Arlen Specter

Mr. SPECTER

Mr. SPECTER. Mr. President, I thank my colleague from Idaho for yielding me 10 minutes. This is an important amendment, Mr. President, because it is a forceful condemnation against violence. It might be thought unnecessary to condemn violence because it is so obvious that violence is the major problem in the United States today, with the crime wave, and the major problem in the world with conflicts and wars going on all around the world. But it is important to have this forceful condemnation against violence, because people are standing up and saying that these acts of violence, these acts of murder, are justifiable homicide, which is an absolute absurdity under the law. The distinguished Presiding Officer has been a law enforcement officer, an attorney general of Missouri. This Senator spent 12 years in the Philadelphia District Attorney's Office--4 years as an assistant, trying murder cases, robbery, rape, and arson cases, and then 8 years as district attorney of an office which handled 30,000 criminal trials a year and some 500 homicide cases. There is no justification whatsoever for saying that murder is justifiable homicide when it is related to someone who performs an abortion. Under the laws of the United States, Roe versus Wade and Casey versus Planned Parenthood, there is a period during which this is lawful conduct, and how anyone can say that it is justifiable homicide is an absolute absurdity. I thank the Chair for nodding in agreement, because I make a point which is very obvious to anyone who has had any experience in law enforcement and, beyond that, to any thinking American. But in newsprint today, stories are carried about people who make this contention. And some of the public opinion polls show a response --one poll showed 3 percent of the people have this idea. It should be labeled as emphatically as possible that it is an absurdity. When the Senate of the United States speaks out, as I am confident the Senate of the United States will speak out tonight, in condemning this kind of violence, it will make an impact. This condemnation should ring from every speaker in America who has an opportunity to speak out, from the President of the United States, to Members of the House, to Members of the Senate, ministers, priests, and rabbis from the pulpit, and anywhere anyone can make a speech. It is atrocious when you think of 130 incidents of death threats, stalking, chemical attacks, bombings, arsons, attempted murder, to say nothing of the four murders which have been perpetrated and the fear that is being created at 900 health clinics around the country. The point has been made, but it is worth reinforcing, that the majority of activities at these clinics do not involve abortion at all. The Appropriations Subcommittee on Health and Human Services, which I chair, will have a hearing on the range of medical services which are performed. As already mentioned: Pap smears, mammograms, other health services for women. These women are being terrified. The resolution calls for the creation of task forces and coordination by U.S. Marshals Service; that is fundamental to help law enforcement, to have the agencies of the law work together. There are substantial funds available at the present time; more than $1 billion available to local prosecutors on applications which would be made. I think that the Department of Justice would look very favorably upon applications which were made along this line. There is also considerable funding in the crime bill to protect women against violence. So funds are available in additional amounts. The final part of resolution, stating that, ``It is the sense of the Senate that the United States Attorney General should fully enforce the law and protect persons seeking to provide or obtain, or assist in providing or obtaining, reproductive health services from violent attack,'' is just very, very fundamental. Not that it is necessary, but there is an additional clause which protects first amendment freedoms of expression. I think Cardinal Law in Boston was right on target when he made a plea to desist from any conduct which could be remotely connected with inciting violence at these clinics. First amendment freedoms have to be protected so that people can speak up. I think that it is a very, very important statement to have this kind of a forceful condemnation against violence, especially in the context where so many people are absurdly talking about justifiable homicide. I urge my colleagues to have the strongest conceivable vote in support of this important resolution. I thank the Chair and yield the floor. Mrs. BOXER addressed the Chair.

Mr. SPECTER

Mr. SPECTER. Mr. President, I have sought recognition while there is a lull in the action on the pending legislation to talk for a few minutes about the pending issues before the Judiciary Committee on possible legislation regarding the antitrust exception which might have an impact on the current baseball strike. I believe that it is highly unlikely--virtually impossible--for the Congress of the United States to act on an antitrust exemption to have any meaningful impact on the pending strike and, therefore, urge in the strongest possible terms that both parties return to the negotiating table to work in a collective bargaining sense to end the strike and bring baseball to the playing field this spring. I have had long reservations about the antitrust exemption as it applies to baseball, as it applies to other major sports, like football, which has an antitrust exemption for revenue sharing, and participated more than a decade ago, in 1982, in extensive hearings when the Los Angeles Raiders, then the Oakland Raiders, were proposing a move. And those hearings were very important and raised some of the same considerations which are now pending on the baseball strike. As we have moved forward in the consideration of the complex issues on the antitrust exemption, my view has been to retain the exemption as it impacts on the Pirates, which are a major factor in Pittsburgh, and a major constituent interest of mine. If we eliminate the antitrust exemption, we will have bedlam with respect to franchise changes. I notice my colleague Senator Gorton nodding in agreement because of the impact on the Seattle baseball team. One thing is certain, Mr. President, and that is that it is highly unlikely, I am almost certain, that Congress is going to act with any speed, and I think that Congress should not act, should not get involved in the midst of a labor dispute, where there are very, very serious issues, to try to affect the outcome of that labor dispute. At the present time, the Judiciary Committee is totally involved in the consideration of the constitutional amendment for a balanced budget. And on the Senate floor we are involved in very complex legislation on taking away mandates by the Federal Government which are not paid for. There is a very, very heavy agenda on economic issues, budget issues, trying to reduce the size of Government, trying to reduce spending, and the consideration of tax cuts, so that far behind on the back burner is this issue of changing the antitrust exemption. My comments this morning are prompted, in part, by this banner headline in the Philadelphia Inquirer this morning: ``Phillies President Blasts Union, Hinting at Player Defections.'' Bill Giles is president of the Philadelphia Phillies, and he is a very, very mild-mannered man. I cannot remember a headline on Bill Giles speaking out in such emphatic terms. What he is saying bears directly on my comments, where he makes the statement that ``The union has spent most of their energy in Washington trying to do away with our antitrust exemption instead of negotiating and trying to grow the game.'' I have been in frequent contact with Mr. Don Fehr, head of the union, asking him what help I could be or what help the Senate could be in a constructive way in trying to bring the strike to a close. I first made that contact with Mr. Fehr last summer before the strike started on August 12. And at the same time period, I talked to the acting commissioner, Bud Selig, and the officials of both the Philadelphia Phillies and Pittsburgh Pirates, my two home State teams, to see what help we could be. The antitrust exemption came up briefly last fall on the Judiciary Committee calendar, and it was voted down, I think, largely because of a sense that the Congress and the Senate should not get involved in a pending labor dispute. The issue in Pittsburgh is especially touchy at the present time because the Pittsburgh Pirates are up for sale, and the Pirates have been kept in Pittsburgh by a consortium of hometown business people who have bought the Pirates, to keep it in Pittsburgh. That is a difficult matter because the Pirates are losing so much money, which is a source of the controversy today which has led to the strike. The Pirates have had a prospective buyer, John Rigas, of Coudersport, PA. I have been trying to be helpful in meeting with officials of the Pittsburgh Pirates to see if that sale could be effectuated. That sale is going to be held up because of the uncertainty of what is going to happen in the strike and to the antitrust exemption. Obviously, I speak as only one Senator, one member of the Judiciary Committee. I think that given the complexity of the Judiciary Committee calendar, and given the complexity of the Senate calendar, and the complexity of the House calendar, it is as close to a certainty as anything can be that there is not going to be legislation coming out of the Congress between now and April on the antitrust exemption. There are too many things ahead of it. If it did come to the floor, I think many would agree with my position that the Congress ought not to intervene to try to alter--ought not to change the level playing field. That is an expression we use very frequently about our debates on many subjects, but it is certainly applicable not to change the level playing field when we talk to the baseball effort. What the Phillies' president has had to say on one end of my State, and what is happening with the Pirates at the other end of my State, trying to sell the team to keep it in Pittsburgh, I hope that the parties will go back to the bargaining table and will settle the dispute so that we can have baseball this spring, and not to look to the Congress to try to intervene, which is not our place and is so highly unlikely on the current state of the record. I thank the Chair. I yield the floor. I suggest the absence of a quorum.

Mr. SPECTER

Mr. SPECTER. Mr. President, earlier today the Constitutional Law Subcommittee of the Judiciary Committee had hearings scheduled on the line-item veto, and regrettably those hearings were not held because an objection was lodged under the rule which prohibits committee hearings from going forward or subcommittee hearings from going forward if they are in process more than 2 hours after the U.S. Senate commences its business. I thought it was unfortunate that the hearings were canceled on that ground because a great many witnesses had come, and some from far distances, such as the distinguished Governor of Wisconsin, Gov. Tommy Thompson, to testify about this very important measure. Mr. President, as the Congressional Record will show, this Senator has which would give the President of the United States the authority to strike a given line of expenditure without vetoing the entire bill. There was a very dramatic presentation made by President Reagan a few years ago when the Congress submitted to the President a continuing resolution which was all 13 of the appropriations bills. And it was an enormous pile, about 20 or 24 inches in size. President Reagan at his State of the Union speech was expressing his concern that, instead of sending 13 individual appropriations bills which the President might approve or veto one at a time, this continuing resolution had been sent, so that it was not even the line-item veto but it was a circumstance where the President had this massive legislation. He had the bill precariously positioned on the edge of the podium, and I became somewhat concerned that it was going to fall. Then after 1 minute or 2, I realized that it was President Reagan's method--perhaps you might call it a theatrical method--to underscore the volume and size of the bill. And I think the people watching around the country on national television were concerned that the bill might fall as well. That was a very dramatic way of depicting the problem the President faces with a continuing resolution with some 13 appropriations bills. But the same principle applies to a single bill. I believe that it is very much in the national interest so that the President would have the authority to strike an individual item one by one without vetoing the entire bill. It is my view, Mr. President, that the President of the United States possesses constitutional authority under existing law to exercise the line-item veto. That proposition has been supported by very intensive local research which my staff and I have undertaken, and also by very extensive research which has been undertaken by distinguished leading scholars, including Professor McDonald, who has written extensively on this subject. The constitutional approach that the Constitution currently gives the President the line-item veto arises from the fact that clause 3 of article I, section 7, of the U.S. Constitution is an exact copy of the Massachusetts Constitution. The Massachusetts Constitution was enacted substantially before the U.S. Constitution. It goes back to the Massachusetts fundamental charter of 1733, and was implemented specifically to give the royal governor a check on the unbridled spending of the colonial legislature. Professor McDonald points out that at the time of the Constitution's ratification process anti-Federalist pamphleteers opposed the U.S. constitutional provision because it ``made too strong a line-item veto in the hands of the President.'' Federalists, on the other hand, saw this clause, clause 3, and the power to veto individual items of appropriations, as an important executive privilege. James Bowdoin, the Federal Governor of Massachusetts, argued that the veto power conferred upon the President in the Federal Constitution was to be read in light of the Massachusetts experience which did give the U.S. President the line-item veto. In the Federalist Paper No. 69, Alexander Hamilton, a member of the Constitutional Convention, who was soon to become the first Secretary of the Treasury, wrote that the constitutional veto gave power which ``tallies exactly with the revisionary authority of the council of revision'' in New York, which according to Professor McDonald had the power to revise appropriation bills and in effect exercise the line-item veto. Without going into great detail--and I will put in the Record a statement which will amplify this--in the early days of the Republic the President did in effect exercise the line-item veto. President Washington and Treasury Secretary Hamilton acted upon the authority to shift appropriated funds from one account to another. And Thomas Jefferson as President also embraced that practice and on at least two occasions refused to spend money that the Congress had appropriated. President Andrew Jackson declined to enforce provisions of a constitutional enactment, in effect exercising the line item veto, and similarly in 1842, President John Tyler signed a bill which he refused to execute in full--there again, really exercising the line- item veto. It was not until after the Civil War that the President assumed that he did not have the individual line-item veto when President Grant urged Congress to grant him such authority. Mr. President, that is an abbreviated statement of the reasoning that there is constitutional authority presently for the President of the United States to exercise the line-item veto. I had occasion to discuss this matter with President Bush when he was in office on a long plane ride, and the President said that his lawyer told him he did not have the power to line-item veto. I suggested, perhaps somewhat cavalierly, that perhaps he should change lawyers. I quickly suggested that President Bush not tell the bar association because I might want to practice law again some day. In 1993, I had occasion to travel with President Clinton to western Pennsylvania and discussed with him the issue of the line item veto, and upon my saying to President Clinton that he had the authority to exercise the line-item veto, he asked me to send him a memorandum on the subject, which I did. I think it useful at the conclusion of my presentation to include that memorandum together with the letters I sent to President Clinton and his reply to me on the subject. I am introducing, Mr. President, two resolutions, so that the Judiciary Committee will have these resolutions before them when they next have deliberation on the line-item veto. We had a Judiciary Committee hearing last year on a resolution which I had introduced, which would propose: The Constitution grants to the President the authority to veto individual items of appropriation and the President to exercise that constitutional authority to veto individual items of appropriation without awaiting the enactment of additional authorization. When that matter was pending before the constitutional law subcommittee, there was considerable sentiment among other Members that that might have gone a little farther than they wanted to go. But they were prepared to vote out a resolution which would say that there was at least sufficient authority so that the President should exercise the line-item veto. I am introducing the first resolution again which was before the 103d Congress, and then the second resolution which would provide that it is the sense of the Senate that the President should exercise the line-item veto without awaiting the enactment of additional authorization for the purpose of obtaining a judicial determination of its constitutionality. In my opinion, Mr. President, the line-item veto is very, very important and ought to be exercised now. I think anyone who is President ought to move forward because of the legal authority that the President currently has that authority. But at a very minimum, there is sufficient legal authority for the law to be submitted for a judicial test. Mr. President, I have long supported a line-item veto for the President, I have proposed constitutional amendments to grant the President such authority, and I have supported statutory enhanced rescission authority. As these measures have failed, after extensive legal research and analysis, I now urge the President to exercise the line-item veto without further legislative action. I do so because I believe, after a careful review of the historical record, that the President already has the authority under the Constitution to veto individual items of appropriation in an appropriations bill and that neither an amendment to the Constitution nor legislation granting enhanced rescission authority is necessary. The line-item veto would be effective in helping to reduce the huge deficit that now burdens our country. While alone it is no panacea, its use would enable the President to veto specific items of appropriation in large spending bills, thereby restraining some of the pork-barrel or purely local projects that creep into every appropriations bill. With the broad national interest rather than purely local concerns at work, the President's use of the line-item veto would cut significant amounts of this type of spending. on Members of Congress. Knowing that their attempts to insert items into appropriations bills will be subjected to presidential scrutiny, Members are likely to become more reluctant to seek special favors for the home district at the expense of the Nation at large. While such discretionary programs and earmarks do not account for a large part of Federal spending, getting control over them will improve the authorization and appropriations process. The President could use the veto to eliminate funding for unauthorized programs. Such a message would motivate Congress to reauthorize programs with regularity, improving our oversight and the effectiveness of the Government. The line-item veto is not a partisan issue. It is a good Government issue. Many Democrats support the line-item veto; some Republicans oppose it. As a candidate in 1992, Bill Clinton firmly embraced the line-item veto. As President, he has the opportunity to make effective use of it to help control in some small measure the deficits we accumulate. By exercising this option, the President can provide a check on unfettered spending and carve away many of the pork-barrel projects contained in both versions of the budget that serve primarily private, not national interests. Beyond the specific savings, the presence and use of the line-item veto by the President could give the public assurances that tax dollars were not being wasted. Each year the media report many instances of congressional expenditures which border, if in fact they do not pass, the frivolous. Those expenditures are made because of the impracticality of having the President veto an entire appropriations bill or sometimes a continuing resolution. That creates a general impression that public funds are routinely wasted by the Congress. The line-item veto could eliminate such waste and help to dispel that notion. The resentment to taxes is obviously much less when the public does not feel the moneys are being wasted. Notwithstanding the so called taxpayers' revolts in some States, there is still a willingness by the citizenry to approve taxes for specific items where the taxpayers believe the funds are being spent for a useful purpose. The line-item veto could be a significant factor in improving such public confidence in governmental spending even beyond the specific savings. I now turn to the basis for my position that the President already has authority under the Constitution to exercise the line-item veto, without a need for additional constitutional or statutory legislation. The constitutional basis for the President's exercise of a line-item veto is found in article I, section 7, clause 3 of the Constitution. Clause 2 of article I, section 7 provides the executive the authority to veto bills in their entirety. The question of conferring on the President the power to veto specific items within a bill appears not to have been discussed at the Constitutional Convention. During the drafting of the Constitution, however, James Madison expressed his concern that Congress might try to get around the President's veto power by labeling bills by some other term. In response to Madison's concern, Edmund Randolph proposed and the Convention adopted the third clause of article I, section 7, whose language was taken directly from a provision of the Massachusetts Constitution of 1780. Clause 3 of article I, section 7 provides that in addition to bills-- the veto of which is set forth in clause 2: Every Order, Resolution, or Vote to which the Concurrence of the Senate and House of Representatives may be necessary (except on a question of adjournment) shall be presented to the President of the United States; and before the same shall take effect, shall be approved by him, or being disapproved by him, shall be repassed by two thirds of the Senate and House of Representatives, according to the Rules and Limitations prescribed in the case of a Bill. While the clause does not explicitly set out the executive authority to veto individual items of appropriation, the context and practice are evidence that that was its purpose. According to noted historian Prof. Forrest McDonald of the University of Alabama, the clause was taken directly from a provision of the Massachusetts Constitution of 1780. In his article entitled ``The Framers' Conception of the Veto Power,'' published in the monograph, ``Pork Barrels and Principles: The Politics of the Presidential Veto'' 1-7 (1988), Professor McDonald explains that this provision dates back to the State's fundamental charter of 1733 and was implemented specifically to give the royal Governor a check on the unbridled spending of the colonial legislature, which had put the colony in serious debt by avoiding the Governor's veto power by appropriating money through ``votes'' rather than through legislation. Professor McDonald also points out that at the time of the Constitution's ratification process, anti-Federalist pamphleteers opposed the proposed Constitution and in particular clause 3 of article I, section 7, precisely because it ``made too strong a line-item veto in the hands of the President.'' Federalists, on the other hand, saw clause 3 and the power to veto individual items of appropriation as an important executive privilege-- one that was essential in assuring fiscal responsibility while also comporting with the delicate balance of power they were seeking to achieve. For example, during his State's ratifying convention, James Bowdoin, the Federalist Governor of Massachusetts, argued that the veto power conferred to the President in the Federal Constitution was to be read in light of the Massachusetts experience under which, as I have already noted, the Governor had enjoyed the right to veto or reduce by line-item since 1733. In the Federalist No. 69, Alexander Hamilton, a member of the Constitutional Convention who was soon to become the first Secretary of the Treasury, wrote that the constitutional veto power ``tallies exactly with the revisionary authority of the council of revision'' in New York, which, according to Professor McDonald, had the power to revise appropriations bills, not merely accept or reject legislative enactments in their entirety. This power was not unique to New York, as the Governors of Massachusetts, Georgia, and Vermont--soon to be the first new State admitted to the new union--also enjoyed revisionary authority over legislative appropriations. As many of my colleagues know, our distinguished colleague from West Virginia, the chairman of the Appropriations Committee, has made a series of speeches on the Senate floor drawing on his vast knowledge about the historical underpinnings of our republican form of government and on the Framers' rationale for the checks and balances they created. His review of Roman history is apt, because, as he knows, the Framers were acutely aware of Roman history. This awareness helped them develop their government of limited powers and of checks and balances. The Framers knew that the vice of faction, the desire to pursue one's private interest at the expense of the public interest, had helped bring on the downfall of the Roman Republic. Madison and others were convinced that by diffusing power and balancing it off in different branches of government, we might avoid to the fullest extent possible, the defects of faction. In another sense, however, the distinguished chairman of the Appropriations Committee, overlooks the fundamental differences between Rome's ancient government and ours. In ours, the people have a direct say. In Rome's the male citizens had a limited, indirect say, but mostly the ruling class was hereditary or was based on wealth. We have a democracy; Rome did not. This fundamental difference between our Nation and ancient Rome means that there are more factions with which our Government must contend. With so many different factions, or ``interest groups'' as we call them today, it is much easier for one of them to capture a single Member of Congress to advance its cause and to fund it. Each Representative has a much narrower focus than a Senator, each of whom has a much narrower focus than the President. Thus, Congress is more susceptible to pressure from factions, as one Member who wants a favor for a particular faction trades his or her support for another Member's preferred faction. We all know that this appropriations log-rolling occurs. Ultimately, the President is presented with one large spending bill, much of which reflects the political horse-trading that occurs. interests that seek to use the appropriations process for their own private benefit. By excising line items and making Congress vote on them individually in an effort to override the veto, the President can shed light directly on these private interests and force Members to be more accountable to their constituents by voting on the projects identified by the President as unnecessary and wasteful. Some, like the distinguished chairman of the Appropriations Committee, contend that the line-item veto would result in an intolerable shift of power from Congress to the Executive. To this argument, I have two responses. The first is that, as I believe I show, the Framers of the Constitution intended that the President have the authority to veto individual items of appropriations. Thus, in their concept, the line-item veto does not offend the balance of powers. The second response is related to the entire structure of the Government. The Constitution places the power of the purse in the hands of Congress. It is a peculiarly legislative function to decide how much money to spend and how to allocate these expenditures. In this regard, however, spending is no different than any other legislative function. Thus, there is no reason to consider the line-item veto any more of an infringement of the separation of powers than the President's ability to veto bills at all. Hamilton recognized the structural importance of the veto in the Federalist 73, when he wrote that the veto provides ``an additional security against the enaction of improper laws * * * to guard the community against the effects of faction, precipitancy, or of any impulse unfriendly to the public good, which may happen to influence a majority of [the legislative] body'' from time to time. The Framers were acutely aware that it is the legislative branch that is most susceptible to factional influence. Thus, they understood that the veto served a critical role. But, opponents of the line-item veto argue, Hamilton's point went to bills as a whole, and not simply pieces of them. The legislative process necessarily relies on horse-trading to get things done, and nowhere is such trading more important than in the appropriations process. This response, while acknowledging the reality, is an answer that directly contradicts the Framers' intent and leads to bad government, for it accepts the premise that factions and the prominent Members of Congress who support their causes must be bought off with goodies in appropriations bills. But that is precisely the evil that the Framers sought to insulate against with the veto. Given the role of factions in the appropriation process, the use of the line-item veto is completely consistent with the Framers' conception of the veto power. Indeed, that is not surprising, as the Framers believed they had granted the President a line-item veto. Despite the arguments of the distinguished chairman of the Appropriations Committee to the contrary, the line-item veto was not only intended by the Framers but is an appropriate limitation on congressional authority to combat the force of faction. This process would not surprise the Framers of the Constitution. Madison and the others who met in Philadelphia in 1787 were not just knowledgeable about history. They were practical men of affairs and politics who understood human nature. They knew the dangers of faction and the likelihood that faction would influence Congress more so than the President, who is responsible to the entire Nation, not a single district or State. Thus, it is only to be expected that the Framers provided Congress with the power to appropriate funds, tempered with executive authority to line-item veto as a means of expunging special interest spending was their resolution, and history bears this out. The line-item veto is entirely consistent with the Framers' conception of government and the dangers of faction. Shortly after the new Federal Constitution was ratified, several States, including Georgia, Vermont, Kentucky, and my home State of Pennsylvania, rewrote their constitutions to conform with the Federal one and specifically incorporated language to give to their executives the authority to exercise a line-item veto. These States were in addition to the States like Massachusetts and New York, where the Governor's power to revise items of appropriation was well-established. For example, article II, section 10 of the Georgia Constitution of 1789 gave the Governor the power of ``revision of all bills'' subject to a two-thirds vote of the general assembly. Section 16 of chapter II of the Vermont Constitution of 1793 vested in the Governor and council the right to revise legislation or to propose amendments to the legislature, which would have to adopt the proposed amendments if the bill were to be enacted. Article I of the Kentucky Constitution of 1792 and section 23 of article I of the Pennsylvania Constitution of 1790 tracked the language of article I, section 7, clause 3 of the new U.S. Constitution. The chief executives of both the State and new Federal governments immediately employed the line-item veto. On the national level, the early practice was one in which the President viewed appropriations as permissive rather than mandatory. President Washington and his Treasury Secretary Hamilton assumed the authority to shift appropriated funds from one account to another. Although his party had at one time opposed such transfers, once he became President, Republican Thomas Jefferson also embraced the practice, and at least on two occasions, he refused to spend money that the Congress had appropriated. The practice continued. As late as 1830, President Andrew Jackson declined to enforce provisions of a congressional enactment. Likewise in 1842, President John Tyler signed a bill that he refused to excute in full. It was not until after the Civil War that a President assumed he did not already have the authority to veto individual items of appropriation, when President Grant urged the Congress to grant him such authority. But President Grant's view was anomalous. The Framers' understanding and their original intent was that the Constitution did provide the authority to veto or impound specific items of appropriation. The States understood that to be the case, and many in fact embraced the Federal model as a means of providing their own executives this same authority. I believe that the evidence strongly supports the position that under the Constitution the President has the authority to employ the line- item veto. At the very least, the President's use of the line-item veto will almost certainly engender a court challenge if the veto is not overridden. The courts will then decide whether the Constitution authorizes the line-item veto. If they find it does, then the matter will be settled. If they find it does not, then Congress may revisit the issue and decide whether to amend the Constitution or grant statutory enhanced rescission authority to the President. In conclusion, I urge the President to employ the line-item veto if he is seriously committed to deficit reduction. As I have argued here today, the authority to exercise this power is not dependent on the adoption of a constitutional amendment or any additional legislation; it already exists. The Framers' intent and the historical practice of the first Presidents serve as ample evidence that the Constitution confers to the Executive the authority to line-item veto. Given President Clinton's use of the line-item veto as Governor and his support of it as a candidate, I urge him to act on that authority consistent with his rightful power to do so. Mr. President, with these documents in the Record, there will be a reasonably full explanation of the legal basis for the line-item veto and the two resolutions which I am submitting for consideration of the Senate and which will be on the record when the Judiciary Committee next holds its hearing on this subject. I thank my colleagues for the time I have taken. Mr. President, I ask unanimous consent that additional material be printed in the Record.

Mr. SPECTER

Mr. SPECTER. Mr. President, earlier today the Commonwealth of Pennsylvania established a new administration with a new Governor, Tom Ridge, and a new Lieutenant Governor, Mark Schweiker, in very ornate and interesting ceremonies at the State capital in Harrisburg, PA. That event is worth a comment for our colleagues for permanency in the Congressional Record. Tom Ridge is a man well known to those of us in the Congress because Congressman Ridge served for 6 terms, 12 years in the House of Representatives, and takes an extraordinarily fine record to the Governor's chair in the Commonwealth of Pennsylvania. Governor Ridge had served in Vietnam, he had served as a prosecuting attorney in Erie County, PA, and he had served as a distinguished trial lawyer. Today he became the Governor of Pennsylvania. Pennsylvania is a State which is now in its 314th year, some 100 years-plus more than the United States of America. And Governor Ridge made a very, very profound speech in outlining his aspirations and goals for the Commonwealth of Pennsylvania. He talked about the problems of an expanding economy, talked about the issue of crime, discussed the future of education, talked about environmental control with an appropriate balance for an expanding economy and for job opportunities in what was a profound and distinguished speech. He said that tomorrow he will call a special session of the legislature of Pennsylvania to deal with the issue of crime. And was eloquent in his determination to hold accountable, as he put it, ``those who prey on the weak,'' and expressed his determination as the new Governor of the Commonwealth that they would be called to account and firm action would be taken. In his economic causes of crime as well on a very broad approach to the problem. He called for a redefinition of the relationship between State government and the local communities, articulating on the State level the kind of legislation which is now being considered here in the U.S. Senate on trying to redefine the federalism and the relationship between the United States Government and the States. What Governor Ridge was talking about was leaving more authority in local communities to try to bring government down to the grassroots so that people in the townships and in the ``burbs'' or in the cities who know best what their problems are and can best address them in trying to reach as much revenue as possible, cutting taxes at the Federal level, cutting taxes at the State level, to leave the resources as close to the people as possible so that the problems are addressed by the people who know the most about them. He said in eloquent terms that, ``Government has gone too far in treating people as the servants rather than as the served,'' an objective which really ought to be the standard for all governments. He said again in eloquent terms, ``What government can do for people is limited. What people can do for themselves is limitless.'' I think in that articulation he is talking about more accountability for the individual, more opportunity for the individual, and really more responsibility for the individual. Sworn in alongside Governor Ridge today was a distinguished Pennsylvanian, Mark S. Schweiker, who came to that position having served as a commissioner in Bucks County. Mark Schweiker made a very distinguished speech as well in his induction ceremony in the ornate Pennsylvania Senate an hour-and-a-half before Governor Ridge took the oath of office. One of Lieutenant Governor Schweiker's statements, which was very profound, was, ``A government big enough to give you everything you want is a government big enough to take everything you have.'' I think in Pennsylvania today with the legislature, both houses, the State house of representatives and the State senate, under Republican control, and the newly elected Governor being a Republican, mirrors very much what happened in the elections nationwide last November. If I may say, not in a partisan sense, but in a recognition of what the voters did, returning to what would be called core Republican values as expressed by the people in the historic election of the Republican U.S. House of Representatives and in a change in leadership in the U.S. Senate now controlled by the Republicans and an effort to return to core values of limited Government, less spending, lower taxes, strong crime control, that is the pledge which was made by two very distinguished Pennsylvanians today, Gov. Tom Ridge and Lieutenant Gov. Mark Schweiker. Mr. President, if anyone else seeks recognition at this point, I would be glad to yield. If not, I would like to proceed to a discussion of another subject. I ask unanimous consent that I may proceed again in morning business for a period not to exceed 10 minutes.

Mr. SPECTER. I thank the Chair.

Mr. SPECTER

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

Mr. SPECTER. I ask unanimous consent that I may proceed as in morning business for 5 minutes.

Mr. SPECTER. Mr. President, if I might amplify.

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

Mr. SPECTER

Mr. SPECTER. Mr. President, in the absence of any other pending business in the Senate, I have sought recognition to comment briefly about violence at clinics, with respect to two principle issues. been used as a possible legal defense, that violence and murder is justifiable homicide. There is absolutely, positively no basis whatsoever in criminal law for such an assertion that anybody who murders or assaults or maims at a clinic where the clinic may be performing abortions has any conceivable legal justification under the doctrine of justifiable homicide. That is a legal principle that I worked with to a considerable extent during my 12 years in the Philadelphia district attorney's office, and the doctrine of justifiable homicide has been worked out in a very careful way; for example, when a police officer may seek to defend an innocent victim, citizen, during the course of a robbery and may shoot a robber in order to stop the murder of an innocent citizen in the course of a felony. And for someone to seize upon the term of ``justifiable homicide,'' picking it out of the thin air to say that that is any reason for committing violence at a clinic where abortions may be performed is just absolutely preposterous. One of the problems which has arisen, Mr. President, has been really insufficient condemnation of violence at these clinics. I was very pleased to see the statement made by Cardinal Law of Boston asking for a cessation of any picketing, where the situation may be permitted to cool. But it seems to me that we need to speak out on levels to condemn that kind of conduct and to state as unequivocally as possible that there is no conceivable justification as ``justifiable homicide.'' The other point that I want to comment on briefly, Mr. President, is that at these clinics where women secure medical care, abortion is a relatively small percentage of what is done; that most of the women who go there--I heard the percentage is as high as 90 percent--are there for medical purposes. They are there for mammograms to guard against breast cancer. They are there for Pap smears to guard against cervical cancer. They are there for a whole range of medical procedures. When there has been an epidemic of violence at these clinics, the women stay away in droves because there is terror that in being there, they may be in the midst of violence. So I wanted to take a few moments in the interlude of the proceedings, Mr. President, to make those two points and to speak out as forcefully as I can, and with the background I have had as a district attorney dealing with the concept of justifiable homicide, to make it as unequivocal and forceful as I can that there is no conceivable justification for that violence and to say, at the same time, that it is driving many women urgently in need of medical care away from those facilities. I thank the Chair, and I thank my colleague from Kentucky for securing the time. I suggest the absence of a quorum.

Mr. SPECTER. I do. Mr. EXON addressed the Chair.

Mr. SPECTER

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

Mr. SPECTER

Mr. SPECTER. Madam President, within the past week, the State of Texas has executed a man named Jesse Jacobs for murder in a case which, in an unusual twist, will severely hamper law enforcement and thwart the use of the death penalty as a deterrent against murder. In this case, the State of Texas first convicted Jesse Jacobs on a murder charge and then convicted his sister, Bobbie Jean Hogan, for the same murder, articulating very different factual circumstances as to how the murder was committed. In the first trial involving Jesse Jacobs, the State of Texas contended that he had, in fact, committed the murder, based largely on his confession. At the time of trial, Jesse Jacobs recanted his confession and said, in fact, that he was trying to protect his sister. The jury convicted him of murder in the first degree with the death penalty, which was later imposed. Between that trial and the execution of Jesse Jacobs, which occurred within the past week, the State of Texas indicted his sister, Bobbie Jean Hogan, and said that she, in fact, had committed the murder, and she was convicted of homicide in the second trial. When the case reached the Supreme Court of the United States, the court refused to hear the appeal of Jesse Jacobs on the ground that Jacobs had presented no newly discovered evidence requiring Federal review, which is a very startling finding under the facts of this case. The decision by the Supreme Court not to review Jesse Jacobs' case was 6 to 3. And Justice John Paul Stevens said this in asking the Supreme Court to review the case: ``It would be fundamentally unfair to execute a person on the basis of a factual determination that the State has formally disavowed,'' because when Jacobs was convicted of murder, it was on the State's representation that he had, in fact, pulled the trigger. Later, the State found different facts, that it was not Jacobs who had pulled the trigger but that it was his sister, Bobbie Jean Hogan, whom he had sought to protect. I submit, Madam President, that this case poses a very material problem in a number of directions. First, on the facts, I think that Jacobs was entitled to have the case reviewed because of the very unusual circumstances where a later investigation disproved his confession and in fact showed that what he had said at trial when he recanted--that is took back his confession--that it was his sister, was true, because the State then proceeded to prosecutor the sister. Beyond the palpable unfairness to Jacobs, who was executed, without the Supreme Court even reviewing the case, this is a real threat to the continued use of the death penalty, which I believe is very important for law enforcement in the United States. I served as an assistant district attorney in Philadelphia for some 4 years, tried many cases of violence, robbery, murder, rape, and later was district attorney of an office handling 30,000 prosecutions a year, including some 500 homicide cases. I have found in that experience that the death penalty is a very effective deterrent against violence. The death penalty has been imposed relatively little since 1972 when the Supreme Court of the United States in a case called Furman v. Georgia, said that the death penalty was unconstitutional, unless very stringent standards were set where the State proved a series of aggravating circumstances which overbalanced any mitigating circumstances which the defendant might produce--that is, that it was a very horrendous offense. And all the people on death row at that time had their convictions invalidated. During the course of the intervening years since 1972, there have been other Supreme Court decisions which further limited the applicability of the death penalty. So that in the most recent statistics available, with some 2,800 people on death row, only 38 cases had the sentence of death carried out. The statistics show that when the death penalty was being enforced, the homicide rate was much less than it is in the period since 1972 when the death penalty had not been enforced. In my own State of Pennsylvania, there has been no carrying out of the death penalty since 1962. My conclusion, as a former prosecuting attorney, that the death penalty is, in fact, a deterrent was based on many, many cases, where I saw professional burglars and robbers who were unwilling to carry weapons because of the fear that they might commit a killing in the course of a robbery or burglary, and that would constitute murder in the first degree, as a felony murder. There is a vast volume of evidence to support the conclusion that the death penalty is an effective deterrent, although I would say, at the same time, that many people disagree with the statistics, and there are many people who have conscientious scruples against the imposition of the death penalty, which I respect. But it is the law of 36 of the States of the United States that the death penalty is valid and in effect. There is a move in many other States--in New York now, with the newly elected Governor; in Iowa at the present time, and other States--to reinstitute the death penalty because of the conclusion of most people that it is an effective deterrent against violent crime and we should use every weapon at our disposal to try to curtail crimes of violence, which is the most serious problem facing the United States on the domestic scene. I submit, Madam President, that if we impose the death penalty in a callous or unreasonable fashion that we are going to lose the death penalty. The death penalty remains a penalty which the American people want enforced, as demonstrated by poll after poll, with more than 70 percent of the American people favoring the death penalty. In the U.S. Senate during the recent votes, more than 70 United States Senators consistently voted in favor of the death penalty, as they did on my Terrorist Prosecution Act, for the imposition of the death penalty for terrorists anywhere in the world who murder a U.S. citizen. But if we are to retain the death penalty, we are going to have to use it in a very careful way. If we are to find cases like the Jacobs case, where a man is executed after the State represents, in an affirmative way, on the subsequent trial of his sister Hogan that, in fact, the materials presented to the jury in the Jacobs case, where the jury imposed the death penalty, were false, then that is going to undermine public confidence in what we are trying to do. For the past 5 years, I have tried to change the Federal procedures on Federal review of death penalty cases because today it is ineffective. There are some cases which go on in the Federal courts for up to 20 years, where the death penalty is not imposed because of arcane and illogical decisions in the appellate courts; where the case goes from the State courts to the Federal courts, back and forth on many occasions, because of the Federal procedural law which requires what is called exhaustion of State remedies. The case will go to the Federal court, which will send it back to the States, saying there has not been an exhaustion of State remedies, and back to the State and back to the Federal courts. So that the legislation which I have pushed would give the Federal court jurisdiction immediately, on the conclusion of the State supreme court that the death penalty is imposed with time limits providing fairness to the defendant, but an end to the ceaseless round of appeals. My bill was passed by the Senate in 1990, but was rejected by the House. I believe in this Congress, the 104th Congress, there is an excellent opportunity to have those changes made in the application of Federal procedures so that the death penalty will again be an effective deterrent. And it is effective only if it is certain and if it is swift, penalty is, in effect, a flagship of punishment under our criminal justice system. So, that the when the criminals know that the death penalty is a laughing stock, it impedes law enforcement in a very generalized way. So when I read about the execution of Jesse Jacobs in Texas under circumstances which are going to undermine public confidence in the death penalty, may make it harder to get a reform of Federal law to handle the cases in a timely way so that they are decided in approximately 2 years instead of 20 years, and where the use of the death penalty may be undermined generally, that is very counter to the interests of society and effective law enforcement. It is obviously fundamentally unfair, as Justice John Paul Stevens said and three Justices who wanted the Supreme Court of the United States to review this case. I believe that the Congress is going to have to enact legislation to correct what is happening in the Supreme Court on these procedural matters. When they hand down decisions on constitutional grounds, that is it, unless there is a constitutional amendment. But when they establish their own procedural rules as to when they will review a State case involving the death penalty, that is a matter where the Congress can legislate because we can establish the standards under which jurisdiction attaches and under which the Supreme Court and the other Federal courts will consider these cases. This case has not received the kind of attention which is really warranted. There are so many events that happen every day and so many matters which come across the television screens and in the newspapers and on the radio that there is not a great deal of opportunity to focus on this kind of a matter. I had been looking for a few minutes when the Senate was not otherwise engaged. I regret keeping people here for a few minutes, but I think this is an important matter which will require the attention of our Judiciary Committee so that there will be some realistic and reasonable standards by the Supreme Court of the United States in the interest of fundamental fairness to defendants, and also so that we can retain the death penalty and speed up the process so that it can be an effective weapon for law enforcement I thank the Chair and I thank the attending staff, and I yield the floor.

Mr. SPECTER

Mr. SPECTER. Mr. President, I move to lay that motion on the table. The motion to lay on the table was agreed to.

Mr. SPECTER

Mr. SPECTER. Mr. President, there is no disagreement on the floor today about the desirability of having a balanced budget so that the Federal Government would live within its means as every other governmental entity, like the Commonwealth of Pennsylvania has a constitutional requirement to have a balanced budget. Every city and county in my State and every governmental unit across the country has to live within its means within a balanced budget. Only the Federal Government has the prerogative to print money, script, and borrow and not live within its means. This is an affront to every family, and the comment has often been made on this floor. In the 14 years-plus that I have been in this body, we have debated and talked about this subject, I think, more than any other and there is I think agreement that we need a balanced budget. Yesterday, in the Judiciary Committee, we had a very constructive hearing analyzing many legal considerations on enacting a constitutional amendment for a balanced budget. I think we will soon do that. The amendment proposed by the Senator from Nebraska on its face does something a little different. That is, it ``enforces through the congressional budget process the requirement to achieve a balanced Federal budget.'' The distinguished chairman of the Budget Committee has raised an understandable objection to this point in tying the hands of the Budget Committee this afternoon with very little debate and only a few Senators on the floor, tying the hands of the Budget Committee on what it will do. I would suggest to the Senator from Nebraska that the preferable course would be for the Senator from Nebraska in his position as the senior Democrat on the Budget Committee to offer the specific amendments to achieve a balanced budget. One of the difficulties in the Senate and the House has been that we have done a lot of talking about the desirability of a balanced budget, but no one has come forward and introduced on the floor the specifics of a balanced budget. So I would say to the Senator from Nebraska, as the ranking member, the senior Democrat on the Budget Committee, let him come forward with the specifics. He wants a balanced budget. We all do. He thinks he can propose a balanced budget this year. Let him do so. Let him take it to the committee or let him take it to the floor and then we will vote on it. I expect to be a chairman of the Appropriations subcommittee this session on Labor, Health, Human Services and Education, a committee I have served on in the 14 years-plus I have been in the Senate, and was ranking member last year. I have already called the Secretaries of each of those departments and have said to them, what are you going to be asking for by way of appropriations next year? What is it that may be eliminated? What is it that we may be able to cut on the budget in terms of specifics? I think there is no doubt that the mandate of last November's election was that the American people want smaller Government, want reduced spending, and would like to see tax cuts. I believe that we should have tax cuts but I am not prepared to vote for a tax cut sight unseen. I am not prepared to engage in the bidding on a middle-class tax cut until we see that we have savings. I do not think we should have tax cuts if it will add to the deficit. I do think, parenthetically, we should have promptly a capital gains tax cut. That is the one tax cut which we could enact promptly which would not lead to a revenue loss. There were 56 Members of this body in the last session of Congress prepared to have a capital gains tax cut. We could not get it through against a filibuster. That is one tax cut we could have. As to others, we ought not to be in that bidding war until we see what spending cuts we will have. Now, as the prospective chairman of the Subcommittee of Labor, Health, Human Services and Education with a discretionary budget of approximately $70 billion, I am looking for places to cut. But I am not prepared to make cuts prepared to talk about the generalizations. I think that the distinguished Senator from New Mexico, Senator Domenici, the chairman of the Budget Committee, is exactly right when he says, as the chairman with the responsibility to direct those deliberations, that he does not want to see an enforcement mechanism which will compel the Budget Committee to take action before the Budget Committee has a chance to go through the items line by line, which is what the Senator from Arkansas, Senator Pryor, is in effect saying. What I am saying, is take a look at the specifics of the budget on Labor, Health, Human Services and Education, three committees that have discretionary budgets up to $70 billion. The other two provisions in the amendment by the Senator from Nebraska I think are not worthy of adoption. The first one is to adopt in the first session of the 104th Congress, a joint resolution proposing, an amendment to the Constitution requiring, a balanced Federal budget. We are already considering that. It will not do any good to talk any more about that until the Judiciary Committee reports out an amendment and we act on it on the Senate floor. The second line to set forth with specificity in the first session of the 104th Congress is what the policies of achieving such a balanced Federal budget would require. Mr. President, I think we are well aware at this stage of the life of the Congress of what the policies are. I would say that although this matter is worthy of debate it has been on the floor for a little more than an hour. I do not see any avalanche of Senators coming to the floor to debate the resolution. What we ought to be doing at this point is talking about the specifics. Talking about the specifics in my subcommittee and talking about the specifics in the Budget Committee. I would invite the Senator from Nebraska to propose the details as to how he would balance the budget. I can assure that this Senator will look closely at that role and would work with him in trying to balance a budget with real money. Not a confederate proposition of ``let's talk about it,'' but let Members be specific about how we will do it. I join him in that effort. Mr. President, I yield the floor.

Mr. SPECTER

Mr. SPECTER. I thank the Chair. Mr. President, I shall be brief. I begin by associating myself with the passion of the distinguished Senator from Colorado, as he articulates a very strong position against the overregulation by the Federal Government which is well known across the length and breadth of this land. And I support the efforts which have been brought by the distinguished Senator from Iowa [Mr. Grassley] and the distinguished Senator from Connecticut [Mr. Lieberman] on S. 2 to provide accountability by the Congress, by making Members of the Senate and Members of the House of Representatives subject to the same laws which govern every other citizen. As a matter of basic fairness, Mr. President, there is no reason why a Senator or Member of the House should not be subject to every rule of law which governs every other American. Basic fairness should mean that every rule of law applies equally to Members of the Senate and House as they do to every other American. And if that were the case, there would be less regulation in our country. With respect to the amendment which is now pending, offered by the distinguished Senator from Michigan, to have a gift ban, I believe that there is great merit in that proposal and in fact supported the gift ban when it was before the Senate during the 103d or last session of Congress. There are a great many amendments which might be offered to the pending legislation; also talk about campaign finance reform which in a sense is related to the subject before the Senate at the present time. I believe that it is very important that we move forward with the Congressional Accountability Act, which is the pending legislation, without encumbering it with other amendments which will slow its progress. The reality, Mr. President, which may not be known by many watching on C-SPAN 2 is that when an amendment is tabled or rejected on the pending legislation, it does not mean that those who vote in favor of tabling the amendment disagree with the substance of it, if it were present as a freestanding bill, as it was during the last Congress and, as I said before, a measure which I supported. There is an effort known well through the length and breadth of the land at the present time for the newly elected 104th Congress, controlled by the Republicans, to get some things done and done promptly. And the House of Representatives is moving on similar legislation on congressional accountability, and it is the effort now of the Republican-controlled Senate to move ahead with this bill without having amendments pending which will slow the progress. Our distinguished majority leader has already given assurances that this issue will be revisited and the distinguished Senator from Maine, Senator Cohen, has commented about bringing the matter up again with Senator Levin of Michigan. So this matter will again be before the Senate and we can act to do what is necessary to ban lobbyists' gifts. But at the present time I think our focus ought to be on congressional accountability, which I support, and that is why I will back the forthcoming motion by the distinguished majority leader to table the pending amendment. I yield the floor.

Mr. SPECTER

Mr. SPECTER. Mr. President, there are some who believe health care reform is dead and declared as much last Fall when Congress failed to enact reform legislation. But they are wrong. President Clinton was grossly in error when he proposed health care by government mandate and massive bureaucracy. But anyone who reads the repudiation of the Clinton bill as an excuse to do nothing is equally in error. There is as much need now as there was then to correct the problems in our health care system for the 14.6 percent or 39.7 million Americans, for whom the system does not work--a group which, according to the Census Bureau, contained 1.1 million more uninsured individuals in 1993 than the previous year. As I have said many times, we can do so without big government and turning the best health care system in the world, serving 85.4 percent of all Americans, on its head. The legislation I am introducing today, the Health Care Assurance Act of 1995, will do just that. While Congressional jaw-boning in the 103d Congress may have caused market competition to dampen cost increases a bit and encouraged more talk will fix many of the problems that still exist--for instance, the pre-existing condition problem, where people are denied health care insurance because of a pre-existing health problem; or the portability problem, where people lose their job or are otherwise between jobs and lose their health coverage; or the self-employed problem, where self- employed individuals are denied the right to deduct as a business expense their health care costs unlike other employers who may deduct 100 percent of that business expense; or the problem of employees in small businesses not having health coverage because their employer simply cannot afford to provide it. The recent November elections reaffirmed the basic principle of limited government. Limited government, however, does not mean an uncaring or do-nothing government. Consistent with this principle, Congress should enact health care reform legislation that focuses on these and other problems in the current system while leaving intact what already works for 220 million Americans. To be sure, health care reform remains a very complex issue for Congress to address. But it is not so complex that we cannot act now in a bipartisan way. As many of my colleagues will recall, in 1990 the Congress passed Clean Air Act amendments that many said were not doable. That issue was brought to the Senate floor, and task forces were formed which took up the complex question of sulfuric acid in the air. We targeted the removal of 10 million tons in a year. We made significant changes in industrial pollution and in tailpipe emissions. We produced a balanced bill which protected the environment and retained jobs. This can be done with health care reform. If we forces on the areas both Democrats and Republicans agree upon--insurance market reforms, full-deductibility for the self-employed, administrative simplification, to name a few--we will accomplish a lot in addressing problems with our current health care system. I have been advocating reform in one form or another throughout my now 15 years in the Senate. My strong interest in health care dates back to my first term when I sponsored the Health Care Cost Containment Act of 1983, S. 2051, which would have granted a limited anti-trust exemption to health insurers permitting them to engage in certain joint activities such as acquiring or processing information, and collecting and distributing insurance claims for health care services aimed at curtailing then escalating health care costs. Later, in 1985, I introduced the Community Based Disease Prevention and Health Promotion Projects Act of 1985, S. 1873, directed at reducing the human tragedy of low birthweight babies and infant mortality. Since 1983, I have introduced and cosponsored numerous other bills concerning health care in our country. A complete list of the 20 health care bills that I have sponsored since 1983 are included for the Record. During the 102d Congress, I pressed to have the Senate take action on this issue. On July 29, 1992, I offered an amendment on health care to legislation then pending on the Senate Floor. This amendment included provisions from legislation introduced by Senator Chafee, which I cosponsored and which was previously proposed by Senators Bentsen and Durenberger. The amendment included a change from 25 percent to 100 percent deductibility for health care insurance purchased by self- employed persons and small business insurance market reform to make health coverage more affordable for small businesses. When then- Majority Leader George Mitchell argued that the health care amendment I was proposing did not belong on that bill, I offered to withdraw the amendment if he would set a date certain to take up health care, just as product liability legislation had been placed on the calendar for September 8, 1992. The Majority Leader rejected that suggestion and the Senate did not consider comprehensive health care legislation during the balance of the 102d Congress. The amendment was defeated on a procedural motion by a vote of 35 to 60 along party lines. The substance of that amendment, however, was adopted later by the Senate as part of broader tax legislation on September 23, 1992 when it was included in an amendment to H.R. 11 introduced by Senators Bentsen and Durenberger and which I cosponsored. This latter amendment, which included substantially the same self-employed deductibility and small group reforms that I had proposed on July 29, passed the Senate by voice vote. Unfortunately, these provisions were later dropped from H.R. 11 in the House-Senate conference. On January 23, 1994, when Senator Mitchell was asked on the television program ``Face The Nation'' about Senator Bentsen's bill from 1992, he stated that President Bush vetoed that provision as part of a broader bill. In fact, the legislation sent to President Bush never included that provision. On August 12, 1992, I introduced legislation entitled the ``Health Care Affordability and Quality Improvement Act of 1992,'' S. 3176, that would have enhanced informed individual choice regarding health care services by providing certain information to health care recipients, lowered the cost of health care through use of the most appropriate provider, and improves the quality of health care. On January 21, 1993, the first day of the 103d Congress, I introduced comprehensive health care legislation, entitled the ``Comprehensive Health Care Act of 1993,'' S. 18. This legislation was comprised of reform initiatives that our health care system could adopt immediately. They were reforms which both improved access and affordability of insurance coverage and implemented systemic changes to bring down the escalating cost of care in this country. S. 18, which is the principal basis of the legislation I am introducing today, melded the two health care reform bills I introduced and the one bill that I cosponsored in the 102d Congress and built upon with significant additions. On March 23, 1993, I introduced the Comprehensive Access and Affordability Health Care Act of 1993, S. 631, which was a composite of health care legislation introduced by Senators Cohen, Kassebaum, Bond, and McCain, as well as my bill, S. 18. I introduced this legislation in an attempt to move ahead on the consideration of health care legislation and provide a critical mass as a starting point. On April 28, 1993, I proposed this bill as an amendment to then pending S. 171, the Department of Environment Act in an attempt to urge the Senate to act on health care reform. In total, I have taken to this floor on 13 occasions over the past 3 years to urge the Senate to address health care reform. On two occasions I introduced health care related amendments. As early as June 26, 1984, I stated that the issue of health care is one of the most important matters facing the Nation today. That statement continues to ring true today, 10 years later. As reported in the New York Times on December 29, 1993, the Commerce Department estimated that health spending would total $942.5 billion in 1994 and would rise 12.5 percent in 1995. Moreover, there are an estimated 40 million, or 15 percent of the American population without health insurance. Not long ago, Mr. President, in June 1993, I had my own health problem when a magnetic resonance imaging machine discovered an intercranial lesion in my head. I was the beneficiary of the greatest health care delivery system in the world. That experience made me ever more aware, knowledgeable of and sensitive to the subject than I had been in the past. I share the American people's frustration with government and their desire to have the problems addressed. This past November they made it abundantly clear that they want the problems fixed--be it health care, welfare, tax or spending reform. But I want to make clear, Mr. President, since it has been said from time to time that Republicans support only the status quo, that many of my Republican colleagues have shared my sentiment to pass health care legislation, and we continue to be committed to action. In the 102d Congress, for instance, Senate Republicans were instrumental in the passage of reforms that would have helped small businesses and self-employed individuals to afford coverage more easily. In the 103d Congress, Senate Republicans introduced numerous health care bills that did not go to the many of the problems and will result in affordable coverage for millions of the uninsured. From last year's debate, I believe we learned a great deal about our health care system and what the American people are willing to accept from the Federal Government. The message we heard loudest was that Congress was acting too hastily, and that Americans did not want a massive overhaul of the health care system. Instead, our constituents want Congress to proceed more slowly and to target what isn't working in the health care system while leaving in place what is working. As I have said both publicly and privately, I was willing to cooperate with President Clinton in solving the problems facing the country. However, there were many important areas where I differed with the President's approach and I did so because I believed that they were proposals that would have been deleterious to my fellow Pennsylvanians, to the American people, and to our health care system. Most importantly, I did not support creating a large new government bureaucracy because I believe that savings should go to health care services and not bureaucracies. On this latter issue, I first became concerned about the bureaucracy back in September 1993 after reading the President's 239-page preliminary health care reform proposal. I was surprised by the number of new boards, agencies, and commissions, so I asked my legislative assistant to make me a list of all of them. Instead, she decided to make a chart. The initial chart depicted 77 new entities and 54 existing entities with new or additional responsibilities. When the President's 1,342-page Health Security Act was transmitted to Congress on October 27, 1993, my staff reviewed it and found an increase to 105 new agencies, boards, and commissions and 47 existing departments, programs and agencies with new or expanded jobs. This chart received national attention after being used by Senator Bob Dole in his response to the President's State of the Union address on January 24, 1994. The response to the chart was tremendous, with more than 12,000 people from across the country contacting my office for a copy. Numerous groups and associations--such as United We Stand America, the American Small Business Association, the National Federation of Republican Women, and the Christian Coalition--reprinted the chart in their publications amounting to hundreds of thousands more in distribution. I might add, Mr. President, that proposals offered during last year's debate by Democratic leaders like Senator Kennedy, then-Chairman of the Labor Committee, and then-Majority Leader, Senator Mitchell, also suffered from the same big government affliction, as the Kennedy plan proposed 107 new entities and the Mitchell plan proposed 167 new entities. In addressing our health care problems, let me be clear: In creating solutions it is imperative that we do so without adversely affecting the many positive aspects of our health care system which works for 85 percent of all Americans. I believe our approach should be to focus on affordable coverage for the approximately 15 percent of the population without insurance, covering people who change jobs, providing adequate coverage to the underinsured, holding down spiraling costs and generally addressing the specific problems with the current system rather than a massive change. If such reforms do not solve the problems of coverage and costs then we will need to revisit them. Different proposals introduced in the last Congress had a phase-in period under any reform plan. I believe that a prudent approach is to implement targeted reforms and then act to improve upon what we have done. I call this trial and modification. We must be careful not to damage the positive aspects of our health care system upon which more than 220 million Americans justifiably rely. Legislation which I am introducing today has four objectives: (1) to provide affordable health insurance for the 40 million Americans now not covered; (2) to reduce the health care costs for all Americans; (3) to increase the security of coverage and the portability of health insurance between jobs; and (4) to improve coverage for underinsured individuals and families. This legislation is comprised of initiatives that our health care system can readily adopt in order to meet these objectives, and it does not create an enormous new bureaucracy to meet them. This bill builds and improves upon provisions put forth in my legislation from the 103d Congress, S. 18, which included: full deductibility of health care costs for the self-employed; purchasing groups and insurance market reforms for small employers to have access to affordable health insurance; increased availability to prenatal care and outreach for the prevention of low-birthweight births; improved implementation of patients' rights regarding medical care at the end of life; improved health education; greater emphasis on and expanded access to primary and preventive health services; and improved utilization of non-physician providers, consumer information, and outcomes research. To this I have added: insurance market reforms to provide greater coverage security and portability between jobs; COBRA reform to extend the time period for employees who leave their jobs to continue their health benefits until alternative coverage becomes available and provide such individuals with additional affordable options; an obligation on employers to offer--but not to pay for--health care insurance; and a 1-year extension of the Medicare Select Program, which gives beneficiaries the option to select a managed care plan and provides Medicare recipients more choice in choosing supplemental insurance plans. Taken together, I believe these reforms will both improve the quality of health care delivery and will cut the escalating cost of health care in this country. They represent a blueprint which can be modified, improved and expanded. In total, I believe this bill can significantly reduce the number of uninsured Americans, improve the affordability of care, ensure the portability and security of coverage between jobs; and yield cost savings of billions of dollars to the Federal Government which can be used to insure the remaining uninsured and underinsured Americans. increasing coverage and saving costs The 6 titles of the bill seek to reduce the health care costs and the concerns regarding security for the 220 million, or 85 percent of Americans now covered, and to increase coverage for the other 39.7 million, or 15 percent, of Americans who are not. coverage The 220 million Americans now covered derive their health insurance coverage as follows: approximately 57 percent from employer plans; 24.9 percent from Medicare and Medicaid; 3.7 percent from the military; and 13 percent from individual private insurance. Title I would implement health insurance reforms which include: extending full deductibility of health insurance premiums to the self- employed; establishing small employer and individual health insurance purchasing groups; obligating employers to offer, but not pay for, at least two health insurance plans that protect individual freedom of choice and that meets a standard minimum benefit package; improving health insurance market practices to guarantee coverage of pre-existing conditions; and extending COBRA benefits and coverage options to provide portability and security of affordable coverage between jobs. While it is not possible to predict with certainty how many additional Americans will be covered as a result of the reforms in Title I, a reasonable expectation would be that the reforms included in this legislation will cover approximately 21 million Americans. This estimate encompasses the provisions included in Title I which I discuss in further detail below. Title I seeks to make insurance affordable by enhancing portability of insurance and choice to cover persons who are uninsured for brief periods between jobs. The reason that we often hear varying statistics cited regarding the number of uninsured persons is because a number of the uninsured are without insurance for limited periods of time between jobs. To address this portion of the uninsured, Title I includes reforms to increase the portability of coverage. These reforms also address the 220 million with insurance and their concerns with security and portability. These reforms include: (1) insurance market reform to cover pre- pregnancy; (2) extending COBRA health benefits option from 18 to 24 months and enhancing coverage options under COBRA to make insurance more affordable; and (3) providing individuals access to affordable insurance through purchasing groups. Coverage of pre-existing conditions is a concern of many people with insurance who face the potential threat of losing their coverage if they or a family member becomes ill. I believe that these practices are resulting in too much litigation and too much money being spent on lawyers rather than providing coverage for such persons. According to the Employee Benefit Research Institute, of the 5.9 million workers American who are denied coverage through their employers' health plan, 100,000 workers are ineligible for insurance because of pre-existing health conditions. Under my bill, no one will be denied reasonably priced coverage or continued coverage due to a pre-existing condition. Title I also extends the COBRA benefit option from 18 months to 24 months. COBRA refers to a measure which was enacted in 1985 as part of the Omnibus Budget Reconciliation Act [OBRA '85] to allow employees who leave their job, either through a law-off of choice, to continue receiving their health care benefits by paying the full cost of such coverage. By extending this option, such unemployed persons will have enhanced coverage options. In addition, options under COBRA are expanded to include plans with lower premiums and higher deductible of either $1,000 or $3,000. This provision is incorporated from legislation introduced in the 103rd Congress by Senator Phil Gramm and will provide an extra cushion of coverage options for people in transition. According to Senator Gramm, with these options, the typical monthly premium paid for a family of four would drop by as much as 20 percent when switching to a $1,000 deductible and as much as 52 percent when switching to a $3,000 deductible. With respect to the uninsured and underinsured, my bill would permit individuals and families to purchase guaranteed, comprehensive health coverage through purchasing groups. Health insurance plans offered through the purchasing groups would be required to meet basic, comprehensive standards with respect to benefits. Such benefits must include a variation of benefits permitted among actuarially equivalent plans to be developed by the National Association of Insurance Commissioners. The standard plan would consist of the following services when medically necessary or appropriate: (1) medical and surgical devices; (2) medical equipment; (3) preventive services; and (4) emergency transportation in frontier areas. It is estimated that for businesses with fewer than 50 employees, voluntary purchasing cooperatives such as those included in my legislation could cover up to 17 million people who are currently uninsured.\8\ My bill would also create individual health insurance purchasing groups for individuals wishing to purchase health insurance on their own. In today's market, such individuals often face a market where coverage options are not affordable. These purchasing groups will change that by allowing small businesses and individuals to buy coverage by pooling together within purchasing groups, and choose from among insurance plans that provide comprehensive benefits, with guaranteed enrollment and renewability, and equal pricing through community rating adjusted by age and family size. Community rating will assure that no one small business or individual will be singly priced out of being able to buy comprehensive health coverage because of health status. With community rating, a small group of individuals and businesses can join together, spread the risk, and have the same purchasing power that larger companies have today. For example, Pennsylvania has the fourth lowest rate of uninsured in the nation with over 90 percent of all Pennsylvanians enrolled in some form of heath coverage. Lewin and Associates found that one of the factors enabling Pennsylvania to achieve this low rate of uninsured persons is the practice by Pennsylvania's Blue Cross/Blue Shield plans which provide guaranteed enrollment and renewability, an open enrollment period, community rating, and coverage for persons with pre- existing conditions. My legislation seeks to enact reforms to provide for more of these types of practices. The purchasing groups as developed and administered on a local level, in addition to the insurance market reforms related to pre-existing conditions for all insurance policies, will provide small businesses and all individuals with affordable health coverage options. For individuals who are self-employed, this bill seeks to extend the same tax advantage for the purchase of health insurance to these individuals as is afforded to all other employers. Under current law, businesses are permitted to deduct 100 percent of what they pay for the health insurance of their employees, but self-employed individuals may not deduct any of their cost. The provision permitting self-employed individuals to deduct 25 percent of their health insurance costs expired on December 31, 1993. It is hard to find a provision in the Internal Revenue Code that is more discriminatory than this one. According to the Congressional Research Service, 12 percent or 3.9 million of uninsured workers are self-employed. Providing full deductibility of health insurance premiums, beginning with reinstatement of the 25 percent deduction for 1994 and reaching 100 percent by 1999, for self-employed individuals is a simple matter of fairness. It also should make health insurance coverage more affordable for the estimated 3.9 million self-employed individuals and their families who are now uninsured. The Joint Committee on Taxation has estimated the cost of this provision at $1.0 billion in the first year and $5.2 billion over the next 5 years. Unique barriers to coverage exist in both rural and urban medically underserved areas. Within my home State of Pennsylvania, there are examples of such barriers due to a lack of health care providers in rural areas and other problems associated with the lack of coverage for indigent populations living in inner cities. This bill improves access to health care services for these populations by increasing Public Health Service programs and also through training more primary care providers to serve in such areas; increasing the utilization of non- physician providers including nurse practitioners, clinical nurse specialists and physician assistants through direct reimbursements under the Medicare and Medicaid programs; and increasing support for education and outreach. While I reiterate the difficulty in making definitive conclusions regarding the reforms put forth under this legislation and accomplishing universal health coverage for all Americans, I believe that it is a promising starting point. Admittedly, the figures are inexact, but by my rough calculations potentially 21 million of the 40 million uninsured will be able to obtain affordable health care coverage under my bill. I arrive at this figure by including the 17 million that will be able to purchase insurance as a result of allowing individuals and small employers to purchase insurance through voluntary purchasing cooperatives, the 3.9 self-employed individuals who are uninsured that will now have full-deductibility for the cost of their health insurance, and the 100,000 who now will not be denied coverage due to pre-existing conditions. Certainly increasing the 220 million Americans with coverage to 241 million is a significant improvement. But we must not lose sight of those who for whatever reason may not achieve coverage under this plan. In this regard, I welcome any and all suggestions that make sense within our current constraints to increase coverage. I am committed to enacting reforms this year and committing to a time certain when the Congress must revisit the issue and act to modify these reforms and correct problems related to coverage where they still exist. cost savings It is anticipated that the increased costs of coverage to employers choosing to cover employees under Title I would be offset by administrative savings from the development of the small employer purchasing groups. Such savings have been estimated as high as $9 billion annually. In addition, if we address some of the areas within the achieve significant savings to be redirected toward direct health care services. Title I includes a provision to extend the Medicare Select program, which already has demonstrated success in passing along savings to the consumer. The Medicine Select program is a demonstration project initiated in the Omnibus Reconciliation Act of 1990 that allows Medicare recipients to select managed care plans, specifically through preferred provider organizations, for their Medicare supplemental insurance. Fifteen States have demonstration sites and over 400,000 Medicare beneficiaries are enrolled in the program. Medicare Select plans are 10 to 30 percent less expensive than traditional plans that offer the same benefits and quality is not sacrificed. The August 1994 Consumer Reports rated Medicare Select plans as some of the best Medigap products nationwide. Of the top 15 Medigap rated policies, 8 were Medicare Select plans. While savings from such reforms are difficult to predict, I believe that savings of $214 billion over 5 years can be achieved through the reforms set forth in this legislation. While examining the issues that contribute to our health care crisis, I was struck by the fact that so much attention is being focused on treating the symptoms and so little on some of its root causes. Granted, our existing health care system suffers from very serious structural problems. But there also are some common sense steps we can take to head off problems before they reach crisis proportions. Title II of my bill includes three initiatives which enhance primary and preventive care services aimed at preventing disease and ill-health. Each year about 7 percent, or 287,000, of the 4,100,000 American babies born in the U.S. are born of low birth weight, multiplying their risk of death and disability. Nearly 37,000 of those born die before their first birthday. Approximately 1,000 of those deaths are preventable. Although the infant mortality rate in the United States fell to an all-time low in 1989, an increasing percentage of babies still are born of low birth weight. The Executive Director of the National Commission To Prevent Infant Mortality, put it this way, ``More babies are being born at risk and all we are doing is saving them with expensive technology.'' It is a human tragedy for a child to be born weighing 16 ounces with attendant problems which last a lifetime. I first saw 1-pound babies in 1984 when I was astounded to learn that Pittsburgh, PA, had the highest infant mortality rate of African-American babies of any city in the United States. I wondered, how could that be true of Pittsburgh, which has such enormous medical resources. It was an amazing thing for me to see a 1-pound baby, about as big as my hand. Beyond the human tragedy of low birth weight there are the financial consequences. Low birth weight children, those who weigh less than 5.5 pounds, account for 16 percent of all costs for initial hospitalization, re-hospitalization and special services up to age 35. The short and long-term costs of saving and caring for infants of low birth weight is staggering. A study issued by the Office of Technology Assessment in 1988, concluded that $8 billion was expended in 1987 for the care of 262,000 low birth weight infants in excess of that which would have been spent on an equivalent number of babies born of normal weight birth averted by earlier or more frequent prenatal care, the U.S. health care system saves between $14,000 and $30,000 in the first year in addition to the projected savings in lifetime care. The Department of Health and Human Services estimated that by reducing the number of children born of low birth weight by 82,000 births, we could save between $1.1 billion and $2.5 billion per year. We know that in most instances prenatal care is effective in preventing low birth weight babies. Numerous studies have demonstrated that low birth weight, that does not have a genetic link, is associated with inadequate prenatal care or lack of prenatal care. To improve pregnancy outcomes for women at risk of low birth weight, Title II authorizes the Secretary of Health and Human Services to award grants to States for projects to reduce infant mortality and low birth weight births and to improve the health and well-being of mothers and their families, pregnant women and infants. The funds would be awarded to community-based consortia, made up of State and local governments, the private sector, religious groups, community and migrant health centers, and hospitals and medical schools, whose goal would be to develop and coordinate effective health care and social support services for women and their babies. The second initiative under Title II involves the provision of comprehensive health education for our nation's children. The Carnegie Foundation for the Advancement of Teaching recently conducted a survey of teachers. More than half of the respondents said that poor nourishment among students is a serious problem at their schools; 60 percent cited poor health as a serious problem. Another study issued in 1992 by the Children's Defense Fund reported that children deprived of basic health care and nutrition are ill-prepared to learn. Both studies indicated that poor health and social habits are carried into adulthood and often passed on to the next generation. To interrupt this tragic cycle, this nation must invest in proven preventive health education programs. My legislation includes comprehensive health education and prevention initiatives through increased support to local educational agencies to develop and strengthen comprehensive health education programs and to Head Start resource centers to support health education training programs for teachers and other day care workers. Title II further expands the authorization for a variety of public health programs, such as breast and cervical cancer prevention, childhood immunizations, family planning and community health centers. These existing programs are designed to improve the public health and prevent disease through primary and secondary prevention initiatives. It is essential that we invest more resources now in these programs if we are to make any substantial progress in reducing the costs of acute care in this country. The proposed expansions in preventive health services included in Title II are conservatively projected to save approximately $2.5 billion per year or $12.5 billion over 5 years. I believe the savings will be higher. Again, it is impossible to be certain of such savings; only experience will tell. For example, how do you quantify today the savings that will surely be achieved tomorrow from future generations of children that are truly educated in a range of health-related subjects including hygiene, nutrition, physical and emotional health, drug and alcohol abuse, accident prevention and safety, et cetera? I suggest these projections, subject to future modification, only to give some generalized perspective on the impact of this bill. Title III would establish a federal standard and create uniform national forms concerning the patient's right to decline medical treatment. Nothing in my bill mandates the use of uniform forms, rather, the purpose of this provision is to make it easier for individuals to make their own choices and determination regarding their treatment during this vulnerable and highly personal time. Studies have also found that improved access to living wills and advanced directives will lead to substantial dollar savings. According to a 1978 study by the Health Care Financing Administration, about 30 percent of expenditures for people who died were spent in the last 30 days of life and constituted 8 percent of total Medicare expenditures that year. Approximately 27 percent of Medicare expenditures are made in the final days of life, and conservatively estimating that approximately 10 percent of such expenditures are unwanted, we could save nearly $4 billion per year. I believe that such savings could be greater. A recent study by researchers at Thomas Jefferson University Medical College in Philadelphia also concluded the notion that greater use of advanced directives have potential for enormous cost savings. This study also cited research which found that about 90 percent of the American population expresses interest in participating in advance directives discussion although adults have prepared a living will. Provisions in my bill would provide information on individuals' rights regarding living wills and advanced directives and would make it clearer for people to have their rights known and honored. Title IV provides incentives to improve the supply of generalist physicians and would increase the utilization of non-physician providers like nurse practitioners, clinical nurse specialists and physician assistants through direct reimbursement under the Medicare and Medicaid programs. These provisions I believe will also yield substantial savings. A study of the Canadian health system utilizing nurse practitioners projected a 10 to 15 percent savings for all medical costs--or $300 million to $450 million. While our system is dramatically different from Canada's, it may not be unreasonable to project a 5 percent--or $41.5 billion--savings from the increase in the number of primary care providers in our system. Again, experience will raise or lower this projection. Assuming this savings, though, it seems reasonable, based on an average expenditure for health care of $3,299 per person in 1993, that we could cover over 10 million more uninsured persons. Outcomes research is another area where we can achieve considerable health care savings in the long run and improve the quality of care. According to the former editor-in-chief of the New England Journal of Medicine, Dr. Marcia Angell, 20 to 30 percent of health care procedures are either inappropriate, ineffective or unnecessary. If the implementation of medical practice guidelines eliminates 10 to 20 percent of these costs, savings between $8 and $16 billion can be realized annually. To achieve this we must, as Dr. C. Everett Koop, former Surgeon General of the United States says, have a well funded program for outcomes research. Title V would accomplish this by imposing a one-tenth of 1 cent surcharge on all health insurance premiums. Based on the Congressional Budget Office's estimate that in 1993 private health insurance premiums totalled $315 billion, this surcharge would result in a $315 million outcomes research fund-- compared to the approximately $81 million appropriated for fiscal year 1995. Title V also includes provisions to reduce the administrative costs incurred by our health care system. Estimates for administrative costs range as high a 25 cents per dollar spent on health care, or over $225 billion annually. A reasonable expectation is that we can reduce administrative costs by 25 percent through such reforms. This would yield savings of $55 billion over the next 5 years. While the development of a national electronic claims system to handle the billions of dollars in claims is complex and will take time to implement fully, I believe it is essential for operating a more efficient health care system and achieving the savings necessary to provide insurance for the remaining uninsured Americans. Title V also includes a provision to improve consumer access to health care information. True cost containment and competition cannot occur it purchasers of health care do not have the information available to them to compare cost and quality. Title V authorizes the Secretary of Health and Human Services to award grants to States to establish or improve a health care data information system. Currently, there are 39 States that have a mandate to establish such a system, and 20 States are in various stages of implementation. In my own State, the Pennsylvania Health Care Cost Containment Council has received national recognition for the work it has done in providing important information regarding health care costs and quality. Consumers, businesses, labor, insurance companies, health maintenance organizations, and hospitals have utilized this information. For example, hospitals have used information provided by the Pennsylvania's Cost Containment Council to become more competitive in the marketplace; businesses and labor have used this data to lower their health care expenditures; health plans have used this information when contracting with providers; and consumers have used this information to compare costs and outcomes of health care providers and procedures. States have not yet produced any figures on statewide savings as a result of implementing health information systems, however, there are many examples of savings from users of these systems all across the country. In Pennsylvania, for example, Accutrex, a mid-size company that is part of an alliance of businesses in southwest Pennsylvania, reported a savings of $1 million over a 6-month period by using information produced by the Pennsylvania Cost Containment Council. There are many other examples of savings such as this, and I believe that if such systems where in place in every State, the savings could be substantial. Title VI addresses the issue of home nursing care. The costs of such care to those requiring it are exorbitant. Title VI proposes, among other things, a tax credit for premiums paid to purchase private long- term care insurance and tax deductions to offset long-term care expenses and proposes home and community-based care benefits as less costly alternatives to institutional care. The Joint Tax Committee estimates that the cost to the Treasury of this proposal is approximately $20 billion. Other tax incentives and reforms to make long term care insurance more affordable are: (1) allowing employees to select long-term care insurance as part of a cafeteria plan and allowing employers to deduct this expense; (2) excluding life insurance savings used to pay for long term care from income tax; and (3) setting standards for long term care insurance that reduce the bias that favors institutional care over community and home-based alternatives. While precision is again impossible, it is a reasonable projection that we could achieve under my proposal a net savings of approximately $174.9 million. I arrive at this sum by totaling the projected savings of $214 billion over 5 years--$45 billion in small employer market reforms coupled with employer purchasing groups; $12.5 billion for preventive health services; $20 billion for reducing unwanted care; $41.5 billion from increasing primary care providers; $40 billion through outcomes research; and $55 billion through reducing administrative costs--and netting against that the projected cost of $39.1 billion--$5.2 billion for extending full deductibility of health insurance cost to the self employed; $20 billion for long term care; and approximately $13.9 billion in funding for primary and preventive health care programs and the initiatives that I am proposing. Since there are no precise estimates in each one of these areas, experience will require modification of these projections, but at least it is a beginning. I am prepared to work with other Senators in the development of implementing legislation, to press this important area of health care reform. Conclusion The provisions which I have outlined today contain the framework for providing affordable health care for all Americans. I am opposed to rationing health care. I do not want rationing for myself, for my family, or for America. The question is whether we have essential resources--doctors and other health care providers, hospitals, pharmaceutical products, et cetera--to provide medical care for all Americans. I am confident that we do. In my judgment, we should not scrap, but build on our current health delivery system. We do not need the overwhelming bureaucracy that President Clinton and other Democratic leaders proposed last year to accomplish this. I believe we can provide care for the almost 40 million Americans who are now not covered and reduce health care costs for those who are covered within the currently growing $884.2 billion in health spending. With the savings projected in this bill, I believe it is possible to provide access to comprehensive affordable health care for all Americans. This bill is a significant first-step in obtaining that objective. It is obvious that the total answer to the health care issue will not be achieved immediately or easily but the time has come for concerted action on this subject. I understand that there are several controversial issues presented in this bill and I am open to suggestions on possible modifications. I urge the Congressional leadership, including the appropriate committee chairmen, to move this legislation and other health care bills forward promptly. text of the bill be printed in the Record.

Mr. SPECTER. Mr. President, as we begin the 104th Congress, we have an historic opportunity to make fundamental changes in the Federal government. We have an opportunity to reduce the size of Government, to have less spending, to reduce taxes, to attack crime control, and to speak with a strong voice on foreign policy. I think it is very important, as we approach the issue of reducing expenses, that we be very careful and handle the issue with a scalpel as opposed to a meat axe. As we look forward to cutting taxes, we should examine the capital gains tax which should have been cut long ago, and which will probably produce more revenue because of more transactions. It is something we should have accomplished a long time ago. But where we have tax cuts we should not add to the deficit, unless we first have spending cuts so that we know precisely what we are doing. I agree with key points in the Contract With America. I have long urged the adoption of a constitutional amendment for a balanced budget when it came to the floor of the Senate more than a decade ago. And I have urged the President to exercise the line-item veto on the fundamental proposition that the President currently has authority under the Constitution to do so because the Federal provision is identical with the provision of the Massachusetts State constitution, followed by other States, where the Governors, the chief executive officers, have exercised the line-item veto. I tried to persuade President Bush to exercise the line-item veto under existing authority, and he said, ``Arlen, my lawyer tells me I cannot do that.'' I made perhaps the tempered suggestion that he change lawyers. I quickly added that he should not tell the Bar Association about that. I have urged President Clinton to do the same and sent him a detailed memorandum of law. These are items within the Contract With America, and others, which we can implement to have very sensible change in the Federal Government. I hope, Mr. President, that the Congress does not move to the activist social agenda. There is nothing in the Contract With America on school prayer. Although I very fervently believe in the power of prayer, I think that it belongs in the churches and synagogues and homes, and not in the schools. I recall my own experience as a child of six or seven in Wichita, KS, when there was school prayer. I recall how uncomfortable I felt--perhaps not quite intimidated--but I hope that issue does not come before the Congress. If it reaches the floor of the U.S. Senate, it is a matter which will take weeks or perhaps months before it is concluded. Senate on the abortion issue. Here again, I personally am very much opposed to abortion, but I believe it is a matter for the individual, again and for families or ministers, priests and rabbis. And I hope that we will spend our time tackling the tough, substantive issues which I think last November's mandate calls upon the Congress to do. It is my hope, Mr. President, that we will not become embroiled in the gridlock and partisanship which occupied so much of the 103d Congress. I think it would be a mistake for those on this side of the aisle, Republicans, to think that the mandate of last November's election is a blanket endorsement for whatever views we have. In many quarters--and I think with some cause--it is viewed that last November's election was a repudiation of the Congress controlled by the Democrats for what the administration had done. So it is my hope that we will tackle these core issues and that we will deal with them in a way which does not get us bogged down in partisanship but looks to the national interests. When we talk about the agenda, I hope, Mr. President, that we will tackle health care reform early on. I think that there are a number of divergent positions regarding health care reform, but a centrist position is one I will urge the Congress to adopt. I will be introducing today a bill designated as Senate bill 18, by prearrangement, which is the same number my health care reform bill had last year. Senate bill 18 preserves the free enterprise entrepreneurial system, which provides the best health care in the world to approximately 85 percent of the American people, and then targets the specific problems to extend coverage to people when they change jobs, to cover preexisting conditions, where we find in the courts that lawyers spend more time arguing about what is a preexisting condition than it would take the doctors to treat the condition. We will also deal with the issue of spiraling health care costs, with more managed care in Medicare, for example, where the costs are astronomical and have to be brought under control. And managed care has to be very carefully calibrated so that the care is adequate and with a view to more than a profit motive. A significant provision of my legislation is dealing with low-birthweight babies. They are a human tragedy, weighing no more than a pound, a human about as big as the size of my hand, carrying scars for a lifetime and enormous health care costs of more than $150,000 per child. Provisions in S. 18 are one way of how we can curtail health care costs. Mr. President, I intend to introduce today Senate bill 17, a number arranged by a designation which will deal with an urban agenda for America's cities, which I will introduce on behalf of Senator Carol Moseley-Braun and myself. I think it may well be the case that the Federal Government, Washington, DC, has given up on America's cities, and I think that is a tragedy. We have long seen the unsuccessfulness and difficulties of throwing money at the problems of cities. My legislation embodied in the urban agenda for American cities is patterned after proposals suggested by the distinguished mayor of Philadelphia, Edward Rendell, and has the backing of many mayors in America and the National League of Cities. What it intends to do is to provide assistance to the cities, without additional Federal expenditures, by means such as a requirement that Federal procurement be located in the distressed areas of America's cities; that 15 percent of foreign aid be expended in distressed areas of American cities; that items like the historical tax credit, scaled back in 1986, be restored. It has been a revenue loser for the Federal Government to strike that form of a deduction, which had been tremendously developmental for American cities and had produced a net effect of more money. These items which are encompassed within the legislative proposal by Mayor Rendell and embodied in this bill will do much for America's cities. I live in one of America's great cities, the city of Philadelphia. My experience goes beyond the big city to my birthplace of Wichita, KS, which is a moderate-size city in America, and to the town where I moved when I was 12, Russell, KS, a city of 5,000. The problems of the cities, Mr. President, are not left for the cities alone, but they travel across America. Today, you may find the gangs of Los Angeles, the Bloods and the Crips, in Des Moines, IA, or in Lancaster, PA. So that in moving to assist the cities, we are moving to assist all of America. Mr. President, I know my time is short with the period set aside for each Senator being limited to 10 minutes. I thank my colleagues, and the distinguished Senator from West Virginia, for awaiting my presentation. Mr. President, We convene in legislative session eight weeks after the most extraordinary congressional election in American history. With a voice that was consistent throughout the nation, the American people repudiated the policies of the current Administration and its congressional majorities, and for the first time in four decades gave control of both houses of Congress to Republicans. The very extraordinariness of the election that has brought us here guarantees that the 104th Congress that we begin today will be historically memorable. We have it in our power now, and as we work together over the next two years, to determine whether this Congress will be remembered as the moment when a new majority and new legislative leadership spawned a new American Renaissance of growth, prosperity and accomplishment--or as the moment when Republicans showed that they were no more capable or governing than Democrats. the failures of the 103d congress The 103d Congress just concluded will find its own way into the history books, and I do not believe the references will be complimentary. The legislative accomplishment of the last two years were meager, as we failed to do anything to expand access to health care; as we failed to enact meaningful Congressional reform or curb the influence of lobbyists; as we failed in our efforts at campaign finance reform; and as we consigned our children to more years of deficit and more mountains of debt by failing to adopt a balanced budget amendment to the Constitution. Only in the area of international trade, with most Republicans joining some Democrats to support the NAFTA and GATT agreements-- agreements worked out under both Republican and Democratic administrations--was there real legislative cooperation to promote the best interests of the nation. We also passed a Crime Bill that, while not perfect, should help to make America safer by providing more police, building more prisons, expanding the federal death penalty, and reducing violence against women--but we did so in such a spirit of legislative acrimony that the meanness of the debate nearly overswept the bill's value as an anticrime measure. In fact, it may be that the spirit more than the substance of the 103d Congress is what endures. If so, it will not be a pleasant recollection. In my 14 years in this body, I do not recall a session when party and partisanship, rather than honest debate on the merits of the issues, played so large a role in determining what legislation would be considered, or when, or how it would be voted upon. Take the issue of health care. Faced only with the alternatives of the massive bureaucracy and government regulation proposed by the Clinton administration, on the one hand, and the determination of some in my own caucus to do nothing, on the other, we accomplished nothing. That failure was almost entirely a failure of process--begun by the administration, which excluded Congressional Republicans from the formulation of its health care proposals; and compounded by some in the Republican caucus who decided that it was more important to deny the President whatever credit there might be in a good health care bill than to address the problems of those Americans who lacked coverage, or were not getting care. The enormous miscalculation of the Democratic congressional leadership in refusing even to bring up health care until late August, when they thought the coercive power of a summer recess would let them force a bad bill through, was the final nail in the coffin. Had we gone about our work differently, we could have had a good the problems of portability, of pre-existing conditions and other impediments to health insurance access, while at the same time maintaining the private market and patient-physician choice system that has given the best health care in the world to 86% of Americans. What we needed, but did not have, was an open process of bipartisan consideration and debate, where the needs of working Americans were considered ahead of tactical maneuverings for the next election. For my part, I have been pushing for wise health care reform since my first term in the Senate, when I sponsored the ``Health Care Cost Containment Act'' of 1983. In the 102d and 103d congressional sessions, I made repeated attempts to bring the health care issue to the floor in a setting where the issue could receive full and fair consideration. My attempts were, unfortunately, blocked by the Democratic leadership. What we got, instead, were partisan efforts to pass the so-called Clinton and Mitchell health care bills--bills drafted without Republican participation, and bills which relied on massive federal bureaucracy rather than free market forces to produce health care reform. Regrettably, the very process of health care reform turned the issue into a matter of partisanship. The Administration's health care task force met in secret, illegally as it turns out, and made no effort to reach out to Republican Senators with a demonstrated commitment to health care reform to create a broad base of Congressional support that crossed party lines. Similarly, the Democratic leadership in both houses made no effort to build bipartisan support, believing instead that they could pass a bill by legislative hardball. The result, not surprisingly, was a bad bill--a bill based on more Big Government and social engineering; a bill that undercut the longstanding determination we've had that health care choices should be made by patients and their physicians and not faceless bureaucrats; a bill that in the name of reform threatened to raise premiums and reduce choice for working Americans; a bill that, once it was understood, had no chance of passage. The result of this partisan hubris, unfortunately, was also to preclude those Republicans and Democrats who were interested in forging a compromise on health care from having the opportunity to do so. The American people would have welcomed a health care reform package that relied on market mechanisms to expand coverage and control costs, but the social engineers of the Democratic left demanded a bill that put America's whole health care system under the thumb of more than 150 federal agencies, while the naysayers of the Republican right were only too happy to use the Democrats' excess as an excuse to do nothing. The 103d Congress is likely to be remembered more than anything else as the Congress of gridlock--and not just for its failure to enact health care reform. Senators of both parties were more willing than ever to invoke pointless procedural rules, like requiring bills to be read in full, to keep the Senate in session nearly all night and to delay adjournments. The results were short tempers and frayed nerves-- and an erosion of some of the sense of collegiality that ought to have allowed us to cross boundaries of partisanship and ideology in search of compromise and in service of the people's best interests. Obstructionism found its practitioners on both sides of the aisle; it was the delaying tactics of a Democratic chairman that forced us to return for a special post-election session to take up the GATT issue. The inability of Democrats in the Senate to reach agreement with their own colleagues in the House prevented campaign finance reform from coming to the Senate floor until the final days of session, when it had no chance for passage. The record of the 103d Congress is one we would do well not to replicate. the 104th congress: a new spirit of bipartisanship? Fiorello La Guardia, a great Republican Mayor of New York, once observed that ``There is no Democratic or Republican way of cleaning the streets.'' La Guardia did not mean that there were not differences, longstanding and important, between the two major American parties, but rather that sometimes those differences need to be overcome in doing the work of governing. I agree, and I share Woodrow Wilson's wish, expressed while he was a candidate for President, that ``party battles could be fought with less personal passion and more passion for the common good.'' I urge in the strongest terms that the spirit of putting the common good ahead of party advantage be the spirit of the 104th Congress. In a spirit of accommodation, I urge my colleagues across the aisle to recognize in the results of the last election the people's rejection of high taxes, big government and bureaucracy--and the people's rejection of an entrenched and tired Congressional leadership. But in that same spirit, I urge my colleagues on this side of the aisle not to misread the results of the last election as a mandate for uncaring or do nothing government, or a government that turns its back on people's problems--because if we do, our majorities will be short lived. I urge all my colleagues in this body, and those in the House, to hear in the election just past the voice of the American people calling on us to leave behind partisanship, to end gridlock, to stop wrangling for tactical advantage, and instead to forge a new spirit of compromise and cooperation that will enable the 104th to be remembered as a Congress of accomplishment. Sometimes, as one of the giants of this body, Scoop Jackson, observed, ``[t]he best politics is no politics.'' A spirit of bipartisanship that in critical moments puts the national interest above party has always been part of the American grain. In his Farewell Address, Washington warned that ``[t]he alternate domination of one faction over another, sharpened by the spirit of revenge natural of party dissension * * * is itself a frightful despotism.'' At the close of his life, Jefferson wrote that a democratic government, like ours, demands much compromise of opinion; that things even salutary should not be crammed down the throats of dissenting brethren * * * and that a great deal of indulgence is necessary to strengthen habits of harmony and fraternity. In more recent years, a great American who was to be elected President as a Democrat, John F. Kennedy, spoke out while a Senator to remind us ``not [to] seek the Republican answer or the Democratic answer, but the right answer.'' Another great American who was to be elected President as a Republican, Dwight Eisenhower, said that ``[t]o define democracy in one word, we must use the word `cooperation.''' Even in the bitter 103d Congress, we did have moments where we could lay partisanship aside and cooperate in seeking ``right answers'' for the American people. I have already mentioned NAFTA and GATT. President Clinton had the full backing of Congressional Republicans for his prompt response to last fall's provocative Iraqi troop movements, just as many Democrats had supported President Bush's liberation of Kuwait. So we know that today legislative bipartisanship is not an impossibility. I respectfully suggest to my colleagues that bipartisanship and cooperation are now not only possibilities, they are imperatives. In the last Congress, we too often did our legislative business with our eyes fixed on the electoral calendar, more concerned with polls and ``spin'' and ``fallout''--with getting credit and placing blame--than with meeting the needs of the nation. The voters responded by repudiating the Congressional majority with unprecedented unanimity. So if the 104th Congress does no better, we should not be surprised if the people render the same verdict on its new Congressional majority. As World War I ended, and controversy swirled over whether America would continue to play a role in maintaining a peaceful world, President Wilson asked Americans ``What difference does party make when mankind is involved?'' Today, when our schools do not educate; when violent crime spreads from city to suburb to rural America; when a sixth of our population cannot get health insurance; when teen pregnancy rates soar and our welfare system works more as a trap of dependency than a door to opportunity; when our cities decay as at home and our competitiveness abroad are held back by a government that overspends, overtaxes and overregulates--Today, we ought to ask what difference does party make when the future of the nation is at stake? America's needs are real enough. Let us spend these two years addressing them without rancor or bitterness, looking on both sides of the aisles for honest answers and constructive solutions. Let us not waste time worrying about who will get the ``credit'' for our successes, because in that divisive struggle lies the certainty that we will all be held accountable for our failures.