Pete Stark

Mr. STARK

Mr. STARK. Mr. Speaker, the issue of providing universal access to health care for our citizens has been a major goal of every Member of Congress. Over the past 32 years we as a body have enacted many changes to achieve this goal for the Nation. In those efforts, many in the private sector have worked with us to develop responsible health legislation. Dr. James M. Moorefield, a radiologist from California is a private sector physician leader who came to us in Congress to offer a solution to physician payment under Medicare. As a result the physician RBRVS was adopted and Dr. Moorefield, as chairman of the board of chancellors of the American College of Radiology, worked tirelessly with us to achieve that milestone. In recognition for that leadership and his many other contributions to radiology, medicine, and America's health care system, the American College of Radiology will award him the ACR Gold Medal in Atlanta, GA, at its annual meeting September 6-10, 1997. The ACR, in announcing his award of the prestigious gold medal, published the following comments by Christopher M. Rose, M.D. and Frederick R. Margolin, M.D. in the ACR Bulletin: Jim Moorefield is a tireless leader in the field of radiology. Few people have made a commitment to our specialty that has been as complete or as longstanding as his. The tracks of his dedication to radiology and medicine reach from the halls of his hospital to the halls of Congress. He has served us on a local, state, and national level with distinction deserving our highest honor. After attending Georgetown University, Dr. Moorefield received his medical training in his native New York at the State University of New York. He went on to serve as a medical officer in the U.S. Navy before his radiology residency at the University of California, San Francisco. In 1969 he entered private practice in Sacramento. Dr. Moorefield's local and state involvement provided him his first opportunities to distinguish himself in the politics of medicine. As a delegate to the state medical society, he became an outspoken opponent of self-referral, winning him much respect, if not many friends, among the self-referrers. His College activities began with committee and commission service, and he served as a councilor from California. After the College successfully defeated the RAPs legislation in 1987, Dr. Moorefield was picked to lead the arduous task of pulling members and staff together to develop a radiology relative value that could be used by Medicare. The system he created was copied and is still used by the AMA to set relative values recommended to HCFA for Medicare. He worked to convince Congress and HCFA to accept it, and thus helped preserve the right of the radiology profession to establish its own guidelines and definitions. Dr. Moorefield went on to serve as vice-chairman and chairman of the ACR Board of Chancellors and as ACR president. It is particularly noteworthy that during the past 25 years, he has been in the full-time private practice of radiology. During most of his years of service to the College, he also served as president of his group. The time that he has unselfishly devoted to advance our interests as radiologists has been extracted at some measure of personal cost. Dr. Moorefield is an articulate and effective representative of our specialty. He is a wonderful person with a fine sense of humor, a great collegiality, and fine perceptive power of people, ideas, and future trends. He is blessed with enormous stamina and a will designed to test that strength. He has used all his talents in the pursuit of the betterment of his colleagues and the College. The ACR and the profession of radiology are stronger for his efforts. Mr. Speaker, I ask that my colleagues join me in extending our congratulations to Dr. Moorefield for this honor and thank him for the leadership and direction he provided the Congress as we deliberated our Nation's health care issues.

Mr. STARK

Mr. STARK. Mr. Speaker, I yield myself such time as I may consume. I oppose this bill and suggest to my colleagues and the American people that it is unfair and unnecessary. The Congress is lying to the American people because this does not balance the budget. It cannot balance the budget until 2002 unless we make more cuts, and we are not going to make those cuts. We have not now and we will not then. If we did nothing, the budget would balance this year or next year by itself. Government, again led by the Republicans in Congress, is mucking up the economy by bringing forward an unnecessary bill. These unfair tax cuts, 75 percent of these tax cuts go to families with over $150,000 in income. Simmons, the beet king in Texas, gets $104 million individually. Sammon Enterprises in Texas gets $23 million, negotiated in the dead of night in the Republican leadership offices, where they probably got those two $500,000 campaign checks from the Amway Co., and they gave Amway $200 million in tax deductions for their Republican contributions. And in the secret of night it harms poor families who will have a $40 tax increase. And what my colleagues do not know is that it eliminates abortion for poor young women. That is buried in this bill. It hurts cancer victims. Unknown to any of us here, the tobacco settlement, which is not even agreed to yet, $50 billion of the money that should come out of the tobacco settlement is being credited because of the tobacco tax. That money was supposed to go to cancer victims. The Republicans are stealing the money that is supposed to go to cancer victims from an unfinished tobacco settlement and using it to fund this turkey. My fellow colleagues, this is an unnecessary bill with a political purpose and it is economic nonsense. It harms the American public and only helps 1 or 2 percent of the very richest Americans who make their money either through inheritance, not a heavy-lifting job, or through stock market activities. There are secrets buried in this bill which are undetermined at this point and were decided last night in the dead of night. I urge my colleagues, in the sense of parity and economic justice to vote ``no'' on this tax bill.

Mr. STARK. Mr. Speaker, I would ask the gentleman, is it not true that we are not really going to have the budget balanced for 3 or 4 years, 3 or 4 years from now when it finally comes to balance, and if we had no bill yesterday and did not do this tax bill today, we would balance this year or next?

Mr. STARK. And then after that, under the Republican bill, do we not have deficits that just zoom right down to below zero?

Mr. STARK. Mr. Speaker, I yield myself such time as I may consume. I just wanted to repeat for a few of my colleagues who were not here before that, in addition to the patent unfairness of this bill, which is obvious from the charts, that the top 5 percent are getting 44 percent of the breaks. And when my colleagues on the other side suggest that the middle class is getting most of the breaks, they are just taking the first 5 years, they are not looking at the whole 10 years. The fact is that the poorest people in this country are getting nothing out of this and the richest are getting an average of $16,000. But then there are the owners of Amway Corporation, and I was wrong, I misspoke, they gave two $500,000 checks to the Republican Party, and there is a tax break in here totaling $280 million for their Asian subsidiaries. So if one invests a million bucks in the Republicans, they can get $280 million back in special hidden tax breaks. In this bill Sammon Enterprises in Texas, at the last hour, in the Speaker's office, $23 million to one company in Texas. Twenty-three million bucks. That is more than all the people in my district make in a year, Mr. Speaker. Ten times more going to one Texan. I wonder how much money old man Sammon kicked into the Republican Party. It will be interesting to find out. The beet king in Texas, Simmons, I did not realize what he got. He is getting $104 million, a gift from the Republicans in this tax bill, which is hidden here in the documents which never were explained to any of us. This borders on the criminal. And when we talk about investigations as to whether the Vice President was in some Ashram someplace and got money, what went on in the Speaker's office when the chairman of the Committee on Ways and Means and the Speaker and the high-knockers in the Republican leadership were cutting deals to pay back big contributors? That is what we ought to find out that is going on in this bill. I have a page here that lists all of the rifle shots. My goodness, here, ``relating to transition rule for instruments described in a ruling request submitted to the Internal Revenue Service on or before June 8, 1997.'' Does not tell us the name, does not tell us the money, but I will bet it is somebody's buddy who kicked in big to the Republicans. Here it is, section 1005(b). We will make this part of the Record, Mr. Speaker. Here is ``relating to transition rule for instruments described on or before June 8, 1997, in a public announcement or in a filing.'' I want to tell my colleagues, those are provisions, page after page, for individuals who are getting special slush out of this tax bill while lower income Americans are going to pay $40 more a year. Mr. Speaker, the material I quoted from above is submitted herewith: Memorandum To: Honorable Bill Archer, Honorable John Kasich, Honorable Philip M. Crane, Honorable William M. Thomas, Honorable Richard K. Armey, Honorable Tom DeLay, Honorable Charles B. Rangel, Honorable Jim McDermott, Honorable Fortney Pete Stark, Senator William V. Roth, Jr., Senator Pete V. Domenici, Senator Trent Lott, Senator Charles E. Grassley, Senator Kent Conrad, Senator Don Nickles, Senator Daniel Patrick Moynihan, Senator Frank R. Lautenberg, Honorable Robert T. Matsui. From: Kenneth J. Kies. Subject: Provisions in H.R. 2014 which are subject to the line item veto. The Line Item Veto Act (Pub. Law 104-130) (the ``Act''), amended the Congressional Budget and Impoundment Act of 1974 to grant the President the limited authority to cancel specific dollar amounts of discretionary budget authority, certain new direct spending, and limited tax benefits. The Act provides that the Joint Committee on Taxation (the ``Joint Committee'') is required to examine any revenue or reconciliation bill or joint resolution that amends the Internal Revenue Code of 1986 prior to its filing by a conference committee in order to determine whether or not the bill or joint resolution contains any limited tax benefits. The Act also requires the Joint Committee to provide a statement to the conference committee that either (1) identifies each limited tax benefit contained in the bill or resolution, or (2) declares that the bill or resolution contains no limited tax benefits. The Act provides that the statement provided to the conferees must be made available to any Member of Congress by the Joint Committee on Taxation immediately upon request. The Act provides that the conferees determine whether or not to include the Joint Committee's statement in the conference report. If the conference report includes the information from the Joint Committee on Taxation identifying provisions that are limited tax benefits, then the President may cancel one or more of those, but only those, provisions that have been identified. If a conference report contains a statement from the Joint Committee that none of the provisions in the conference report are limited tax benefits, then the President has no authority to cancel any of the specific tax provisions, because there are no tax provisions that are eligible for cancellation under the Act. If the conference report does not include a statement from the Joint Committee regarding limited tax benefits, then the President determines which provisions are subject to cancellation under the Act. Pursuant to section 1027(a) of the Congressional Budget and Impoundment Act of 1974 (as amended by the Line Item Veto Act), attached is the statement of the Joint Committee on Taxation regarding limited tax benefits contained in the conference agreement on H.R. 2014. Sec.--. Identification of Limited Tax Benefits Subject to Line Item Veto Section 1021(a)(3) of the Congressional Budget and Impoundment Control Act of 1974 shall only apply to: (1) Sec. 101(b) (relating to high risk pools permitted to cover dependents of high risk individuals) (2) Sec. 222 (relating to limitation on qualified 501(c)(3) bonds other than hospital bonds) (3) Sec. 224 (relating to contributions of computer technology and equipment for elementary or secondary school purposes) (4) Sec. (relating to treatment of remainder interests for purposes of provision relating to gain from sale of principal residence) (5) Sec. 501(b) (relating to indexing of alternative valuation of certain farm, etc., real property) (6) Sec. 503 (relating to modifications to rate of interest on portion of estate tax extended under section 6166) (7) Sec. 504 (relating to extension of treatment of certain rents under section 2032A to lineal descendants) (8) Sec. 508 (relating to treatment of land subject to qualified conservation easement) (9) Sec. 511 (relating to expansion of exception from generation-skipping transfer tax for transfers to individuals with deceased parents) (10) Sec. 601 (relating to the research tax credit) (11) Sec. 602 (relating to contributions of stock to private foundations) (12) Sec. 603 (relating to the work opportunity tax credit) (13) Sec. 604 (relating to orphan drug tax credit) (14) Sec. 701 (relating to incentives for revitalization of the District of Columbia) to the extent it amends the Internal Revenue Code of 1986 to create sections 1400 and 1400A (relating to tax-exempt economic development bonds) (15) Sec. 701 (relating to incentives for revitalization of the District of Columbia) to the extent it amends the Internal Revenue Code of 1986 to create section 1400C (relating to first-time homebuyer credit for District of Columbia) (16) Sec. 801 (relating to incentives for employing long- term family assistance recipients) (17) Sec. 904(b) (relating to uniform rate of tax on vaccines) as it relates to any vaccine containing pertussis bacteria, extracted or partial cell bacteria, or specific pertussis antigens (18) Sec. 904(b) (relating to uniform rate of tax on vaccines) as it relates to any vaccine against measles (19) Sec. 904(b) (relating to uniform rate of tax on vaccines) as it relates to any vaccine against mumps (20) Sec. 904(b) (relating to uniform rate of tax on vaccines) as it relates to any vaccine against rubella (21) Sec. 905 (relating to operators of multiple retail gasoline outlets treated as wholesale distributors for refund purposes) (22) Sec. 906 (relating to exemption of electric and other clean-fuel motor vehicles from luxury automobile classification) (23) Sec. 907(a) (relating to rate of tax on liquefied natural gas determined on basis of BTU equivalency with gasoline) (24) Sec. 907(b) (relating to rate of tax on methanol from natural gas determined on basis of BTU equivalency with gasoline) (25) Sec. 908 (relating to modification of tax treatment of hard cider) (26) Sec. 914 (relating to mortgage financing for residences located in disaster areas) (27) Sec. 952 (relating to assignment of workmen's compensation liability eligible for exclusion relating to personal injury liability assignments) (28) Sec. 953 (relating to tax-exempt status for certain State worker's compensation act companies) (29) Sec. 957 (relating to additional advance refunding of certain Virgin Island bonds) (30) Sec. 958 (relating to nonrecognition of gain on sale of stock to certain farmers' cooperatives) (31) Sec. 961 (relating to exemption of the incremental cost of a clean fuel vehicle from the limits on depreciation for vehicles) (32) Sec. 964 (relating to clarification of treatment of certain receivables purchased by cooperative hospital service organizations) (33) Sec. 966 (relating to deduction in computing adjusted gross income for expenses in connection with service performed by certain officials) with respect to taxable years beginning before 1991 (34) Sec. 968 (relating to elective carryback of existing carryovers of National Railroad Passenger Corporation) (35) Sec. 1005(b)(2)(B) (relating to transition rule for instruments described in a ruling request submitted to the Internal Revenue Service on or before June 8, 1997) (36) Sec. 1005(b)(2)(C) (relating to transition rule for instruments described on or before June 8, 1997, in a public announcement or in a filing with the Securities and Exchange Commission) as it relates to a public announcement (37) Sec. 1005(b)(2)(C) (relating to transition rule for instruments described on or before June 8, 1997, in a public announcement or in filing with the Securities and Exchange Commission) as it relates to a filing with the Securities and Exchange Commission (38) Sec. 1011(d)(2)(B) (relating to transition rule for distributions made pursuant to the terms of a tender offer outstanding on May 3, 1995) (39) Sec. 1011(d)(3) (relating to transition rule for distributions made pursuant to the terms of a tender offer outstanding on September 13, 1995) (40) Sec. 1012(d)(3)(B) (relating to transition rule for distributions pursuant to an acquisition described in section 355(e)(2)(A)(ii) of the Internal Revenue Code of 1986 described in a ruling request submitted to the Internal Revenue Service on or before April 16, 1997) (41) Sec. 1012(d)(3)(C) (relating to transition rule for distributions pursuant to an acquisition described in section 355(e)(2)(A)(ii) of the Internal Revenue Code of 1986 described in a public announcement or filing with the Securities and Exchange Commission) as it relates to a public announcement (42) Sec. 1012(d)(3)(C) (relating to transition rule for distributions pursuant to an acquisition described in section 355(e)(2)(A)(ii) of the Internal Revenue Code of 1986 described in a public announcement or filing with the Securities and Exchange Commission) as it relates to a filing with the Securities and Exchange Commission (43) Sec. 1013(d)(2)(B) (relating to transition rule for distributions or acquisitions after June 8, 1997, described in a ruling request submitted to the Internal Revenue Service submitted on or before June 8, 1997) (44) Sec. 1013(d)(2)(C) (relating to transition rule for distributions or acquisitions after June 8, 1997, described in a public announcement or filing with the Securities and Exchange Commission on or before June 8, 1997) as it relates to a public announcement (45) Sec. 1013(d)(2)(C) (relating to transition rule for distributions or acquisitions after June 8, 1997, described in a public announcement or filing with the Securities and Exchange Commission on or before June 8, 1997) as it relates to a filing with the Securities and Exchange Commission (46) Sec. 1014(f)(2)(B) (relating to transition rule for any transaction after June 8, 1997, if such transaction is described in a ruling request submitted to the Internal Revenue Service on or before June 8, 1997) (47) Sec. 1014(f)(2)(C) (relating to transition rule for any transaction after June 8, 1997, if such transaction is described in a public announcement or filing with the Securities and Exchange Commission on or before June 8, 1997) as it relates to a public announcement (48) Sec. 1014(f)(2)(C) (relating to transition rule for any transaction after June 8, 1997, if such transaction is described in a public announcement or filing with the Securities and Exchange Commission on or before June 8, 1997) as it relates to a filing with the Securities and Exchange Commission (49) Sec. 1044(b) (relating to special rules for provision terminating certain exceptions from rules relating to exempt organizations which provide commercial-type insurance) (50) Sec. 1091(a) (relating to termination of suspense accounts for family corporations required to use accrual accounting) as it relates to the repeal of Internal Revenue Code section 447(i)(3) (51) Sec. 1089(b)(3)(B) (relating to special rule for decedents dying before January 1, 1999) (52) Sec. 1089(b)(3)(C) (relating to reformations) (53) Sec. 1171 (relating to treatment of computer software as FSC export property) (54) Sec. 1175 (relating to exemption for active financing income) (55) Sec. 1204 (relating to travel expenses of Federal employees doing criminal investigations) (56) Sec. 1236 (relating to extension of time for filing a request for administrative adjustment) (57) Sec. 1243 (relating to special rules for administrative adjustment request with respect to bad debts or worthless securities) (58) Sec. 1251 (relating to clarification on limitation on maximum number of shareholders) (59) Sec. 1253 (relating to attribution rules applicable to tenant ownership) (60) Sec. 1256 (relating to modification of earnings and profits rules for determining whether REIT has earnings and profits from non-REIT years) (61) Sec. 1257 (relating to treatment of foreclosure property) (62) Sec. 1261 (relating to shared appreciation mortgages) (63) Sec. 1302 (relating to clarification of waiver of certain rights of recovery) (64) Sec. 1303 (relating to transitional rule under section 2056A) (65) Sec. 1304 (relating to treatment for estate tax purposes of short-term obligations held by nonresident alien) (66) Sec. 1311 (relating to clarification of treatment of survivor annuities under qualified terminable interest rules) (67) Sec. 1312 (relating to treatment of qualified domestic trust rules of forms of ownership which are not trusts) (68) Sec. 1313 (relating to opportunity to correct failures under section 2032A) (69) Sec. 1414 (relating to fermented material from any brewery may be received at a distilled spirits plant) (70) Sec. 1417 (relating to use of additional ameliorating material in certain wines) (71) Sec. 1418 (relating to domestically produced beer may be withdrawn free of tax for use of foreign embassies, legations, etc.) (72) Sec. 1421 (relating to transfer to brewery of beer imported in bulk without payment of tax) (73) Sec. 1422 (relating to transfer to bonded wine cellars of wine imported in bulk without payment of tax) (74) Sec. 1506 (relating to clarification of certain rules relating to employee stock ownership plans of S corporations) (75) Sec. 1507 (relating to modification of 10 percent tax for nondeductible contributions) (76) Sec. 1523 (relating to repeal of application of unrelated business income tax to ESOPs) (77) Sec. (relating to gratuitous transfer for the benefit of employees) (78) Sec. 1532 (relating to special rules relating to church plans) (79) Sec. 1604(c)(2) (relating to amendment related to Omnibus Budget Reconciliation Act of 1993) spending bill provision (1) Sec. (FUTA exemption for prisoners)

Mr. STARK. Mr. Speaker, I do not have anybody in my district that makes $645,000 a year, but could the gentleman tell me, do they work a lot harder in the gentleman's district than say that group of people down a couple who only make $70,000? Is that what happens in Wisconsin to those folks in the gentleman's district?

Mr. STARK. Does the gentleman suppose they inherited most of their money, what they are getting, $645,000?

Mr. STARK. So if this family around $30,000, $40,000, savings $200, and a family at $150,000 to $600,000 saves $10,000 or $15,000, that $200 is going to be eaten up in higher interest rates, and the people with capital gains in the stock market are going to have all the profit out of this bill?

Mr. STARK. Mr. Speaker, I yield 2 minutes to the gentleman from Vermont [Mr. Sanders].

Mr. STARK. Mr. Speaker, I yield 4 minutes to the gentleman from Wisconsin [Mr. Obey].

Mr. STARK. Mr. Speaker, will the gentleman yield?

Mr. STARK. Mr. Speaker, I yield 3 minutes to the gentleman from Oregon [Mr. DeFazio].

Mr. STARK. Mr. Speaker, will the gentleman yield?

Mr. STARK. Mr. Speaker, can the gentleman tell me, are we still going to build the B-2 bomber and is defense going to go up?

Mr. STARK. We are still going to take money out of people's pockets and spend it here in Washington.

Mr. STARK. Just not on things that help people.

Mr. STARK. Mr. Speaker, I yield 5 minutes to the gentleman from Missouri [Mr. Gephardt], the leader of the Democrats in the House of Representatives. (Mr. GEPHARDT asked and was given permission to revise and extend his remarks.)

Mr. STARK. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I rise in opposition to the bill before us today. Mr. Speaker, H.R. 2014 cuts taxes by over $100 billion in 5 years and almost $300 billion over 10 years. Those are massive cuts, and if this Congress had the gumption to legislate with long-term interests in mind, we might have scrapped these cuts entirely and used the so-called savings to balance the Medicare trust fund, which we have not done. We could have made Medicare solvent well past 2020 had we not entertained this amazing tax bill. Who gets the cuts? Half the cuts go the richest 5 percent of Americans, those with over $150,000 in income. The richest 20 percent gets 75 percent of the benefit, the top 35 percent get huge benefits, the bottom 60 percent get 7 percent of the benefits. Compare that with the richest 1 percent with average incomes of $645,000. They are getting $16,000 every year in benefits out of this. The lowest 20 percent of the people in the low-income class are going to pay $39 a year more taxes. Those are the very people that the Republicans and the President and his welfare bill have cut off the rolls. Those are the people they are dumping on. That is not Christianity, that is greed. That is awful, to take the poorest Americans, deny them the assistance we have all tried to give them, and then increase their taxes, on top of it. There is no magic in projecting who benefits from this bill. When we target $35 billion of estate tax relief, we end up helping those 2 percent or 3 percent of Americans who have huge estates and obviously incompetent children who cannot afford the business, and to pay it off with the generous terms we already give them. When we cut capital gains from a maximum of 28 to 20 percent or even 18 percent, we help the most affluent Americans. We should not be reluctant to question whether it is fair to give massive tax breaks to the wealthiest Americans while those at the bottom pay an increase in excise taxes. The rich make out better than everyone else. Special interests are also making out like the Beltway bandits who represent them. According to the Joint Committee, this bill contains 80 items which are highlighted as required by the line-item veto law because they give tax benefits to 100 taxpayers or less, and create a special transition relief for 10 taxpayers or less in any particular year. This ought to be embarrassing, to have this list appear in a bill that is rushed to the floor so quickly. Members of Congress have not had time to examine those items. I am not saying that all these provisions are bad. I am saying that this list should have been a red light for this Congress to delay the bill until our reservations could be addressed. For instance, it gives Amtrak a $2.3 billion tax break, which no other company enjoys. I support Amtrak, but I am troubled that we tucked away a provision to give a $2.3 billion relief to Amtrak without having discussed it in Appropriations. Another provision gives Amway a break for two of their Asian affiliates. According to yesterday's Wall Street Journal, Richard DeVos, Amway's founder, donated $500,000 to the Republican Party. Now, in July, his company gets a tax break thrown into the conference report that neither the House nor Senate approved. This is the tax fairy who appeared in the middle of the night, giving Amway this huge benefit after they contributed $500,000 in contributions to the Republican Party. That is payoff, big time. That is giving away Americans' tax dollars in exchange for contributions solicited by the Republican Party from their rich benefactors. There is a special benefit in here for Simmons Enterprises, a rifle shot in the estate tax area, and another favor from the tax fairies for Harold Simmons, a Dallas investor and baron of the sugar beet businesses. Mr. Speaker, I do not like what I know about this bill. It is unfair. It discriminates against the average American. It gives only to the rich. But I like even less what I suspect is in this bill, and it is unfair. It deserves to be defeated. I urge a ``no'' vote. Mr. Speaker, I reserve the balance of my time.

Mr. STARK. Mr. Speaker, do not higher deficits that the Republicans are giving us with these bills lead to higher interest rates?

Mr. STARK. Mr. Speaker, I yield 5 minutes to the distinguished gentleman from Washington [Mr. McDermott]. (Mr. MCDERMOTT asked and was given permission to revise and extend his remarks.)

Mr. STARK. Mr. Speaker, will the gentleman yield?

Mr. STARK

Mr. STARK. Mr. Speaker, I am having a little trouble. I guess I am the only person here who does not have both arms broken from patting myself on the back. I am having a little trouble understanding this bill. Before I explain it, I want to take this opportunity to thank the chairman of the Subcommittee on Health of the Committee on Ways and Means, the gentleman from California [Mr. Bill Thomas] for his open and fair manner in handling the Medicare portion of this bill, which, as the House originally wrote it, was quite good; but the Senate gooped it up and the White House caved to the Senate, so we do not have a very good Medicare bill. But the fact is we have a lousy bill. We would have been better if we had stayed home. Look, the budget is going to balance next year without a bill. In this bill, it takes 5 years to balance. After it balances, we get deficits again. If we had no budget bill, we would balance and get surpluses. So I say to the Members, great job. They just stretch out the time and then give us more deficits. Medicare, it is going to go to 2007. Hot dog. If we did not have a tax bill, we would have the money to take Medicare to 2022. So these geniuses have just cut 15 years off the salvation of Medicare. Good job again. What about children's insurance? Super job. They are going to spend $2,500 bucks a kid to insure 2 million more kids, and if Members had let it alone and used that same money to put them into Medicaid, they would have had 5 million kids insured, so I thank the geniuses for the 3 million kids who are going to walk around without any health insurance due to this budget. Here is the perfect example of government run amok. They have fixed everything. The Senate bill adds the Kyl amendment and others, which will, for the first time, allow doctors to charge Medicare beneficiaries an unlimited amount of money and basically kick them out of Medicare. My heavens, how awful, to suddenly find that we are going to have Medicare live up to the Speaker's intention of withering on the vine because it is going to be a two-class system. Medicare beneficiaries will be able to be charged unlimited amounts for the rich. This is the country club health care relief act to end them all. Medicare costs are going to go up $1.5 billion to try out a medical savings account, which will only, again, help the wealthy and the healthy. So as we go along, we have the right-to-life group who wanted to have this Medicare amendment that Senator Kyl put in there, and it is useless. We were going to cut $100 million out of poor inner-city hospitals; save it, as we like to say. Where are we now? We are going to save $600 million out of inner-city hospitals, $500 million bucks more out of the poorest hospitals in every one of the Members' districts, those hospitals that help the needy and the indigent. Mr. Speaker, this is a lousy bill. Vote ``no.'' Go home and know you are going to be better off for not having a bill.

Mr. STARK

Mr. STARK. Mr. Chairman, I rise in support of the Lowey-DeGette- Hansen-Meehan-Smith amendment to the fiscal year 1998 Agriculture appropriations bill. This amendment is exactly what the doctor ordered. It is ridiculous for the Federal Government to be subsidizing the crop insurance for a product that is so harmful and addictive. Taxpayers now pay for the crop to be harvested, provide insurance against crop damage, pay for the health care costs of tobacco related illness through increased Medicare and Medicaid costs, and pay for advertising subsidies for overseas promotion. It is outrageous to me that while we limit the safety net for our poor, sick and elderly, we maintain a safety net for agribusiness and tobacco. This subsidy should be eliminated. Mr. Chairman, Joe Camel does not need a government handout. I urge my colleagues to support this amendment.

Mr. STARK. Mr. Chairman, I rise in support of the Meehan amendment to the fiscal year 1998 agriculture appropriations bill. This amendment is the next important step in the fight against teen smoking. This amendment appropriates $10 million to the Food and Drug Administration to implement the agency's tobacco initiative requiring retailers to check the photo identification of persons seeking to purchase tobacco products. Similar to the way retailers check ID for alcohol purchases, this amendment does the same for cigarettes. There is a large body of evidence about the harmful and addictive effects of tobacco. Adults have the right to decide for themselves about the choices they make with regard to what they eat, drink, or smoke. However, children are not always able to make those same decisions. It is illegal to sell tobacco to children under the age of 18. This amendment helps to implement the FDA policy of carding those individuals who smoke. It is merely an enforcement tool in the fight against youth smoking. This amendment should be non-controversial and should enjoy unanimous support in this chamber. I urge my colleagues to support the Meehan amendment.

Mr. STARK

Mr. STARK. Mr. Speaker, in recent months, the future of graduate medical education [GME] has been one of the most frequently discussed topics, both by this Congress and the interested public. While the budget reconciliation bills currently underway in the Congress make some changes in GME, the key long-term problems are not being addressed, and time is running out for our Nation's premier academic teaching and research institutions. Health care in 1997 is far different than it was in 1965 when Medicare was established. The environment and methods for training the next generation of physicians and other health care providers has changed, but the way we fund that training has not kept pace. The evolution of managed care has had a definite impact on our medical schools and our academic health centers. Governmental support in the form of Medicare has been sufficient in the past, but similar guarantees no longer exist. Now is the time to consider revolutionary changes in graduate medical education. The establishment of an all- payer trust fund, supported by the Government, as well as by all users of health care, is a reasonable option to consider. If we don't begin to rethink and change the way in which we currently fund graduate medical education, the quality and stability of health care in America may be the price we pay. The most recent edition of ``The Journal of the American Medical Association'' [JAMA] includes an alarming study that may represent the direction we are heading if we continue to treat graduate medical education the same way it has always been treated. The study focuses on the decreasing levels of research being conducted in academic medical centers. The authors found that, ``Anecdotal evidence suggests that managed care has the potential to affect research conducted in academic medical centers by challenging clinical revenues.'' Their findings provide evidence of the existence of an inverse relationship between growth in awards by the National Institutes of Health [NIH] and managed care penetration among U.S. medical schools. They found that medical schools in markets with high-managed care penetration had slower growth in dollar amounts and numbers of NIH awards compared to schools in markets with low- or medium-managed care penetration. If managed care has the potential to affect research levels in a negative manner, then we must find a way to provide for alternative funding mechanisms to continue research in our medical schools and academic health centers. An all-payer trust fund could help support vital and necessary research activities in appropriate settings. The authors state: Managed care plans often select physicians and hospitals on the basis of cost. As managed care entities negotiate discounted fees with the faculty practice plans and teaching hospitals that support medical schools, the ability of medical schools to maintain their research base may be jeopardized. It is a known fact that medical schools in the United States rely heavily on clinical revenues generated by their faculty. These revenues help support a wide variety of medical school functions, including the core academic programs, undergraduate and graduate medical education, and biomedical research. According to the study in JAMA, this clinical support was estimated to total $2.4 billion in 1993. Of this, approximately $816 million or $0.10 of every faculty practice plan dollar collected was used to finance research. If the emergence and growth of managed care has had a demonstrable impact, as suggested by the article, then we must explore other avenues to ensure that valuable research activities are not sacrificed in the process. Establishing an all-payer trust fund would better ensure that all components of medical education receive adequate support. For years, Medicare has been the single best source of reliable funding for teaching and research hospitals, but the available funds are already shrinking in relative terms as we struggle to maintain solvency of the Medicare trust fund while preparing for the aging of the baby boom population. An all-payer trust fund would help alleviate some of the current drain on Medicare through GME while concurrently increasing the total amount of funds available to qualified institutions. A trust fund would rely on support from a broader patient population than exists today. It would require fair and equal contributions from all those who benefit from care provided by physicians and health care professionals trained in the world's most advanced and well-respected institutions. The idea has been discussed previously. Research today. What about tomorrow? What activities will be sacrificed next because of insufficient funds in the world of health care? If we continue to delay, we may discover the hard way what the answer to that question is. That's one risk I don't intend to take. The time for support is now. The report of a decline in research activities should be a call to action.