost composite materials for bridges and other structures, low-cost but highly reliable processes for making biotechnology products, and advanced techniques for computer-aided manufacturing. Cost-shared projects in such areas create the new seed corn for a new generation of American industry. At the Federal level, these cost-shared technology partnerships with industry now constitute less than 3 percent of the Government's $72 billion annual R&D budget. The entire budget of the Government's civilian technology agency--the Commerce Department's National Institute of Standards and Technology, NIST--constitutes little more than 1 percent of Federal R&D. With the cold war over and the world economic race in full swing, this is hardly overspending. And mark my words, other nations will not drop out of the world economic race just because Congress has thrown in the towel in the fight to help develop and market leading edge technologies. Along with Japan and Europe, we now see major new industry-government technology investments in South Korea, Taiwan, and even smaller states such as Singapore. In the real world, these countries are out to clean our clocks--and they want to use America's own university discoveries and entrepreneurial ideas to do it. The United States has just now climbed back to a solid, but fragile, lead in most key technologies. Well-run, cost-shared Government programs have played an important role in helping American industry regain that lead. But we now combine government cutbacks with ever increasing Wall Street pressures for companies to focus their own funds only on the short term, then we will most certainly fall behind again. And the American worker and the American dream will be the losers. Killing Federal technology programs, including those of the Commerce Department, will send our companies into economic battle with second- rate support and one arm tied behind their backs. It is a prescription for economic retreat and economic stagnation. In the name of some ideology, we risk destroying key foundations of future prosperity. And future generations will wonder why the Nation that used industry- government R&D cooperation to create the modern agriculture, aircraft, and biotechnology sectors abandoned a proven formula and let other nations walk all over us. Which brings me back to the amendment and the Department of Commerce. This amendment is quite simple, it states that ``the public welfare, economy, and national security of the United States have benefitted enormously from the investment the Federal Government has made over the past fifty years in research, technology, and trade promotion and trade law enforcement,'' and that these should remain a national priority for the 21st century. Again, Mr. President, the elimination of an agency of Government so vital to our Nation's interests is tantamount to economic surrender. I think our international competitors will see it as just that. In my view, proposals to eliminate the Department of Commerce amount to unilateral disarmament, and I will fight against those who are determined to raise this white flag.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, I rise in strong support of the earned income tax credit [EITC], and Senator Bradley's amendment to rescue one of this country's clearest incentives and rewards for hard- working families. We are forced to offer this amendment to fix one of the worst parts of the budget offered by the other side of the aisle. Believe it or not, the architects of this budget are trying to cancel tax relief for the families in this country struggling every day to make ends meet so the funds--$21 billion in all--can be redirected to households and corporations in the upper tiers. They justify their attack on tax relief for working families by claiming that the credit--the EITC--is growing out of control. That is totally misleading, and deliberately so. Yes, the EITC is growing. That's because an economic and deficit reduction plan enacted in 1993 included an initiative to increase this tax credit for very logical reasons. There is nothing to hide or apologize for. Those of us who voted for that budget, with $600 billion in deficit reduction and many cuts in spending, put our priority on hard working Americans who are working to make ends meet and raise their children. We wanted the EITC to grow because of its fundamental role in helping parents who are teetering on the economic edge to be able to choose work over welfare, independence over dependence, dignity over the indignities of the welfare system. I am proud of my vote to expand the EITC because it is needed tax relief for more than 100,000 West Virginia families. That may be another statistic, but it stands for real people and families across my State working as hard as they can to make it each day. The McCumbers of Frametown, WV, count on the EITC to make ends meet. She works full-time as a receptionist at the Mountaineer Food Bank, and her husband works full-time as a maintenance worker. They have two children, ages 8 and 10. For the past 4 years, the McCumbers have gotten tax relief thanks to the EITC. And let me tell you how they used that money. Three years ago, their EITC helped them make a down payment on a home. They also have used it to pay property taxes and homeowners insurance. Another year, it covered glasses for their daughter, and a new bed for their son. The McCumbers family is like many of our neighbors next door. Parents who work hard, but struggle to pay the bills each month. Let me tell you about another West Virginia family that relies on the EITC--the Helmicks of New Milton. He works full-time driving a truck for Mountain View Construction. She is a full-time homemaker caring for six children, ranging in age from their 15-year-old twins to a 4-year old. The first time this family used the EITC was when the twins were born and they needed extra baby furniture and twice as many supplies. Over the years, the EITC has helped the family buy a used truck to ensure Mr. Helmick had reliable transportation for work. It has helped them paint their home, put a concrete floor in their basement, and even put up a home basketball court so they could keep their teenagers close to home. Hard working families like the McCumbers and the Helmicks deserve our admiration and support. We should not pull the rug out from under them and their children by eliminating the tax relief promised to them. And we certainly should not take tax relief away from hard working people who are struggling in order to give a bonus to wealthy Americans. That's what this budget resolution proposes to do, believe it or not. That's why we should pass the Bradley amendment, and reject an idea as dumb and unfair as robbing struggling families to give something more to the well off. If the proponents of the Republican budget get their way on the EITC, it will mean that more than 80,000 West Virginia families will lose about $1,494 over the next 7 years that they would have gotten for playing by the rules and doing something called work. That would renege on a promise to 12 million families in West Virginia and across our country. I urge my colleague to support the Bradley amendment and the men and women who work hard every day, struggling to provide for themselves and their children. The other side wants to focus on all the excuses for backing away from a policy of rewarding work and discouraging welfare. They talk about error rates, fraud, other problems. Where these problems need to be fixed, let's fix them. Let's not hide behind excuses to walk away from families who deserve every reward possible in a country that says it values work and children above all. The McCumbers and the Helmicks are my guidepost in this debate. They should serve as a reminder to every one of my colleagues that a growing EITC is exactly where our priorities should be. opposing cuts to the earned income tax credit and the repeal of the davis-bacon act