Alan Simpson

Mr. SIMPSON

Mr. SIMPSON. Mr. President, I ask that I be added as a cosponsor of the Leahy-Kassebaum amendment.

Mr. SIMPSON. Mr. President, I want to show my support for this amendment, which, of course, includes U.S. funding for the U.N. Population Fund, UNFPA, as it is known. President Clinton had to resume funding for the population fund 2 years ago after a 7-year suspension during the Reagan and Bush administrations. I did not ascribe to that. I did not agree with the fine Presidents of my own party on that issue--either the wonderful Ronald Reagan or my fine, loyal friend, George Bush. Last year, the Congress appropriated $40 million for the fund, and $50 million was appropriated for 1995. This year, we are looking at funding levels of $35 million. I do understand that funding for all programs across the board needs to be reduced if we are to incur savings in this year's budget bill. However, I do not want to see population programs unfairly targeted for larger reductions than other foreign assistance programs. The United States needs to keep its funding at an adequate level, or we will surely send exactly the wrong message to the rest of the developed nations across the world. Last year, the United States was seen as a world's leader of population and development assistance at the International Conference on Population and Development in Cairo. I was a congressional delegate at the conference, as was my friend, Senator John Kerry. There were not a lot of colleagues eager or seeking to go to that particular conference. I came away very impressed with the leadership and direction displayed there by Vice President Gore, and the assistance given him by the now Under Secretary of State, former Senator, Tim Wirth in guiding the conference and its delegates in developing a ``consensus document,'' on a broad range of short- and long-term recommendations concerning maternal and child health care, strengthening family planning programs, the promotion of educational opportunities for girls and women, and improving status and rights of women across the world. We surely do not want to lose our moral leadership role and relinquish any momentum by abandoning or severely weakening our financial commitment to population and development assistance. The United States needs to continue its global efforts to achieve responsible and sustainable population levels, and to back that up with leadership with specific commitments to population planning activities. In my mind, of all of the challenges facing this country--and there are surely plenty of them--and around the world--none compares to that of the increasing of the population growth of the world. All of our efforts to protect the environment, all the things we hear about what is going to happen, what will happen to this forest system, or this ecosystem, promoting economic development, jobs for those around the world, are compromised and severely injured by the staggering growth in the world's population. I hope my colleagues realize, of course, that there are currently 5.7 billion people on the Earth. In 1950, when I was a freshman at the University of Wyoming--not that long ago, surely--there were 2.5 billion people on the face of the Earth. Mr. President, 2.5 billion people using the Earth's surface for sustenance and procreation in 1950. Today, 5.7 billion--double--more than double. Since 1950 to today, the figure has doubled and it will double again if birth and death rates continue. The world's population will double again in 40 years. These are huge figures. If you want to talk about food supply, want to talk about the environment, pollution, fish, timber, coal, resources, there is your figure. Nobody pays much attention to that because we allow this debate to slip over to abortion. It does not have anything to do with abortion or coercive practices. That is why it is so important we show our support by funding this particular fund. It is supported entirely by voluntary contributions, not by the U.N. regular budget. You do not have to get into this one because you hate the United Nations either. This is not about whether you like the United Nations or not. Many of us have great problems with the United Nations, and they have certainly failed in many endeavors, but this is not a ``U.N. caper.'' There were 88 donors to the fund in 1994, most of which were developing nations. Japan and the United States were the leading contributors to the fund with the Nordic countries not lagging far behind. UNFPA assistance goes to support 150 countries and territories across the world. UNFPA total income in 1994 was $265.3 million, and it provides about one-fourth of the world's population assistance to all developing countries. I think it would be a real shame if the United States were to back away from its commitment to the world's largest source of multilateral assistance for population programs. I want to reiterate again what has been said already about U.S. participation in this fund. The U.S. contribution would be subject to all the restrictions which have been in place for many years. These restrictions are in place to address concerns specifically about U.S. funds being spent in China. I hear those concerns. Under current appropriations law, foreign aid funding is denied to any organization or program that ``supports or participates in the management of a program of coerced abortion or involuntary sterilization'' in any country. That is pretty clear. I agree with that. Furthermore, current appropriations law ensures that none of the United States contribution to UNFPA may be used in China--none. Listen carefully: The United States is not funding any of the population activities in China. Furthermore, the U.N. Population Fund does not fund abortions or support coercive activities in any country including China. The UNFPA assistance goes toward family planning services and maternal and child health care across the developing world. Finally, no U.S. funds may be commingled with other UNFPA funds and numerous penalties exist in law for any violation of this requirement. I also have deep and serious concerns about China's coerced abortion policy, but forcing the U.N. Population Fund to withdraw from China will not affect that policy one whit. In fact, without [[Page S 16493]] the careful monitoring that the fund performs, conditions in China would get very much worse. That is an important consideration. The world and the United States cannot turn its back on what is currently going on in China. Remove the funding and that great door will close ever further. No one will be able to participate or to change those policies. Finally, this amendment would strike the House Mexico City language that denies United States population assistance to groups that are involved in dialog with foreign governments about abortion policy or even distribute literature on preventing unsafe abortions. This House amendment would ultimately deny family planning activities overseas. Since the House language applies to nongovernment organizations [NGO's] it would cut off funds to the most effective and dedicated providers of services, groups that best understand the needs of the people in the country they serve. I urge my colleagues to vote for the Leahy-Kassebaum amendment so that the United States might continue its leadership role in addressing the global population issues which are wholly significant in the range of other issues that we confront from day-to-day, because all of it comes back to the simple fact, how many footprints will fit on the face of the Earth? Mr. President, I suggest the absence of a quorum.

Mr. SIMPSON

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

Mr. SIMPSON. Mr. President, I rise today to offer an amendment that all Senators should be able to agree on. It would require that the President's annual budget continue to include a chapter on generational accounting. ``Generational accounting'' is a way to consider the fiscal treatment of different generations. Specifically, it indicates what the members of each generation can expect to pay on average, now and in the future, in taxes, as a result of current budget expenditures and revenues. President Bush included a chapter on generational accounting in his 1993 fiscal year budget and President Clinton included a chapter on generational accounting in his 1995 fiscal year budget--but he failed to include any mention of generational accounting in this year's budget. Thirty of the 32 of us on the bipartisan commission on entitlements and tax reform concluded that if we do nothing about the impending entitlements crisis, by 2012 every penny of our Federal revenues will be necessary to pay for entitlements and interest on our national debt. In 2040, our children and grandchildren will be forced to pay 40 percent of the national payroll tax base in taxes. It is crucial that we begin to take a longer term view of the future and consider how the impact of our decisions today will affect our children and grandchildren. If you truly are concerned about the burden of taxes on those we love, then you will support this amendment. For 2 days now, I have listened to my colleagues wail about the poor, the young, the disenfranchised while they ignore the biggest crisis-- the impending bankruptcy of the Social Security Program. It is like crying about slipping on a banana peel on the deck of the Titanic. Our temporary fix for the Medicare Program is nothing more than delaying the inevitable. My colleagues are cheering that Medicare will not go broke in 2002, but rather in 2008. Now that is something to be proud of. Yet, we only have ourselves to blame. In the past, the Social Security Advisory Council provided guidance on Social Security and Medicare issues. However, we got rid of the Advisory Council and instead created an Advisory Board--except that they no longer provide guidance on Medicare issues. How ironic. The program that is going to the dogs first, is the program we decided we do not want any guidance on. So we have done it to ourselves. But we can stop this game-playing if we are forced to consider what we are doing to future generations--and this is why generational accounting is so important. Mr. President, this amendment would simply require the annual budget of the President include a chapter on generational accounting. [[Page S 16011]] The President of the United States, President Clinton, did a nice job on that in the first budget message. It was left completely out of the second one. I think it is vitally important we tell the American people 20 and 30 years down the line who is paying the bills. I hope we can get back what President Clinton put in his first budget. This requires that so that we know what is out there 20 or 30 years from now--generational accounting, who is paying the bills, who really cares about the children of the country and also deals with that issue in an upfront way.

Mr. SIMPSON

Mr. SIMPSON. I move to reconsider the vote.

Mr. SIMPSON

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

Mr. SIMPSON

Mr. SIMPSON. That is true. But they are just struggling along. And we want to continue to send our $8 dues to them because my mail is running 16 to 1 against the AARP, and most of it comes from their own members who say, ``I am still going to pay the 8 bucks, but go hit `em a lick.'' And I am certainly going to be delighted to do that.

Mr. SIMPSON. Mr. President, I too listened with great interest to some of the rather vigorous debate, I believe is the phrase. It was rather strained a time or two, and almost a little bit hysterical, I thought a time or two also, just hearing snatches of it from those on the other side of the aisle. It would, indeed, as my good old friend from Wyoming has indicated, make you weary. And indeed it will. What will make you even more weary is to read once again, which has been alluded to many times in this debate, ``The Status of the Social Security and Medicare Programs in the United States of America,'' this wonderful little yellow pamphlet which has been recommended to all Americans for many months now. And I wish I could put it in more earthly vernacular, and I could ordinarily, but this forum does limit one in that particular dependency, so let us just say that Social Security is going to go broke and Medicare is going to go broke. So if you want to have another TV ad of somebody smashing into their oatmeal with the pitch that the Republicans are doing something horrid, get a real picture of someone who is watching Medicare go broke in the year 2002, where you do not have a ``less'' benefit in the years out; you have ``no'' benefit. Try that one on. So too even with the hard work we have done here, be of stout heart. For medicare will not go broke in the year 2002. It will now go broke in the year 2008. So gird your loins, cheer yourselves, and know that the draconian activity we have undertaken here on our side of the aisle--and we will do it, and we will do it by ourselves--will ``save'' it till then. And in a year we will tell the American people what we did, and they will be very pleased. This is what we are about. I have not heard a single recommendation from the other side of the aisle that would do anything, and certainly $89 billion is not going to do anything because they did not even talk about part B. How phony can you get to come in and talk about you only need $89 billion to save Medicare, and leave off part B? How really phony can you get when you want to know, ladies and gentleman of America, that part B premiums are totally voluntary, they are not part of any Contract With America, and they were not part of any contract with senior citizens. In every sense, it is an income transfer. It is a welfare program because right now the senior citizen who has chosen to accept this is paying 30 percent of the premium, and the people who maintain this magnificent building at night when we are not here are paying 70 percent of the premium. I hope somebody will figure that one out. So I want to watch the votes. Again, how we are going to handle part B premiums when we have this peculiar situation, to say the least, where ``Joe Six-Pack'' is paying 70 percent of the premium for somebody who is ``Mr. Megabucks.'' If you want to get into this business about ``the little guy,'' let us get really into this one. This is about the little guy, the guy that does not have anything, and he or she is going to work every day to pay 70 percent of the premium for everybody in Medicare part B. That is absolutely absurd. So I am anxious that we do cast some votes in that area. We will smoke them out and see who really is for ``the little guy''. Then, of course, we will see a unique and remarkable experience. We will get there in conference. The President of the United States has said that Medicare will not be allowed to go up over 7.1 percent, and we are saying we will not let it go up over 6.4 percent. Does anybody in America believe we will not get there? There is not a single person on the other side of the aisle that does not know the President of the United States of America has already recommended that Medicare not be allowed to increase over 7.1 percent and not 10.5. We all know that. I hope the American people cut through the babble on that one. We all know the President of the United States has now said we will have a 7-year budget instead of a 10-year budget. It is good that he is calling it a 7-year budget because his 10-year budget thing was just a thing. It was not a budget. So we will address that. Now he has admitted that he went too far in raising taxes. I saw a fellow get beat on that once in a campaign--two of them, in fact. Now, surely, perhaps three. So we are ready to go. We will go over the cliff together. We will not get a single vote from the other side of the aisle. And between now and next October, next election season, we will describe to the American people just exactly what we did, how we saved Medicare, how we began to get on track again all over the United States, and all over the world with our work, with our debt limit, our deficit, our savings rate with all of the things that are critical to us, and be a solvent country. But in the next few days, and weeks, we will be accused of being the party that broke all the ketchup bottles over the heads of every child in the first grade, threw all the bed pans out of the nursing homes, destroyed every possible facility that shelters the homeless, the aged, and the infirm. And be ready for that. And the charge may be led by the AARP, which is a group of 33 million Americans bound closely together by a love of airline discounts, automobile discounts, and insurance discounts--one of the biggest businesses in America who even have a thing called ``tax advice'' for their members. And this is a group that has paid the IRS $135 million in back taxes. Boy, I would love to have them giving tax advice! They need all the money they can to figure out how to get back $135 million. So be ready for it. Dig in. We are going to have a lot of fun. And when it is all over, we will have the votes. And when it is really completed, the American people are going to be very excited and pleased months from now when they figure it all out as to what we did and what they on the other side of the aisle did not do.

Mr. SIMPSON. They are a ragged lot. They are just a tattered band of ragamuffins. They have a building downtown here which could be described as ``the Taj Mahal,'' and their lease rental there per year is $17 million--$17 million a year on a 20-year lease. They have $314 million in the bank in T bills. They get $106 million a year from Prudential Life Insurance, taking 3 percent of every premium. They get premiums and royalties from Scudder on investments, from New York Life, from the R.V. insurance. They are a big, big, big business, and they also get $86 million from the U.S.A. to run some of their programs on top of all that.

Mr. SIMPSON

Mr. SIMPSON. Mr. President, I rise to respond to the statement made yesterday by the distinguished Senator from Michigan, my old friend Senator Carl Levin. We came here to the Senate together. I have the greatest admiration and personal regard for him. I trust that my colleagues will listen very carefully to what I have to say about this issue--the so-called ``Istook-McIntosh'' amendment which may be included in the Treasury-Postal appropriations conference report. I ask for your close attention because I am certain that your offices are hearing about this language, just as the Senator from Michigan has been hearing about it. And, if the material coming across my desk is any guide at all, a clump of what you are hearing about it is plain hogwash, or more civilized, rubbish. I would surely include the commentary of the New York Times within that description. I have been in the negotiations concerning the Istook-McIntosh language. I have been working side by side with my colleague from Idaho, Senator Larry Craig. One could not ask for a better ally in this or any other cause. The Senator from Idaho brings many singular qualities to this work--a commitment to genuine reform, great realism about what it is possible to achieve in legislating, and unflagging consideration for the concerns of his colleagues--especially including me. We know what this proposed amendment does, and what it does not do. And I can certainly assure my colleagues that much of the lobbying on this amendment has been hysterical at the worst, misleading at best. It is no wonder that my friend, the Senator from Michigan, is agitated about it, given the abjectly horrifying portrayal by those lobbying this issue. It almost tempts me to coin a new aphorism--``hell hath no fury like an individual whose access to Federal bucks has been conditioned in any way.'' Because that is what this issue is about--access to the Federal Treasury. It is not about ``free speech'' or the first amendment, or anything of the sort. Those are merely the terms which are being applied during the argument by those who wish to continue to ensure themselves of continued delivery of Federal money. Let me begin my description of this amendment by going back to first principles. I have a few views which might be termed eccentric or quaint or even naive in this era of behemoth government, and one of them is that there are ``responsibilities'' which follow from being a custodian of Federal money. I know that is a strange and even bizarre thing in this day and age, to talk about ``responsibility'' instead purely of ``rights,'' or purely of ``victims.'' We are all experts on our own rights, but rarely do we acknowledge that these rights confer responsibilities. And that is what this issue is about--the responsibilities of those who receive Federal money. The Senator from Michigan is justly concerned about the influence of lobbyists over the public policy process. This concern animates his sincere desire to pass lobbying reform legislation--and he is proceeding remarkably toward that end. I agree with that concern, and I would add to it by saying that the American public knows that ``something is wrong'' with the process. They know that the process itself interferes with good policy. They know that the interests of the public at large are not served well when Washington has so contrived matters as to amplify the access and the influence of certain special interests, which comes effectively at the expense of the interests of the whole. The average person on the street would be scandalized to find out that we, the Congress, have been blithely engaging for years in the practice of favoring political organizations with taxpayer-provided money. I am not talking about simply the narrow practice of using Federal dollars to lobby. That is illegal already, as the Senator from Michigan has so ably pointed out. But I think we need to agree that it is wrong to be giving Federal dollars to political organizations, whether or not we ``mark'' those bills they receive and then say that only those dollars can't be used for lobbying Congress. Can you imagine the outcry, wailing and gnashing of teeth that would exist if the Federal Government were found to have channeled millions in grant money to the Christian Coalition? Or the Heritage foundation? It wouldn't matter whether that money was used to hold seminars or to buy stationery. The public would swiftly know that this was wrong, that Government should not be in the business of propping up the operations of political organizations. And yet that is precisely what we in America have been doing. I found this year that the AARP received $86 million in Federal grants--this, the largest and most powerful lobbying organization in the country--the King Kong of lobbying ``gorillas.'' At the time, I was criticized for ``singling out'' the AARP. I was told that the only way ``to be fair'' was to deal with the problem as a whole, to put a stop to the practice across the board. That is what Congressmen Istook, McIntosh, and Ehrlich are attempting to do. Let me repeat that I believe we should all agree on the basic premise from which we should be working; we should not be in the practice of funding political organizations with Federal money. Thus, I have been working with my colleagues on the House side to try to develop a reasonable and balanced test for eligibility for public funds. Not to restrict anyone's rights of political expression--but rather, to specify minimum standards for the non-political, impartial distribution of public monies. I believe that our final product will try to set reasonable boundaries for the types of organizations which should be receiving Federal money. Let me remind my colleagues that this is not a novel concept. Already in the law there are restrictions on the amount of lobbying which can be done by 501-C-3 organizations which take the 501-H election to identify themselves as charities. In return for the benefit of tax deductible contributions, these organizations agree to limit their lobbying expenses. They may spend 20 percent of their first $500,000 on lobbying, 15 percent of their next $500,000, 10 percent of their next $500,000, and 5 percent after that, on up to a global cap of $1 million on lobbying. Let me repeat for my colleagues: This formula is already in the law. Now. It is accepted by all as a reasonable and balanced limit upon the political activities of such organizations. No one construes this as an abridgement of first amendment rights. It is a consequence of our consensus opinion that predominantly political organizations should not receive certain Government benefits. I urge my colleagues to go out in the land and talk to various individuals about the 501-H spending formula. Not the ones ``beating the drum'' about this legislation. But most others would agree that the formula is extremely lenient, very generous--some would say it is so generous as not to constitute a significant restriction at all. I have been working with my House colleagues to develop reforms of these boundaries to make certain that they work in practice in a way that they have not always worked before this time. The Senator from Michigan highlighted one particular feature of the originally proposed Istook language, singling it out for criticism. This concerns the application of the spending formula to non-Federal money. I listened carefully to that commentary, and I wonder whether or not my old friend from Michigan and the rest of the Senate are aware of the way in which the law already works in this area. I have been distressed to see the howls and shrieks of outrage from Government grantees when we suggest that they should no longer be able to ``count'' the amount of their Federal grants in computing their lobbying expenses under the formula which I just outlined. This has even been a rallying cry against the principles in the grant reform amendment--how outrageous, it is said, that there should be any restriction on the use of private funds. Let me try to calm the heaving bosoms out there by asking my colleagues to think about this substantively for just a moment. First of all, the existing formula--already in the law--already applies to all 501-H groups even if they don't receive Federal money. So this supposed restriction on the use of private funds already exists. Furthermore, consider the paradox that results if we continue to ``count'' the Federal money when computing allowed lobbying expenses. If you have two organizations--each with the same amount of private support--then, under current law, the one that pulls down a Government grant can spend more on lobbying than the one which doesn't. That is the very essence of taxpayer-subsidized lobbying, which we all agree is wrong. It only makes sense for an organization's lobbying expenses to be based on their degree of private support, not on the amount given to them in Federal money. I expect that this debate will heat up still further, and I expect that hysteria and distortion will abound. I can see some of it already. I have read articles saying that somehow this legislation will stop organizations from being able to write editorials and to even make their opinions known. That is nonsense, unless somewhere in this country it costs you $1 million to write a letter to the editor. I personally will have my old bald dome battered because I have stated all along that I would seek to protect the ``true'' charities from the scope of any legislation--the 501-C-3 organizations which we all care so much about--and should. Well, the amendment which hopefully will shortly be presented as an Istook-Simpson compromise will indeed protect them. We will protect them not by creating a blanket exemption for all charitable groups, but by leaving ``in place'' the spending restriction formulas that already apply to charitable organizations. I have also heard various muted and sometimes raucous imputations that this amendment is somehow discriminatory, that it singles out a particular ``type'' of recipient for restriction. It has been implied-- although not overtly stated--that somehow we are working to exclude for-profit lobbyists from this legislation, targeting the legislation only against ``nonprofits.'' That is simply untrue. The Istook-McIntosh-Ehrlich amendment does not distinguish between for-profit and nonprofit entities. If a grant is given to a for-profit taxpaying organization, they are subject to the same lobbying caps. The language does not exclude ``contractors'' in any general way, although the language does not apply specifically to ``contracts.'' There is a very good reason for this, and this is the ambiguity as to what constitutes a ``contract'' with the Federal Government. The inclusion of ``contracts'' in this legislation would mean that every HMO around the country which contracts to provide services under Medicare would be covered. That and similar consequences are the reasons that ``contracts'' are not included; it is not some sinister conspiracy to exclude or target any particular group. If opponents of the legislation can figure out a way for us to responsibly include ``contracts'' in the scope of this legislation without creating serious ambiguities and contradictions, we would be most happy to work with those suggestions. Mr. President, I will conclude my remarks, because there will be time to debate this later at length. But for the record today, I do not want to let the current characterization of this legislative language go unchallenged. I want first and foremost to repeat my response to a central point made by the opposition. Somehow the Istook language is said to be sinister because it applies the spending formula to the nonfederal, private money. Of course it does. Which money is the existing 501-H spending cap formula supposed to apply to? The Federal money? That is supposed to be illegal, to use Federal money for lobbying. No, it has always been understood that those restrictions applied to the private support; there is nothing novel or sinister of evil about that. The Proposed language would simply make this explicit. We are still working with House negotiators to try to craft a package which we believe will be worthy of Senate support. I trust that my colleagues will study the details about the finished product rather than to listen to the characterizations that have been made by those who are lobbying against it. This could be our best chance to effect true lobbying reform--and the best measure of that is the degree to which this has agitated those lobbyists suckling at the Federal breast. We should be equally vigilant about gifts from lobbyists, and gifts to lobbyists. This measure attempts to deal with the latter. I thank my colleagues and I yield the floor.

Mr. SIMPSON

Mr. SIMPSON. Mr. President, it is a great pleasure for me, as chairman of the Senate Veterans' Affairs Committee, to introduce today the Veterans Health Care Management and Contracting Flexibility Act of 1995. This legislation, Mr. President, would free the Department of Veterans Affairs [VA] from a number of statutory restrictions which unnecessarily limit its authority to contract for health care-related services. It would also ease and clarify current reporting requirements which excessively impede VA's ability to manage its own affairs. What this bill would accomplish is best understood by considering, first, the health care environment within which all health care providers--including VA--must operate today, and then the state of the law under which VA attempts to so operate. If there is any certainty today with respect to health care, it is this: those who pay for health care--whether those payers be State or Federal Government agencies, insurance carriers or health maintenance organizations, or better informed consumers drawing, perhaps some day, from health savings accounts or simply from their own bank accounts--will no longer tolerate the unrestrained cost inflation that they have been forced to put up with in the past. All health care providers, therefore, are now--and will continue to be--under unprecedented pressure to rein in costs and find operating efficiencies so that they can compete in an increasingly cost sensitive environment. In light of these realities, all now agree that health care providers must restrain the growth of--or affirmatively cut--costs. One sure way of doing that is to share certain resources--including, but not necessarily limited to, high tech medical resources--lest there be wasteful duplications in expenditures and effort within local markets. For example, it has become increasingly common for one hospital or practice group to sell, for example, Magnetic Resonance Imaging [MRI] services to another, while buying other diagnostic services from the same purchaser. Like any health care provider, VA medical centers ought to be able to share, buy and swap all sorts of services with other community providers. But they cannot fully capitalize on such opportunities under current law. Presently, VA can only share or purchase ``medical'' services. It cannot share or purchase other critical services, for example, risk assessment services, that all health care providers must either buy or provide ``in house.'' Even within the narrow authority allowing only ``medical'' services to be shared or purchased, there is an unnecessary restriction. VA cannot purchase or share any medical resource; it can only purchase or share ``specialized'' medical resources. And that is not all, Mr. President; there is further restriction imposed upon VA. VA medical centers are not free to purchase from, or share with, any and all health care providers they might find in the local community. They can only ``partner up'' with--and, here, I quote from statute--``health-care facilities (including organ banks, blood banks, or similar institutions), research centers, or medical schools.'' 38 U.S.C. Sec. 8153. This restrictive legal rubric does not extend to VA authority to enter into sensible sharing arrangements with other potential partners such as HMOs, insurance carriers or other ``health plans,'' or with individual physicians or other individual service providers. One provision of my bill, Mr. President, would cut through this legal thicket by expanding significantly VA's current sharing authority. In summary, VA would be authorized to share, purchase or swap any resources with any local provider. VA could enter into contracts for any and all ``health care resources,'' a term which is considerably broader than the ``specialized medical resource'' limitation under which VA now operates. That term would include such resources, but would also include nonspecialized ``hospital care,'' ``any other health-care service,'' and any other ``health-care support or administration resource.'' Further, VA would be authorized to buy from, or share with, any ``non-Departmental health care provider''--a term which would include the ``health-care facilities'' and ``research centers and medical schools'' with which VA may not contract, but which would also include other ``organizations, institutions, or other entities or individuals that furnish health-care resources,'' and also ``health care plans and insurers.'' Thus, Mr. President, my bill seeks to open up to VA an entire new world of potential sharing partners and sharing opportunities. While VA would not have totally unfettered authority to buy and sell services-- for example, VA would be required to ensure that any such arrangements not diminish services made available to its veteran patients--it is my intention that VA be freed from restrictions which were applied when VA tried to do everything itself ``in-house.'' There was a time, perhaps, when VA could afford to try to be everything to everyone, but it cannot do so now. No modern provider can afford that mentality today. I note for the Record, Mr. President, that VA has requested the expanded legal authority that I propose today. But it has done so in the context of a much larger bill, S. 1345, that I introduced at VA's request on October 19, 1995. The main thrust of S. 1345 is so-called ``eligibility reform,'' that is, a broad scale revision of current statutes defining who shall be eligible for what VA medical services. That issue, Mr. President, is an extremely thorny one inasmuch as, lying at its very center, are very difficult judgements about who shall have priority over whom in securing VA health care in a period of limited resources. The Committee on Veterans' Affairs intends to take this critical issue up, but it will take time to sort out conflicting claims to priority to such limited resources. I think we ought to proceed now to streamline the statutes that restrict VA's sharing authority--an action which, in my view, can be taken now, and will made sense whether or not we are able to accomplish ``eligibility reform.'' My bill would do more, Mr. President. As I have pointed out, VA now has authority--though authority that is, in my view, too narrow--to contract for ``specialized medical resources.'' Even so, however, VA medical centers are statutorily barred from ``contracting out'' the very same services. 38 U.S.C. Sec. 8110(c). In addition, they may not contract out activities that are ``incident to direct patient care.'' Id. Finally, VA medical centers may contract out other ``activities'' at VA [[Page S 15576]] medical centers, for example, grounds' maintenance services--but only if VA leaps through a series of substantive and procedural hoops that plainly impede the contracting process. Under my reading of the law, it is apparently acceptable, under 38 U.S.C. Sec. 8153, for a VA medical center to contract for supplemental ``specialized'' medical services--let us say anesthesiology services-- so long as the medical center does not contract out all such services. This distinction, Mr. President, makes no sense to me--and, as I will discuss in a moment, apparently makes no sense to the Congress any longer. Further, it makes no sense to me that VA cannot contract out services that are ``incident to direct care''--assuming one can identify the legal boundaries of activities that are merely ``incidental.'' To my way of thinking, if ``direct care'' activities ought to be shared and purchased without significant restriction--as VA espouses in recommending modifications to 38 U.S.C. Sec. 8153--they ought to be subject to purchase wholly by the medical center through the ``contracting out'' process. And if ``direct care'' activities ought to be subject to contracting, then, clearly, services that are ``incidental'' to such activities should be too. Of course, Mr. President, what is true for direct care services-- services which go to the core of what VA does--is also true for other activities at VA medical centers: all such activities ought to be subject to contracting if contracting makes economic sense. We can afford no other standard. Unnecessary impediments to contracting--such as those set up by 38 U.S.C. Sec. 8110(c)--ought to be swept away. As I noted a moment ago, the Congress has apparently come to that conclusion already. In the 104th Congress, we suspended application of restrictive aspects of section 8110(c) through fiscal year 1999. See 38 U.S.C. Sec. 8110(c)(7). Mr. President, it is clear to us all that VA will not be under less budgetary pressure in the year 2000 than it is now. We ought not to indulge the fiction that VA will be able to afford to hold all activities ``in house'' then, if it cannot afford to do so now. In short, we should have repealed section 8110(c) last year--and we ought to do so now. Finally, Mr. President, I note another restrictive provision of law that ought to be swept away--or at least narrowed--now. Under current law, VA is precluded from putting into effect certain field facility ``administrative reorganizations''--essentially, those which will result in a force reduction of 15 percent or more at any particular site--unless it has first given the Congress 90-days notice computed to count only those days when both Chambers of Congress are in session. 38 U.S.C. Sec. 510. Two difficulties arising from this provision of law came into focus earlier this year when VA's Under Secretary for Health, Doctor Ken Kizer, submitted a proposal to reorganize VA's 172 medical centers into 22 ``Veterans Integrated Service Networks'' [VISNs]. While Doctor Kizer had briefed Congress extensively on his sensible reorganization model during its development, he still had to wait more than 3 months after the announcement of the reorganization before he could, by law, take any ``action to carry out such administrative reorganization.'' 38 U.S.C. Sec. 510(b). Worse, since the statute specifies that the 90-day ``notice and wait'' period runs only when both bodies of Congress are in session, Id., he--and we--were unable to determine when the 90-day notice would expire since no one was able to know when either body of the Congress might recess. Such obstructionism by the Congress is, in my view, most unfortunate and unseemly. I really think that we ought to grant more trust to the senior officials we confirm than is reflected in this statute. Yet, I remain sensitive to the Members' needs to know if a field office reorganization will adversely affect a significant number of their constituents. Therefore, I do not propose today that this provision of law be totally repealed. I do propose, however, that we reduce the ``notice and wait'' period to 45 calendar days. That period, I believe, is sufficient to allow Senators and House Members an opportunity to assess the impact of a given reorganization on their constituents. To recap, Mr. President, my bill would expand VA's authority to share, purchase and swap resources, as is necessary to meet the challenges of 21st century medicine. And it would remove an excessive restriction on VA's right to organize and station its employees efficiently. These measures are dictated by common sense and are, in the main, supported by VA. I request the support of this body. I request unanimous consent that the text of my bill be printed in the Record.

Mr. SIMPSON

Mr. SIMPSON. Mr. President, it is a great pleasure for me, as chairman of the Senate Veterans' Affairs Committee, to introduce today the Veterans Health Care Management and Contracting Flexibility Act of 1995. This legislation, Mr. President, would free the Department of Veterans Affairs [VA] from a number of statutory restrictions which unnecessarily limit its authority to contract for health care-related services. It would also ease and clarify current reporting requirements which excessively impede VA's ability to manage its own affairs. What this bill would accomplish is best understood by considering, first, the health care environment within which all health care providers--including VA--must operate today, and then the state of the law under which VA attempts to so operate. If there is any certainty today with respect to health care, it is this: those who pay for health care--whether those payers be State or Federal Government agencies, insurance carriers or health maintenance organizations, or better informed consumers drawing, perhaps some day, from health savings accounts or simply from their own bank accounts--will no longer tolerate the unrestrained cost inflation that they have been forced to put up with in the past. All health care providers, therefore, are now--and will continue to be--under unprecedented pressure to rein in costs and find operating efficiencies so that they can compete in an increasingly cost sensitive environment. In light of these realities, all now agree that health care providers must restrain the growth of--or affirmatively cut--costs. One sure way of doing that is to share certain resources--including, but not necessarily limited to, high tech medical resources--lest there be wasteful duplications in expenditures and effort within local markets. For example, it has become increasingly common for one hospital or practice group to sell, for example, Magnetic Resonance Imaging [MRI] services to another, while buying other diagnostic services from the same purchaser. Like any health care provider, VA medical centers ought to be able to share, buy and swap all sorts of services with other community providers. But they cannot fully capitalize on such opportunities under current law. Presently, VA can only share or purchase ``medical'' services. It cannot share or purchase other critical services, for example, risk assessment services, that all health care providers must either buy or provide ``in house.'' Even within the narrow authority allowing only ``medical'' services to be shared or purchased, there is an unnecessary restriction. VA cannot purchase or share any medical resource; it can only purchase or share ``specialized'' medical resources. And that is not all, Mr. President; there is further restriction imposed upon VA. VA medical centers are not free to purchase from, or share with, any and all health care providers they might find in the local community. They can only ``partner up'' with--and, here, I quote from statute--``health-care facilities (including organ banks, blood banks, or similar institutions), research centers, or medical schools.'' 38 U.S.C. Sec. 8153. This restrictive legal rubric does not extend to VA authority to enter into sensible sharing arrangements with other potential partners such as HMOs, insurance carriers or other ``health plans,'' or with individual physicians or other individual service providers. One provision of my bill, Mr. President, would cut through this legal thicket by expanding significantly VA's current sharing authority. In summary, VA would be authorized to share, purchase or swap any resources with any local provider. VA could enter into contracts for any and all ``health care resources,'' a term which is considerably broader than the ``specialized medical resource'' limitation under which VA now operates. That term would include such resources, but would also include nonspecialized ``hospital care,'' ``any other health-care service,'' and any other ``health-care support or administration resource.'' Further, VA would be authorized to buy from, or share with, any ``non-Departmental health care provider''--a term which would include the ``health-care facilities'' and ``research centers and medical schools'' with which VA may not contract, but which would also include other ``organizations, institutions, or other entities or individuals that furnish health-care resources,'' and also ``health care plans and insurers.'' Thus, Mr. President, my bill seeks to open up to VA an entire new world of potential sharing partners and sharing opportunities. While VA would not have totally unfettered authority to buy and sell services-- for example, VA would be required to ensure that any such arrangements not diminish services made available to its veteran patients--it is my intention that VA be freed from restrictions which were applied when VA tried to do everything itself ``in-house.'' There was a time, perhaps, when VA could afford to try to be everything to everyone, but it cannot do so now. No modern provider can afford that mentality today. I note for the Record, Mr. President, that VA has requested the expanded legal authority that I propose today. But it has done so in the context of a much larger bill, S. 1345, that I introduced at VA's request on October 19, 1995. The main thrust of S. 1345 is so-called ``eligibility reform,'' that is, a broad scale revision of current statutes defining who shall be eligible for what VA medical services. That issue, Mr. President, is an extremely thorny one inasmuch as, lying at its very center, are very difficult judgements about who shall have priority over whom in securing VA health care in a period of limited resources. The Committee on Veterans' Affairs intends to take this critical issue up, but it will take time to sort out conflicting claims to priority to such limited resources. I think we ought to proceed now to streamline the statutes that restrict VA's sharing authority--an action which, in my view, can be taken now, and will made sense whether or not we are able to accomplish ``eligibility reform.'' My bill would do more, Mr. President. As I have pointed out, VA now has authority--though authority that is, in my view, too narrow--to contract for ``specialized medical resources.'' Even so, however, VA medical centers are statutorily barred from ``contracting out'' the very same services. 38 U.S.C. Sec. 8110(c). In addition, they may not contract out activities that are ``incident to direct patient care.'' Id. Finally, VA medical centers may contract out other ``activities'' at VA [[Page S 15576]] medical centers, for example, grounds' maintenance services--but only if VA leaps through a series of substantive and procedural hoops that plainly impede the contracting process. Under my reading of the law, it is apparently acceptable, under 38 U.S.C. Sec. 8153, for a VA medical center to contract for supplemental ``specialized'' medical services--let us say anesthesiology services-- so long as the medical center does not contract out all such services. This distinction, Mr. President, makes no sense to me--and, as I will discuss in a moment, apparently makes no sense to the Congress any longer. Further, it makes no sense to me that VA cannot contract out services that are ``incident to direct care''--assuming one can identify the legal boundaries of activities that are merely ``incidental.'' To my way of thinking, if ``direct care'' activities ought to be shared and purchased without significant restriction--as VA espouses in recommending modifications to 38 U.S.C. Sec. 8153--they ought to be subject to purchase wholly by the medical center through the ``contracting out'' process. And if ``direct care'' activities ought to be subject to contracting, then, clearly, services that are ``incidental'' to such activities should be too. Of course, Mr. President, what is true for direct care services-- services which go to the core of what VA does--is also true for other activities at VA medical centers: all such activities ought to be subject to contracting if contracting makes economic sense. We can afford no other standard. Unnecessary impediments to contracting--such as those set up by 38 U.S.C. Sec. 8110(c)--ought to be swept away. As I noted a moment ago, the Congress has apparently come to that conclusion already. In the 104th Congress, we suspended application of restrictive aspects of section 8110(c) through fiscal year 1999. See 38 U.S.C. Sec. 8110(c)(7). Mr. President, it is clear to us all that VA will not be under less budgetary pressure in the year 2000 than it is now. We ought not to indulge the fiction that VA will be able to afford to hold all activities ``in house'' then, if it cannot afford to do so now. In short, we should have repealed section 8110(c) last year--and we ought to do so now. Finally, Mr. President, I note another restrictive provision of law that ought to be swept away--or at least narrowed--now. Under current law, VA is precluded from putting into effect certain field facility ``administrative reorganizations''--essentially, those which will result in a force reduction of 15 percent or more at any particular site--unless it has first given the Congress 90-days notice computed to count only those days when both Chambers of Congress are in session. 38 U.S.C. Sec. 510. Two difficulties arising from this provision of law came into focus earlier this year when VA's Under Secretary for Health, Doctor Ken Kizer, submitted a proposal to reorganize VA's 172 medical centers into 22 ``Veterans Integrated Service Networks'' [VISNs]. While Doctor Kizer had briefed Congress extensively on his sensible reorganization model during its development, he still had to wait more than 3 months after the announcement of the reorganization before he could, by law, take any ``action to carry out such administrative reorganization.'' 38 U.S.C. Sec. 510(b). Worse, since the statute specifies that the 90-day ``notice and wait'' period runs only when both bodies of Congress are in session, Id., he--and we--were unable to determine when the 90-day notice would expire since no one was able to know when either body of the Congress might recess. Such obstructionism by the Congress is, in my view, most unfortunate and unseemly. I really think that we ought to grant more trust to the senior officials we confirm than is reflected in this statute. Yet, I remain sensitive to the Members' needs to know if a field office reorganization will adversely affect a significant number of their constituents. Therefore, I do not propose today that this provision of law be totally repealed. I do propose, however, that we reduce the ``notice and wait'' period to 45 calendar days. That period, I believe, is sufficient to allow Senators and House Members an opportunity to assess the impact of a given reorganization on their constituents. To recap, Mr. President, my bill would expand VA's authority to share, purchase and swap resources, as is necessary to meet the challenges of 21st century medicine. And it would remove an excessive restriction on VA's right to organize and station its employees efficiently. These measures are dictated by common sense and are, in the main, supported by VA. I request the support of this body. I request unanimous consent that the text of my bill be printed in the Record.

Mr. SIMPSON

Mr. SIMPSON. Mr. President, as chairman of the Veterans' Affairs Committee, I have today introduced, at the request of the Secretary of Veterans Affairs, S. 1345, a bill to reform eligibility for Department of Veterans Affairs health care benefits, improve the operation of the Department, and improve the processes and procedures the Department uses to administer various benefit programs for veterans; and for other purposes. The Secretary of Veterans Affairs submitted this legislation to the President of the Senate by letter dated September 12, 1995. My introduction of this measure is in keeping with the policy which I have adopted of generally introducing--so that there will be specific bills to which my colleagues and others may direct their attention and comments--all administration-proposed draft legislation referred to the Veterans' Affairs Committee. Thus, I reserve the right to support or oppose the provisions of, as well as any amendment to, this legislation. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record at this point, together with the transmittal letter and the enclosed section-by-section analysis of the draft legislation.

Mr. SIMPSON

Mr. SIMPSON. Mr. President, as chairman of the Veterans' Affairs Committee, I have today introduced, at the request of the Secretary of Veterans Affairs, S. 1345, a bill to reform eligibility for Department of Veterans Affairs health care benefits, improve the operation of the Department, and improve the processes and procedures the Department uses to administer various benefit programs for veterans; and for other purposes. The Secretary of Veterans Affairs submitted this legislation to the President of the Senate by letter dated September 12, 1995. My introduction of this measure is in keeping with the policy which I have adopted of generally introducing--so that there will be specific bills to which my colleagues and others may direct their attention and comments--all administration-proposed draft legislation referred to the Veterans' Affairs Committee. Thus, I reserve the right to support or oppose the provisions of, as well as any amendment to, this legislation. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record at this point, together with the transmittal letter and the enclosed section-by-section analysis of the draft legislation.

Mr. SIMPSON

Mr. SIMPSON. So veterans are well taken care of. This is an assault on the budget process.

Mr. SIMPSON. Madam President, I chair the Veterans' Affairs Committee. It is always remarkable to have to come here to the floor and get into a debate that somehow reflects that we do not take care of our veterans in America. When I came to this committee, we were giving veterans $20 billion. In this proposal, it is now close to $40 billion. Everything we have done with veterans health care has gone up. We have more nurses; we have more doctors. Remember this figure if you will, please. Madam President, 90 percent of the health care goes to non-service-connected disability--90 percent non-service-connected disability--not service- connected disability. This is a serious issue. If anyone can believe we do not take care of the veterans of the United States, please drop by my office. The occupancy rates at the hospitals are going down. The population is going down and the budget is going up, just as it should be.

Mr. SIMPSON

Mr. SIMPSON. Mr. President, again, I speak as chairman of the Veterans' Affairs Committee. There are two facts, alleged to be facts, that are not so. It has been said in the debate some veterans will be turned away. That may be so, but the care for those nonservice connected is on a space-available basis anyway, and some veterans will not be cared for by the VA no matter what the funding level. Please hear that. I hope that those who are debating it will hear it. Some veterans will not be cared for by the VA at any funding level you can put up, including the level proposed by my friend from West Virginia. I commend Senator Bond. He is a fierce fighter for his causes. He had another one that has been erroneously presented. They said there would be no hospital refurbishment. That is wrong. Refurbishment can be funded by minor construction, which is increased by $37 million in this bill. Let me review the bidding in my years here in the U.S. Senate with this remarkable series of charts. I have never done this, probably will never do it again. Here we are. Look here. When I came to the Senate in 1978 with my good colleague from Montana over there--I see him smiling--when I came here, there was the total VA budget of almost $20 billion. The total health care budget in 1978 was $5.1 billion and is $16.2 billion in 1995. Here is what it is today: Nearly double. The total VA budget is almost $40 billion now. It was $20 billion when I started here 17 years ago. If you say it is all in paper or the vapors, here is the increase in VA staff by human beings. We are always talking about human beings here, so we want to talk about the human beings that are working for the VA. There are quite a number of them. Physicians have gone up from 11,200 to 12,300; registered nurses from 26,000 to 37,000; and nonphysician providers FTE, a whole new category of those who serve veterans and who are paid for by the taxpayers were zero in 1975 and 3,079 in 1995. And we hear about veterans growing in number--they are not. We all know that. Here it is: There were 28.5 million veterans in 1978, and we are headed down to the year 2010 where there will be 20 million veterans. When we are finished with this budget exercise in 7 years, there will be 23 million veterans instead of the 26 million today. If we cannot work through the cloud of vapors about what we do for veterans in this country, then look at this. Here is what we have done in 1978. Here is what we are doing now. Hospital admissions, down now. We are trying to do outpatient instead of inpatient. Look at the outpatient visits: 17.4 million in 1978, versus 25.9 million in 1995. It is tough enough to get things done around here using correct figures. It is impossible to get anything done when you use a combination of emotion, fear, guilt or whatever. I am proud to be a veteran, very proud to be a veteran and a lifetime member of the VFW and a member of the American Legion and AMVETS, and we do our share. They know it. We know it. There is not a person in this Chamber that can say in any conscientious way that we have not done yeoman work for our veterans. We will continue to do it for one reason. We will find out when we do this amendment. Mention the word ``veteran'' and hope to get everybody to the floor and vote for it regardless of its sense. An amendment to increase funding for VA health care sure sounds attractive. Who can be against sick veterans? We do have an obligation to care for those who are harmed as a result of their military service. But remember that almost 90 percent of VA patients are being treated for non-service-connected conditions. And, yes, we do have a policy to care for additional veterans to the extent that resources are available. But, that does not mean that we have an obligation to make resources available without limit. America's veterans served to preserve our Republic and to ensure a better future for their own children and grandchildren. But, the Congress will throw away all that our veterans fought to preserve if we fail to stick to our plan to balance the budget. The Rockefeller amendment is an assault on the budget resolution and the goal of a balanced budget. It uses veterans as point men to break down the fire walls that constrain the natural desire of the Congress to spend money. It will put Senators in the position of voting to fund a tax cut for the rich at the expense of sick veterans. It does so by providing for $511 million increased spending for VA health care and offsetting the cost by limiting the benefits of a tax cut to families with incomes over $100,000. Remember that VA health care actually INCREASES in this appropriation. Remember that VA has never had to try to become more cost effective under the pressure of REAL cost constraints. The Rockefeller amendment would have the effect of funding continued business as usual.

Mr. SIMPSON. How much time is remaining, Mr. President?

Mr. SIMPSON. Mr. President, I hope this debate does not come down to who cares more about disabled veterans or homeless people or the lesser in society. That is not what this amendment is about. That truly is a mind-boggling thing to think that there are some people in this Chamber who care less about other people in society. We all have the same level of care toward the lesser in society. Since I have chaired this committee, we have doubled the veterans benefits. The veterans budget when I came to this Chamber 17 years ago was about $20 billion, and we are going to do something which puts it close to $40 billion. And the veterans population is declining. And if anyone can say that we do not take care of veterans, it is usually nonveterans or people who were never overseas or never involved with veterans who say that. And I am not making a reflection on anyone. When I came to this Chamber, I heard the most stirring debate I ever heard about what we did not do for veterans by a person who had never been in the civil air patrol. I had to listen to one-half hour of unmitigated guff about what we were doing for veterans. Now, that is a tiresome argument, and I do not think it fits in any way of what we do for these fine people, now 26 million, now declining 2 percent per year, who have given much, and we have given them much. And we will continue to do so. This is a very isolated incident. If we are talking about caregivers and the conflict of interest, is it a conflict of interest for a caregiver to put aside $100,000 if they know they are going to get it? Let us apply this to everybody, competent veterans and incompetent veterans. That will seem to cover it pretty well.

Mr. SIMPSON. Mr. President, how much time remains?

Mr. SIMPSON. Seven minutes.

Mr. SIMPSON. Mr. President, again, one of these difficult issues that are filled with emotion. I have chaired the Veterans Affairs' Committee for several years. Senator Cranston chaired the committee, Senator Murkowski, Senator Rockefeller. It is a remarkable committee that does tremendous things for veterans, and I very much enjoy having Senator Jay Rockefeller as the ranking member. We work closely together. His staff and my staff work closely together. This is an honest difference of opinion, but again it is one of those that have a ring--a tug at the heart--and I have been through a lot of these through the years, because if you resist this, then it will go out on the wavelength that somehow you do not care about veterans; you are cold and mean spirited and heartless. This one you want to pay close attention to. This is a serious issue that is not leaving any single veteran unattended. We are talking here about an incompetent veteran. We are talking about a person that cannot manage their assets. They have a conservator or a guardian. What we are providing here, it seems to me to make eminent common sense. We are going to suspend the VA disability compensation payments in the case of an incompetent veteran with no dependents whatsoever. If you really want to get a look at what we are talking about, we are talking about a person perhaps in a nursing home or some other institution who is totally incapable of functioning, with not a single person that comes to see them on Christmas or New Years or Easter, not a single dependent ever shows up at the door. We are talking about not including the value of a home in computing the size of the estate, and we are talking about the fact that if a person in that status accumulates over $25,000, we stop. And the purpose of stopping is so that a nondependent heir does not inherit something which is totally a windfall--because the veteran did not need it at all. The veteran's necessities as an incompetent are totally taken care of--food, shelter, clothing. This is for expenses that he or she did not need. That is why it accumulated in a bank account, and that is why it should not go to a nondependent relative who had no desire to care for or even see the person. So if you want to get into the emotion of it--and we always usually do--then remember this is a pretty tragic situation. So we are saying, I think in a very magnanimous way, if it gets above $25,000, we are going stop it so it will not get up to $100,000 and go to somebody who does not care about the veteran. The veteran will be totally taken care of; every single need will be taken care of. I know that and you know that. And then here is the key. If this drops below $10,000, you start the money coming again. Now, that is what we have here, to save $170 million. If it drops below $10,000, it starts again. If it gets above $25,000, it stops. And what is the money for? The veteran. And he is not using it, so why let it go to $60,000, $70,000, or $80,000. And it only affects veterans who are not competent in any way to handle their money. These payments are made to provide for the living expenses of disabled veterans. They are not being used for that purpose. The money is not paying for clothes or food or shelter. It is a accumulating, and it will be ultimately passed on to nondependent heirs. This provision does not affect the standard of living or the condition of living of any veteran because the veterans involved are not now spending the money. If the benefit money is being expended to support the veteran, then the money would not be building up in the bank, and the provision in the bill would not kick in. It is that clear. The amendment is actually an assault on the budget resolution. The cost of this amendment would be offset by reducing the amount available to the Finance Committee to reduce the tax burden imposed on the American people and the American economy. We will hear over and over and over in these next days that Senators must either vote for a tax cut for the rich or vote for disabled and helpless veterans, one or the other. That is a sad choice and quite an extraordinary rigging of the amendment. But we will see a lot of those in the days to come, many, many of those. I personally do not favor a tax cut for the rich or the poor. So at least I am on record on that because we are going to deal with the $5 trillion debt limit in the next few days. And we will deal with Medicare and Medicaid and let that go up 6.4 percent, and that will be called a savage cut from coast to coast. We do not do veterans any favor if we use them as a point man. I was in the infantry. I do not know where others served, but it was not fun to be a point man to begin to do any kind of military activity. And certainly you cannot use veterans as point men to begin dismantling the national effort to try to bring the deficit under control and provide some relief to Americans aged between 18 and 45 who will have nothing in 30 years. And nobody talks about them and that period of time. We always talk about 1 year. We have a Secretary of Veterans Affairs, a Cabinet Member, who will not go past 1 year in his dealings with telling the American veterans what is going to happen to them. And so these are the troublesome things. We do veterans no favor at all if we use them as point men for including spending for a program without at the same time reducing spending in another program. We do veterans no favor if we enact legislation that really has the effect of enriching only their nondependent relatives after their death, people who have not cared a whit about them. I yield the floor. Mr. ROCKEFELLER addressed the Chair.

Mr. SIMPSON

Mr. SIMPSON. Mr. President, I thank the Chair. I particularly thank my friend from Maine, who has been such a stalwart worker in this area. Senator Snowe has proven time and time again, on these issues and other issues of reproductive choice, that this issue is not about abortion. It is sad, actually, that somehow this issue of funding the U.N. Population Fund settles back on the issue of abortion. That is not so. I support this U.S. funding. I commend my colleague from Maine and thank her for her consistency and the energy that she puts into this program and all programs of this nature. It is wonderful to have an ally like that because it has sometimes been a rather lonely venture over here on these particular issues. But you have to, in this situation, give President Clinton some credit, because during the Reagan-Bush administrations, these programs fell into disarray on the issue of abortion, which is very unfortunate. This year, we are looking at funding levels of $35 million. I do understand where we are, obviously, with the budget. I just left a room where we will talk about how we are going to get $270 billion in savings in Medicare and some $180 billion in Medicaid. We all know what is confronting us. But I do not like to see these programs unfairly targeted. It sends a wrong message to the rest of the world. I was a congressional delegate at a conference in Cairo with Senator John Kerry. There were not a great deal of our colleagues seeking passage to Egypt at that time. I have always very much admired President Mubarak and the Government of Egypt. They gave us a remarkable convention and convocation, and I was impressed with the leadership of the Vice President in that effort as that consensus document was formed concerning maternal and child health care, strengthening family planning programs, promotion of educational opportunities for girls and women, improving the status of rights of women across the world, discussion of all issues, including contraception, fertility, and many other serious things. Of all of the challenges that face the country--and, boy, there are plenty of them all around the world--none compares to the increasing of the population of the Earth. Every single effort we use or try to do here to protect the environment, promote economic development, jobs, everything is compromised and severely injured by the staggering growth in the world's population. I hope we realize that there are currently 5.7 billion people on the Earth, and in 1950, when I was a freshman at the University of Wyoming, not that long ago, there were 2.5 billion people on the face of the Earth. Mr. President, 2.5 billion in 1950; 5.7 billion today. Where do we think we are going if current birth and death rates continue? The world's population will again double in 40 years. We will not have to worry about methane gas from cows and how much propellant there is in a shaving cream can. There will not be anything left of the Earth. It will be totally overpopulated. Then what happens to the babies, the old, and the people we all talk about all day who have not enough to sustain them. Civilizations have gone down in that fashion in years past. Here we are again, this same issue. I think we should show our support here. The fund is supported entirely by voluntary contributions, not by the U.N.'s regular budget. There are donors ready to assist, budget has been cut back, and it would be a real shame if the United States were to back away from its commitment to the world's largest source of multilateral assistance for population program. This is subject to all the restrictions in the past, as Senator Snowe has said. These restrictions are already in place to address concerns about U.S. funds being spent in China. Under current appropriations law, foreign aid funding is denied to any organization or program that supports or participates in the management of a program of coerced abortion or involuntary sterilization in any country. That is in the law. Furthermore, current appropriation law assures that none of the United States contribution to this program may be used in China. The United States is not funding any of the population activities of China. The U.N. Population Fund does not fund abortions or support coercive activities. UNFPA funds go toward family planning services and maternal and child health care across the developing world. No U.S. funds may be commingled with any other of these U.N. funds, and numerous penalties exist in the law for any violation of the requirement. For those reasons, I strongly oppose the pending amendment introduced by the Senator from North Carolina to require the United States to stop funding this program unless the fund withdraws from China. I have serious concerns about China, its abortion policy, its coercion in that area, but forcing the U.N. population fund to withdraw from China will not affect that policy. In fact, without the careful monitoring that the fund performs, conditions in China will just simply get much worse. The world and the United States cannot turn its back on what is currently going on in China. We certainly cannot turn our back on the necessity of these funds for the rest of the world, for the sake of humanity. I thank the Chair.

Mr. SIMPSON. Six minutes.

Mr. SIMPSON

Mr. SIMPSON. Mr. President, I rise in opposition to the pending amendment of the Senator from New York, pertaining to assistance for Turkey. I will support the motion to table this amendment, and I urge my colleagues to do the same. Mr. President, I have very firmly held beliefs regarding the importance of the United States-Turkish relationship, and these beliefs have only been strengthened, not diminished, by recent events. Turkey has long been considered of great strategic importance to the United States, most notably since the height of the cold war, when Turkey's participation in NATO gave this important alliance a steady anchor in the Middle East. It was a tremendous advantage to have a stalwart ally of the West sitting in between the Soviet Union and the oil fields and tensions of the Middle East. Let us remember also how Turkey frequently provided more troops to NATO than any nation other than the United States. We are increasingly cognizant that the peace in Europe was kept throughout those years not by the procedures of the United Nations, but by the resolve of NATO-- and Turkey played an indispensable role in that alliance. During the cold war, we came to view the alliance with Turkey as being critically important largely for geographic reasons, and reasons of military strategy. However, since the demise of the Soviet Union, we have found our relationship with Turkey to be of even greater importance. If one lists the principal international developments in the post- cold war world, one repeatedly comes across unmistakable trends which underscore the importance of Turkey. To name but a few: The expansionism of Turkey's neighbor Saddam Hussein, the disintegration of Yugoslavia along ethnic lines, renewed nationalism and anti-Western feeling on the part of many Moslem states, the breakaway of the central Asian republics from Russia, and on, and on. I earnestly hope that my colleagues have noted the opposition of our most notable military leaders to any reductions in assistance to Turkey. Gen. John Shalikashvili has written to commend Turkey's participation in the Korean war, as well as Turkey's defense of 37 percent of the frontier between NATO and the Warsaw Pact during the cold war. During the gulf war, strike missions against Iraq were initiated from Turkish soil--nearly 2,700 sorties, according to the general. Perhaps Turkey's biggest contribution to that effort was the closing of the Turkish-Iraqi oil pipeline, which clamped down solidly on Hussein's strength and surely cost Turkey and its economy dearly. Few Americans know that Turkey contributed troops to the Somalian effort, as well as 1,500 troops in Bosnia. Secretary of Defense William Perry has also testified to the value of continued assistance for Turkey. The great ideological contest in the world is no longer between communism and democracy--capitalist democracy has clearly been the victor of that battle for the allegiance of the greater part of humankind. But there are still contests taking place all over the globe, between competing visions such as secular democracies, nationalist autocracies, and military-religious states. Too much of the Moslem world has chosen the latter route, choosing to devote the resources of the state to military confrontation with their neighbors, and at home, enforcement of religious scruples by the state. Not only did Turkey cast its lot with the West when it was in a lonely military position, surrounded by Soviet-leaning neighbors, but it chooses still to cast its lot with us even when in close contact with many anti-Western Moslem regimes. The majority of Turks believe this is the right thing to do, but there are also voices within Turkey who wonder why it chooses to ally itself with the West, only to receive criticism and suspicion in return from too many quarters. It is greatly and unquestionably in the United States' interest that Turkey's decision to remain a friendly, secular republic be seen as fruitful for a Moslem nation. We do not have a good track record in our relations with Islamic countries. If Turkey is rebuffed in its continued allegiance to us, this will only provide fodder for those who believe that the West cannot be trusted to remain truly friendly toward a Moslem country. None of us would claim that the human rights situation in Turkey is what we would like to see. But we should remember as well that Turkey has been the recipient of thousands upon thousands of uninvited guests, in many cases Kurdish refugees from northern Iraq. Most Kurdish people are not terrorists. They are poor refugees struggling to cope with the tragic reality of living under unfriendly, repressive regimes such as that of Saddam Hussein. But United States protection of the safe havens in northern Iraq also served to shelter those Kurds in the PKK, who were indeed engaged in terrorist attacks against Turkey. Thus we have made our own inadvertent contribution to the conflict Turkey is experiencing in the eastern part of the country. We would do well to confine our sermons about human rights to those situations to which we ourselves have not contributed. Mr. President, I believe that it is strongly in the interest of the United States that we maintain a strong relationship with Turkey, both an economic and military relationship, and that the Turkish commitment to its status as a secular republic be proved again and again to be a most successful one which will assist our friends the Turks to continue the course and the [[Page S 13923]] cause of peace and prosperity in their country. We have a tremendous stake in this question, thus I strongly urge the defeat of the D'Amato amendment.