Paul Simon

Mr. SIMON

Mr. SIMON. The Senator and I differ. But I thank him for yielding to me.

Mr. SIMON

Mr. SIMON. Mr. President and my colleagues in the Senate, I am for the basic aim of this amendment, but I am going to vote against the amendment for two reasons. One is, while I think we do need to spell out in broad outlines where we are going and how we are going to achieve a balanced budget before it goes to the States, I do not believe this should be in the Constitution. We are talking about a procedural thing that should not be in the Constitution. Second, to spell out down to $100 million where we are going I think is just totally unrealistic in terms of where we are going to be 7 years from now. So I think it is an unwise amendment. I would add, if we pass the balanced budget amendment--and my hope is that we will have the wisdom and the courage to do so--I will request-- and I hope to be joined by Senator Hatch and others on this--I will request the leaders of both parties to either ask the Budget Committee or a special task force to put together in broad outlines how we can get to a balanced budget in the year 2002. Now, CBO has outlined some things; the Concord Coalition has outlined some things. There have been other suggestions. But I think a task force that can be appointed immediately after passage and report back to the Senate is the way we should go. I do not believe we should put this kind of an amendment in the Constitution. I think it is just not constitutional in nature. Second, I think to say where we are going to be 7 years from now in terms of $100 million--and at that point it will be about a $1.8 trillion budget--is just unrealistic. So I will be voting for the motion to table. I yield the floor. Mr. HATCH addressed the Chair.

Mr. SIMON

Mr. SIMON. Madam President, the administration has come under much criticism lately for its alleged failure to provide leadership on issues that are important to the nation. The 1996 Immigration Initiative announced by the administration this week, however, belies these contentions. The administration's policy proposal on this extremely important issue is thoughtful and comprehensive, and I applaud it. The administration's initiative recognizes, as do the people of this country, the need to formulate an effective response to the problem of illegal immigration, and proposes increased resources not only for border enforcement, but also increased resources to eliminate the job magnet that will continue to draw undocumented aliens into the country regardless of the success of our border policy. The initiative also reflects a desire to improve our ability to deport those aliens that have been identified as deportable, and to assist States that have long borne the burdens of our inability to prevent illegal immigration. For each of these objectives the administration has proposed the commitment of substantial resources; yet, at the same time, the initiative contains little that unnecessarily feeds the anti-immigrant xenophobia that has characterized the immigration policy debate in recent years. Rather, the administration's proposal takes a measured yet aggressive approach to the problems we must face. In short, while it has taken an undeniably firm stance against illegal immigration, the administration has not succumbed to the belief that immigration in all its shapes and forms is a bad thing. Quite the contrary: the initiative reflects the fact that, as the President has said, an effective immigration policy must combine deterrence of illegal immigration with an encouragement and celebration of legal immigration. I look forward to working with the administration and my colleagues in the Senate to effect this delicate balance, and to implement an immigration policy that is both tough and fair. The administration's proposal is certainly a great step in this direction.

Mr. SIMON

Mr. SIMON. Mr. President, one of the more thoughtful writers on our scene today is Joan Beck with the Chicago Tribune. Recently, she had a column on our national health care system that takes a slightly different perspective on where we are and some of our problems. I believe her comments merit serious consideration. We are talking about some modification of the health care system this year. On the floor of the Senate, several of us on both sides of the aisle have talked about the need for bipartisan cooperation. I hope we can go ahead. In the meantime, I urge my colleagues to read the Joan Beck column, and I ask to insert it into the Record at this point. The column follows: Cruelty to Patients--Nation's Health Care System Needs an Examination (By Joan Beck) Even without new federal legislation, health care in America is changing rapidly. Many of these changes are worrisome. Some are deadly scary. Increasingly, the focus of medical care is becoming to reduce costs, to do only the minimum possible for patients, to wring money out of the system for a new set of corporate providers. Fewer people are now allowed by HMOs and insurance company rules to see specialists. Far more surgery--more than half in many hospitals--is being done on an outpatient basis, often with assembly-line rules. Hospital stays after childbirth are often numbered in hours, not days. Hospitals are cutting nursing staffs, lowering the level of patient care and substituting other caregivers with less training and lower pay. Teaching hospitals, with their higher costs and heavy load of patients needing specialized treatment, are getting squeezed. Many doctors, like Ma and Pa stores swallowed up when a Wal-Mart comes to town, are losing their independence to a whole new world of corporate-managed health care. Physicians, in fact, don't really seem to be major players in the health-care business these days. Politicians, administrators, employers, insurance companies, even the financial markets, are shaping the future of health care to an extent that makes many people highly uncomfortable--and may endanger their health. There is a new emphasis on efficiency, not on humanitarianism and healing. Hospitals are competing for contracts from insurance companies, HMOs and big employers to care for large groups of people, often for a fixed, per- person fee. Then they must try to push down their costs however they can--by eliminating unnecessary tests and treatments, by being more efficient, by avoiding as many high-cost procedures as possible, perhaps even by taking risks with patients' health. Federal efforts to pass national health-care legislation seem to be in hiatus for now, although Illinois Sen. Paul Simon has been trying to talk up the issue again. There are new threats to make drastic cuts and changes in Medicare and Medicaid. Congress may do some tinkering with insurance regulations. But in the immediate future, changes in health care will not come from Washington. There will be more efforts by hospitals to trim costs. More efforts from HMOs, insurers and employers to get discount prices. More pressures on physicians to follow HMO and insurance company rules. More attempts at Minnesota, Washington, Hawaii and Pennsylvania. And more lamenting that while the increase in costs is slowing down, health care still takes 14 percent of the gross national product. It is difficult to measure the impact of all of these changes on the nation's well-being. But a useful yardstick is to evaluate how these changes affect the way physicians can do their job and how well they safeguard patient choice in their doctors. Doctors should be the ones to decide the future of health care in the United States--not Hillary Rodham Clinton or Ira Magaziner or Newt Gingrich or Bob Dole or the Republicans or the Democrats or Prudential or Humana or General Motors or Exxon. It's disappointing to see how little impact doctors have actually had on the health-care debate and on the future of health care and how quietly most of them have gone along with restrictions on how they care for patients. Medical societies, of course, have issued proposals and lobbied legislators. The American Medical Association has a big lobbying arm in Washington and in 1990 proposed its own Health Access America plan. The Journal of the American Medical Association has published hundreds of articles and proposals, as have other medical journals. But these efforts have not had major impact on the future of health care. It is taken for granted among health-care reformers that a major factor in high costs has been overtreating by physicians who stand to make a buck by doing so. Yet these same reformers assume that the same physicians can be trusted not to undertreat patients when the economic incentives are reversed. Undertreatment is hard to define and, often, to detect. It's difficult to measure outcomes; the data is subject to interpretation, not only for individuals, but for HMO populations, communities and states. Monitoring and evaluation protocols are not well developed. Clinical guidelines need further development if they are to be used as protection against undertreatment. Databases that will permit comparisons are still far from adequate. People must rely on their physicians to withstand pressures to undertreat, to do what's best for patients regardless of new and increasing incentives to do less than that. If the kinds of changes now happening in health care really reflect advances in medicine and commendable efforts to reduce unnecessary expenses and unneeded treatment, we should all be cheering. But how can we be sure that pressures from insurers and employers and HMOs won't push doctors and hospitals to cut even more corners that will risk patients' health? There is still an enormous reservoir of trust in physicians in this country. But it will be increasingly hard for doctors to keep that trust and to deserve it in the new regimes of red tape and cost controls. They will have to figure out how to control the health-care system, not be controlled by others. And they will have to stand up for patients against the cost-cutters and the administrators when they interfere with optimum treatment if we are to be comfortable and safe with our health care in the future.

Mr. SIMON

Mr. SIMON. Mr. President, if I may respond to my colleague, the answer is yes and no. The answer is the amendment itself has the requirement for 60 percent to extend debt. So that is self-executing. And if Congress would not pass a single bill to implement, that would be the power that is there. But there is no question that we have to pass legislation to implement. I would not wait for future Congresses to act. I think we ought to start right away. I see my new colleague from Maine nodding in agreement here. But let me make one other point, and that is we can nitpick here and there on this. But the real important question and point is, that dialog took place in 1986. We missed by one vote, passing that in the U.S. Senate. At that point, the debt of this Nation was $2 trillion. Now it is $4.6 trillion. What if we had picked up one more vote? We would have more people working; we would have a higher standard of living; we would have lower interest rates; we would have more homes constructed; we would have a much lower trade deficit; we would have millions more jobs in our country. We would have millions more jobs in our country. And so we failed to act in 1986. There is no question. There are things that we are going to have to work on. I know my colleague from Michigan well enough to know that even though he opposes this, if we have the votes, he is willing to dig in and work on the implementing legislation. He will be a valued Member in doing that. But we should not fool ourselves. We should not nit-pick here and not recognize the basic principle, and that is that we are doing harm to our country in not facing up to our problems. I thank my colleague.

Mr. SIMON. Mr. President, if we had changed the language so it just says ``debt'' instead of ``publicly held debt,'' there would be questions about that. Our intent is clear. When my good friend--he is my good friend--from Michigan implies that we are not going to pay attention to this, the Senator from Michigan, the Senator from Maine, the Senator from Wyoming, and the Senator from Illinois stood over there right to the left of the Presiding Officer. We held up our right hands and we took only one oath--to uphold the Constitution. I do not think this body is going to ignore that. I think that is the real question. I am not suggesting that my colleague from Michigan is not sincere. But we can nit-pick. The principle is clear. The language, constitutional scholars have told us, is clear. I hope we move ahead and not get sidetracked on this. I yield the floor.

Mr. SIMON. We have a statute that limits the debt of the United States.

Mr. SIMON. Mr. President, in response to my colleague, I think those terms are fairly clear. We had testimony on that very question from the former Attorney General of the United States, Bill Barr, who believes that language is very clear.

Mr. SIMON. Mr. President, I will just take a couple of minutes. I agree with my colleague from Ohio, to the great credit of President Clinton and to the credit of 50 Members of this body, we did start down the right path. What I also would have to acknowledge, as our colleague from Nebraska, Senator Kerrey, said, is that it was a first step. But we have not for 26 years balanced the budget. To go back to another time when, as was pointed out in your remarks, we had that kind of decline, you have to go back to Harry Truman's day. I think we have illustrated we just are not doing it on our own. I finally point out we can change a lot of things in this body. We cannot change history. And the history of nations is, as they pile up this debt, they keep piling it up because it is politically attractive to do so, and then they end up monetizing the debt. They just start the printing machines running. That is where we are heading if we do not adopt this amendment, in my opinion. I yield the floor.

Mr. SIMON. I yield to my colleague from Utah.

Mr. SIMON. Mr. President, if I may respond to my friend from Ohio very briefly--and he is my friend and he is one of the most valued Members of this body. Digressing just a moment, if anyone ever questions John Glenn's courage, take a look at that small little thing that he got into--``thing'' is the wrong word, but he knows what I am talking about--that went into space. It is incredible that anyone would get into that and get tossed into space. But any way, I think there are some answers for the questions of my friend from Ohio. One is that we know from the General Accounting Office if we balance the budget--and they suggested by the year 2001. That is now 2002--that by the year 2020 we would have an average increase in income per American, inflation adjusted, of 36 percent-- that is a huge increase--or, as they say, we are going to continue to go downhill. Second, we do know some of the options. And we have not spelled them out in detail. One is the Concord Coalition put together a package. CBO has suggested--and they have the most conservative estimate in terms of what the savings would be on interest--the savings would be $140 billion on interest. We could follow the present limitations we have through fiscal year 1998 and then put together for fiscal years 1999 through 2002 a combination of the last Bush package and the package that we voted for in 1993. I was pleased and proud to join the Senator from Ohio in voting for that. That is not that onerous. That is doable. What I do favor--and I have discussed this just very informally with my colleague from Utah, who is the chief sponsor--I favor, once this passes, asking the two leaders to put together a task force to outline in broad terms where we are going so that the States can know with some more specificity. But I would add that you cannot--the Daschle amendment has us down to $100 million for 7 years out. That is just not realistic. But I think in terms of billions you can do that. I would add the CBO figure on savings on interest is the most conservative. The Wharton School estimates the savings on interest will be 4 percent; Data Resources, Inc., says a savings of 2.5 percent. Their estimate is that half the savings that we will need by the year 2002 can come out of interest. This is Data Resources, Inc. They also estimate if we do it we will have 2.5 million more jobs in this country. How many that will be in Ohio and Illinois, I do not know. But it is a very substantial amount. I would add two other points here. One--and my colleague from Ohio may differ with me as well as my colleague from Utah--I happen to think we would not be in a bidding war on tax cuts right now if we had a balanced budget amendment. I do not think it makes any sense, real candidly, for us to say let us give ourselves a little bit of a tax break and impose a further burden on our children and our grandchildren. I think that is a good example of why we need this. We are not going to be able to do everything we want. We are going to be forced to make some tough votes. But I think we have to be forced to do that. And I hope they will be bipartisan. Let me just add one final point. Those who say we can balance the budget without a constitutional amendment have two things going against them. One is that for 26 years we have not done it. That is a pretty powerful record. And second, they are saying to us you spell out in detail what is going to happen, but they are not spelling it out in detail. And at least we have, by all estimates we are going to save a huge amount of money with interest. Whenever interest rates go down, employment goes up. So there is a revenue plus in addition to the interest savings. So I hope my colleague from Ohio will continue to keep an open mind on this because I think it is really essential for the future of our country.

Mr. SIMON

Mr. SIMON. Mr. President, if I may ask one more question of the Senator? So this talk that when we raise the minimum wage, we are really just helping the teenagers of people who are well off, that really is a myth and has no substance in fact?

Mr. SIMON. Since the bottom fifth in terms of income in our country get 43 percent of the benefits from this, is it not true that if we were to raise the minimum wage as is suggested in this legislation, along the lines of what the Senator has just talked about, it probably would do more to provide real welfare reform than 90 percent of the talk of welfare reform that is going on around right now?

Mr. SIMON

Mr. SIMON. I am pleased to yield to my colleague from Tennessee.

Mr. SIMON. I reclaim my time to point out there is absolutely nothing to prevent us from responding. There is something to prevent us from responding irresponsibly, and that is what we have been doing. We have been saying, basically, ``The heck with our children and our grandchildren and future generations. We are going to give a political response.'' Now, there is no question we are going to have to make some hard choices, but I think it is essential that we make those hard choices. And I think, whether it is the Senator from Maryland or the Senator from Tennessee or the Senator from Pennsylvania or the Senator from Illinois, we have to keep in mind what the GAO says, and that is if-- and they use the year 2001, this was a June 1992 report--by the year 2001, we balance the budget, by the year 2020 there will be a 36 percent increase in the standard of living of all of our people.

Mr. SIMON. I reclaim my time.

Mr. SIMON. Yes, I am pleased to yield. I wanted to make that point.

Mr. SIMON. I will not yield at this point.

Mr. SIMON. The answer is that we are not going to eliminate economic cycles in this country. There are going to be dips. I favor automatic stabilizers, and we have some. Unemployment compensation is one. Social Security is another. It is a very solid stabilizer. I favor creating more that are automatic stabilizers in this kind of a situation. But, Mr. President, I point out to my colleague--he was not on the floor when I said that we can build some small surpluses in. Former Assistant Secretary of the Treasury, Fred Bergsten, whom the Senator from Maryland knows well, says we are frozen by our deficits from responding. That is why we could not, even with a brand new President, and both parties of Congress of his party, pass a $15 billion job stimulus program, because we saw this huge deficit. Fred Bergsten said, build in a 2-percent surplus and then have some automatic programs that kick in when unemployment goes above a certain level in Pennsylvania or some other place. That makes infinitely more sense than what we are doing now. And if we continue on the present path, we are inviting economic chaos. I point out further to my colleagues here that the Investors Business Daily had this substantial item I put in the Record the other day pointing out that this idea that we stabilize the situation and we reduce recessions just does not work. The National Bureau of Economic Research came out with a paper recently, written by two University of California economists, which says, ``Our main finding is that monetary policy has been the source of most postwar recoveries,'' as it has been of this recovery. When those interest rates went down--thanks, I say, to Bill Clinton and his courage in facing this recession--our economy picked up. And Data Resources, Inc., says, if we pass this, when we balance the budget we are going to have a 2.5 percent reduction in interest rates. But here is what the University of California economists say: Our main finding is that monetary policy has been the source of most postwar recoveries. While limited fiscal actions have occurred around most troughs, these actions have almost always been too small to contribute much to economic recovery.

Mr. SIMON. I yielded to my colleague from Maryland for a question. I would be happy to have his question here.

Mr. SIMON. Yes, which we have done in recessions.

Mr. SIMON. I will be pleased to yield, but I will yield only for a question, and I want to retain my right to the floor.

Mr. SIMON. Mr. President, the Senator from Tennessee seems to be stuck presiding whenever I am speaking here. He has my sympathy. I want to slightly differ with my friend from Idaho in that I think, to the President's great credit, in 1993, he did come forward with a program to move that deficit down. The problem is that was a brand new President in a honeymoon period, with both Houses of Congress in his corner. It was a first step. But there is no indication that we are willing to make further steps, and that is why we need the constitutional amendment. And my colleague from Idaho and I agree on that. Senator Smith mentioned that a large majority of Americans are for this, and he also said we are going to have to make some hard choices. What is also true is, according to the Wirthlin poll, that while 79 percent of the people in the United States are for this, 53 percent believe they are going to have to sacrifice if we get it. The American people understand that. But they also, in some vague way--they may not know the General Accounting says if we are willing to sacrifice a little, by the year 2020, our children and grandchildren can experience a 36 percent increase in their standard of living. That is powerful. That is what we ought to be looking at. So I can sacrifice a little--and I have said this half a dozen times, and you are going to hear me saying it again--I have to sacrifice a little so that my grandchildren can have a better future. That is what it is all about. Are we willing to do that? Earlier today, one of our colleagues asked, ``What do we do if we have a recession?'' That was implying that we are not able to respond if there is a recession. But what do we have to do if there is a recession and all of a sudden outlays exceed receipts? First of all, we are implementing legislation--we made clear in committee, and we will make clear in the legislation that there has to be some flexibility in a $1.6 trillion budget. You cannot, right down to the dime, work things out. The best way to protect against that is what has been suggested by Alan Greenspan and Fred Bergsten, and some of the others, that is building up a surplus so if there is a dip in economy, you are not in a deficit situation. The second thing we will make clear is that if it is within 3 percent of being balanced--so on a $1.6 trillion budget, that is $48 billion-- if you are $38 billion or $30 billion in the red, that is considered a balance, but you shift that over to the next fiscal year. So you have that option. Third, we can simply, with 60 percent of the Senate and 60 percent of the House, vote to have that amount in deficit. So there are really a number of options, and the idea that we are frozen and we cannot do anything in a recession--it is very interesting that in past recessions, we have extended unemployment compensation for the people of Pennsylvania, for the people of Tennessee, for the people of Maryland, for the people of Illinois. And in these recessions--it is very interesting--I have been able to find only one time, I say to my colleague from Maryland who spoke on this, when we did not get 60 votes for an extension of unemployment compensation. That was in 1982. Listen to those votes: 92-8, 92-1, voice vote, 75-18, 84-10, 84-16, 61-36, voice vote, voice vote, 86-14, 85-10. It is clear that we have the ability to respond. (Mr. SANTORUM assumed the chair.)

Mr. SIMON

Mr. SIMON. I want to point out that the Senator's figures are conservative figures. For my friends who are new, they may not know that our colleague from Alaska is a banker by background. But the Senator starts off with net interest. For example, he starts off with a $225 billion expenditure here. The net interest is something that administrations like to use rather than the gross interest because it makes it look better. In no other field--in the Justice Department; for example, we do not say, ``Well, they took in so many dollars in fines and, therefore, we should subtract that from the total of the Justice Department expenditures.'' The gross interest expenditure--and I have to give credit to my colleague, Fritz Hollings, for educating me on this--the gross interest expenditure this fiscal year is $339 billion. So the figures that my colleague from Alaska is using, those are conservative figures and I thank him for his contribution.

Mr. SIMON. Will my colleague yield?