Paul Wellstone

Mr. WELLSTONE

Mr. WELLSTONE. That is fine.

Mr. WELLSTONE. Mr. President, let me thank Senator Bayh for his words. It is an honor to be on the floor while you are speaking, and I thank you.

Mr. WELLSTONE. Mr. President, I ask my colleague from New Mexico-- actually, if my colleague wants to respond, I will wait and follow his remarks.

Mr. WELLSTONE. Mr. President, the other question I want to ask my colleagues before I go on the time, I know the Senator from Indiana has been waiting to speak now. Would that happen after this debate? He has been waiting patiently. I don't want to precede him, but I wish to know what your plan is.

Mr. WELLSTONE. That is not my question.

Mr. WELLSTONE. My question was, before I get started, I know the Senator from Indiana has been waiting patiently to speak, I think the first time he has had a chance to speak in the Chamber. I wonder if the Senator wants to wait until after this debate and then he can proceed?

Mr. WELLSTONE

Mr. WELLSTONE. People can disagree, but then a vote for this would be an endorsement of any number of the different recommendations. That might be good for some, but I want to make it clear to colleagues, if you move the Medicare age up from 65 to 67, you go forward with the notion of ``voucherizing'' Medicare, which is very different from Medicare today. To me, this is an up-or-down vote on these recommendations. I could not possibly vote for this right now. I hope other Senators will seriously consider that.

Mr. WELLSTONE. Right here: (6) Congress should move expeditiously to consider the bipartisan recommendations of the chairmen of the National Bipartisan Commission on the Future of Medicare. That sounds to me like an endorsement of the Commission's proposal. Am I wrong or right about that?

Mr. WELLSTONE

Mr. WELLSTONE. Mr. President, can we have order? We cannot hear.

Mr. WELLSTONE. I thank the Chair. Mr. President, I make this appeal to my colleagues as a Senator from Minnesota: First of all, please get this disaster relief bill through, at least get the agricultural part of it through. If we don't get that, our FSA offices run out of loan money. They will have to let people go, and we will not be able to provide people with the loan money that they need and they are going to go under. Please make that happen. We should not go home without that happening. Second of all, I rise to support this amendment. Time is not neutral. It rushes on. It is not on the side of family farmers in our States. I have never seen it this bad in all the years we have lived in Minnesota. People are in real economic pain. It was the wheat farmers in the northwest. Now it is the other grain farmers. It is the dairy farmers in southern Minnesota. The hog producers are facing extinction while the packers are in hog heaven. We have to get the price up. We have to get farm income up. I think this amendment, which speaks to taking the cap off the loan rate, is the right thing to do. Price, price, price. Get farm income up and get it up now. This is a critically important crisis amendment. If Senators are on the side of family farmers and a family farm structure of agriculture, which is good for farmers and rural America and consumers, they will vote for this amendment. I yield the floor.

Mr. WELLSTONE. Mr. President, before I start, I ask unanimous consent that Jodi Niehoff, who works in my office, be granted the privilege of the floor during the duration of this debate.

Mr. WELLSTONE

Mr. WELLSTONE. Mr. President, I rise today to recognize Barbara and Harold Harris on the occasion of their 50th wedding anniversary. Barbara Harris has dedicated herself to educating young people in America in the principles of representative government, imparting to them the virtues of citizenship and democracy, developing in them the values of leadership and civic responsibility. She has pursued this dedication throughout her career, first as an educator in public schools where her personal interest and commitment shaped the lives of thousands of students, and subsequently as a co- founder of the Congressional Youth Leadership Council and the National Youth Leadership Forum, bold initiatives to carry her message of achievement and citizenship to tens of thousands of the Nation's best and brightest young adults; This Congress and the Nation are indebted to her for these efforts and for her contribution to enhancing our two centuries old experiment in self-government. Throughout this distinguished career, Barbara has benefited from the dedication, strength, and devotion of her beloved husband Harold. I ask my fellow colleagues to please join me in congratulating Barbara and Harold on this most auspicious occasion.

Mr. WELLSTONE

Mr. WELLSTONE. Mr. President, what is meaningful about this amendment is it provides the necessary funding for decent health care for veterans. And the veterans community will hold all of us accountable. This is a very meaningful vote, I say to my colleagues.

Mr. WELLSTONE

Mr. WELLSTONE. Mr. President, I rise to introduce the Medicare Prescription Drug Coverage Act of 1999, a bill that calls for a full prescription drug benefit for all of America's senior citizens within the Medicare program. This bill is the Senate companion to H.R. 886, which was introduced by Congressman Barney Frank of Massachusetts earlier this month and which already has 22 House cosponsors. One of the beauties of the Medicare Prescription Drug Coverage Act of 1999 is its simplicity. The Act does four things. First, it directs the Secretary of Health and Human Services to study the establishment of an outpatient prescription drug benefit under Medicare that provides for full coverage of outpatient prescription drugs. Second, the Secretary will determine the sufficiency of the estate tax to fund the costs of that outpatient drug benefit. Third, the Secretary must submit a report to Congress within six months that includes a legislative proposal to provide for full coverage of outpatient prescription drugs. Finally, the bill transfers Federal estate tax revenues to the Medicare Hospital Insurance Trust Fund where those monies will be placed in a separate Outpatient Prescription Drug Account to pay for this coverage. Mr. President, now more than ever, a Medicare prescription drug benefit is needed. When Medicare was first adopted the program was designed to reflect typical private health insurance which often did not include outpatient prescription drugs. Then and since, the pharmaceutical industry has opposed a prescription drug benefit in order to protect its profits without regard to America's senior citizens. Even today, the industry is unwilling to shed some of its profits to allow all senior citizens access to needed prescription drugs. But the time has come for Congress to say ``no'' to the undue influence of drug companies in Washington and ``yes'' to Medicare prescription drug coverage. Why has the need for the Medicare Prescription Drug Coverage Act of 1999 because so acute? The reasons are well known. First, the cost of prescription drugs has skyrocketed in recent years. Last year alone, prices increased an estimated 17%. This increase in drug costs hits seniors disproportionately. A 1998 study by the minority staff of the House Government Reform Committee found that older Americans without prescription drug insurance pay on average twice as much as the discounted prices drug companies offer large scale purchasers like HMOs, pharmaceutical benefit managers and government agencies. Even more astounding are comparisons that show the price of some drugs are up to 15 times higher for seniors. Recalcitrance on the part of the pharmaceutical industry and the Congress has not only forced seniors to the pay for drugs out of their own pockets, but the price seniors pay is a national disgrace. The burden on seniors is hard for them to avoid. More than \3/4\ of Americans aged 65 and over are taking prescription drugs. The average senior citizen takes more than four prescription drugs daily and fills an average of 18 prescriptions a year. Older Americans take significantly more drugs on average than the under-65 population. One- third of all drugs are prescribed for senior citizens even though seniors account for only 12% of the population. Not only do older Americans spend almost three times as much of their income (21%) on health care as do those under the age of 65 (8%), but prescription drugs are the largest single source of out-of-pocket expenses for health services paid for by the elderly-- more than doctor visits or hospital admissions. The primary reason for this is that Medicare does not cover outpatient prescription drugs. It is totally unacceptable that 37% of seniors, nationally, have no prescription drug coverage and another 15-20% have totally inadequate coverage. In my state of Minnesota, where Medicare HMO drug coverage without additional cost is virtually nonexistent, close to 65% of seniors have no outpatient drug coverage at all. The result of this drug pricing inequity and excessive cost burden frequently leads seniors to discontinue their medications against medical advice, to lower the dose they take to make their prescriptions last longer, or to take their medicines as prescribed but then skimp on food and other necessities. Whichever path is taken results in a decrease in health and an increased likelihood of an expensive hospital intervention. That is why we need the Medicare Prescription Drug Coverage Act of 1999. Not to provide this benefit is being penny-wise and pound foolish. Minnesota seniors and others who live in states adjacent to Canada and Mexico often travel hundreds of miles and cross international borders to obtain drugs at prices only available in this country when negotiated by volume purchasers. Mildred Miller, a 78 year old constituent of mine from Minneapolis, found it necessary to travel to Canada and to send a friend to Mexico in order to afford the Tamoxifen her doctor in Minnesota had prescribed. And she is not alone. For some seniors the high price of outpatient prescription drugs has not yet been a burden. They are the lucky ones who are members of Medicare HMOs in counties where the Medicare reimbursement rate to HMOs has been high enough to allow a prescription drug benefit, or are fortunate to be wealthy and healthy enough to be able to purchase one of the three Medigap policies that include a prescription drug benefit, or have drug coverage under health insurance benefits provided by former employers. But for those for whom the high price of drugs has not yet been a burden, the future isn't particularly bright. Medicare HMO reimbursement rates are being reduced and many HMOs have cut back or completely cut out their drug benefit. Medigap policies that cover prescription drugs are expensive, have high $250 deductibles, 50% copays, and caps on benefits of $1250 or $300 per year. Health care benefits offered by former employers are becoming less and less common and less generous. The good alternatives today are out of reach of most senior citizens. For example, in Minnesota, a Medicare-Choice prescription drug coverage option with 20% copay, no deductible, and no cap costs $130 per month. It is no wonder that from Maine to Minnesota to the state of Washington and down to Texas, America's senior citizens are forced to leave the country so they can afford to take the medicines they need. What they find are essentially the same prescription drugs at half of price. With the Medicare Prescription Drug Coverage Act of 1999, they won't have to flee their own country. What is needed is a comprehensive prescription drug benefit that includes outpatient drugs--the same sort of prescription drug benefit available to members of Congress--with no cap, reasonable deductibles and reasonable copays. That is what this legislation calls for. An important aspect of the Medicare Prescription Drug Coverage Act of 1999 is that it calls for a full prescription drug benefit--not one capped at a certain limit. Medicare today doesn't limit the number of necessary doctor visits or the number of needed operations--and it shouldn't. Prescription drugs now are as critical as those doctor visits or operations and it is unconscionable for necessary drugs not to be covered just as fully. If we limit the maximum benefit, we penalize the sickest and most frail elderly who have the greatest need and require the greatest number of prescription medications. I expect that other Medicare prescription drug bills will be offered in this Congress, but I fear they will not provide the full protection seniors really need. If you have a major life threatening illness or multiple chronic diseases (something that is hard to predict before it happens), your monthly drug bill will quickly exceed the oft cited figure of a $1500 annual maximum. With such coverage, the sickest and most needy seniors will quickly find themselves out of the benefit. As I travel about the state of Minnesota, I frequently hear stories of elderly citizens saddled with prescription drug costs in excess of $300 per month who are trying to make ends meet on a monthly income of $1,000. That is why full drug coverage is so important. What is also important to know is that the cost of providing a full prescription drug benefit is affordable and not that much more than the cost of a limited benefit. In 1998, the Lewin Group estimated that a Medicare prescription drug benefit in 1999 with a $250 deductible, a 20% copay and a $1500 annual cap would cost $13 billion. The same plan with no annual cap, providing full protection, would cost $17 billion. Revenues from the estate tax, which will fund the benefit, are estimated to be in the $19 billion to $23 billion range. That is more than enough to provide full coverage the full benefit. Finally, Mr. President, let me say a few words about why using the estate tax to pay for a Medicare prescription drug benefit makes a lot of sense. Many members of Congress have argued that the estate tax is no longer needed for general revenue. If so, there is a great deal of logic in using it for a prescription drug benefit under Medicare. The estate tax today applies only to individual estates that are worth more than $650,000 and to estates of married couples worth more than $1 million. Over the next seven years the amount exempt from the estate tax will rise to $1 million for individuals and $2 million for couples. Well over 90% of the estate tax comes from wealthy individuals who were 65 or older at the time of their death. Most of these people were receiving medical care and benefiting from Medicare coverage. Thus, this bill recycles back into the Medicare program--for badly needed prescription drug coverage for all--money from people who benefited from their Medicare entitlement but were not in financial need of it. That only makes sense. For it is more important to preserve and expand the Medicare program than it is to provide tax cuts for the richest Americans. Mr. President, it is unconscionable that America's senior citizens have such difficulty obtaining the fruits of the scientific advances made by America's pharmaceutical industry. Every day we delay, millions of senior citizens struggle to determine how they will be able to afford their next prescription refill. The time to end that struggle is now. That is why I am introducing the Medicare Prescription Drug Coverage Act of 1999 today. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. WELLSTONE

Mr. WELLSTONE. I thank the Chair. Mr. President, I thank my colleague, Senator Johnson from South Dakota. We have been working pretty closely with the veterans community and, in particular, from the time they came out with their independent budget. I have read that very carefully and I think this work by Veterans of Foreign Wars, DAV, PVA, and AmVets is a very important document. I might also add that many other organizations all around the country have added their strong support to this independent budget. In addition to talking about the independent budget, let me discuss what the veterans community has said based upon their own very careful assessment of this. We start off with the President's flatline budget which is woefully inadequate. Let me say right away as a Democrat, I think the budget is woefully inadequate, and certainly the President's budget was no way to say thanks to veterans. The Budget Committee has called for an increase of $1 billion, but that still leaves a $2 billion shortfall. I want to also quote from a letter from the Senate Committee on Veterans' Affairs to the Senate Budget Committee which pointed out that the VA is facing $3 billion in costs above and beyond what was proposed in the President's budget. That would make it $2 billion right now given the $1 billion increase we have in the budget resolution. I will quote the precise figures from the Senate Veterans' Affairs Committee: * * * an additional $1.26 billion to meet unanticipated spending requirements; an additional $853.1 million to overcome the effects of inflation and other ``uncontrollables'' in order that it may contain current services; and at least $1 billion in additional funding to better address the needs of aging, and increasingly female, veterans population. In other words, our own Senate Veterans' Committee, under the able leadership of Senator Specter and Senator Rockefeller, has basically echoed the same analysis of the independent budget. This is specific and it bears out what I have heard from veterans at rallies. The veterans community is very galvanized on this question. I have heard stories or received letters from veterans at our office--I am sure Senator Johnson gets the same kind of letters from the veterans community. The budget resolution goes a third of the way toward covering this cost. We need to go all the way for the veterans community. We don't ask our troops to take a third of a hill, we don't ask them to win a third of a battle, and in this particular budget we ought not to go just a third of the way toward providing the resources so that we can get good medical care to veterans in this country. Both in the President's proposal and in the budget resolution that we have before the Senate, the veterans are not a top priority. There is no doubt whatever that we should be doing much better. This amendment that we introduce tonight does the job. Let me put this in personal terms for a moment. I don't want to see a good friend, Lyle Pearson from North Mankato--a decorated World War II vet, past commander of the national Disabled American Veterans--I don't want to see him in a position where he doesn't receive the kind of decent health care coverage that he deserves. I don't want to see an ever aging veterans population not receiving the kind of assisted care they will need. Many of our veterans are elderly. The question is, How will we respond to that? I don't want to see a third of the homeless population continue to be veterans, many of them struggling with substance abuse problems, many of them struggling with posttraumatic syndrome, many of them Vietnam vets. I think we can do better. I don't want to see the kind of backlog we have right now. Let me just simply talk about veterans in Bangor, ME, who were concerned after a VA inspector general report noted their outpatient clinic had a 10-month backlog of new patients. Things were so bad last fall that the clinic couldn't see walk-in patients or urgent-care patients and there was a 4-month wait to see the clinic's part-time psychiatrist. Veterans in Iowa are facing the possible closure of one of three major veterans hospitals because of the budget shortfalls. The Veterans Under Secretary of Health, Kenneth Kizer, warned that the VA health care system is in a ``precarious situation.'' Under Secretary of Health for the Veterans' Administration, Ken Kizer, went on to say that the proposed fiscal year 2000 budget--and he was talking about the President's budget--posed very serious financial challenges and that it would require a number of different things that might happen if, in fact, we don't provide adequate funding. Among them: . . . mandatory employee furloughs, severe curtailment of services or elimination of programs and possible unnecessary facility closures. Let me be really clear about the amendment we have introduced. The veterans community was asked by the Congress--they are always asked--to give their positive proposal about what we need to do to have a budget that will serve their needs so that we can live up to our commitment to veterans. We have the independent budget. It was done well. We have a Senate Veterans' Affairs Committee which came out with its own report that said we have a $3 billion shortfall here between what the veterans community needs by way of a real investment in health care and veteran services and other services, versus the President's budget proposal. The President's budget proposal was unacceptable. Now the Budget Committee brings a resolution before the floor and adds an additional $1 billion, but we are still $2 billion short. We ought not to go just a third of the way. We ought not to make estimates that make it clear that if we are really serious about our commitment to veterans, we are going to make up this $3 billion debt. We ought not say that and then not reflect that in our budget resolution. My colleague, Senator Johnson, has done an excellent job of summarizing the offset, and I do not need to repeat it. I conclude this way: I have never, in my 8 years in the Senate, seen the veterans community so galvanized and so focused on any question. There is a tremendous amount of anger. People are smart. Four years of flatline budgets have not served the veterans community well. This budget by the President and what we have in the Budget Committee resolution does not go far enough. It doesn't do the job. It does not enable us to live up to our commitment to veterans. I feel very strongly about this. This amendment we have introduced tonight provides the funding that will make sure we have the health care and decent services. It lives up to the very words that all of us have spoken as Senators. If we are serious about our commitment to veterans, then we have an opportunity to show that commitment and to vote for this resolution that Senator Johnson and I and other Senators have introduced.

Mr. WELLSTONE. Reserving the right to object, Mr. President. What is the request? Is it that we lay aside our amendment so our colleague could offer an amendment on NIH?

Mr. WELLSTONE. No objection.

Mr. WELLSTONE

Mr. WELLSTONE. Mr. President, I rise to introduce the Medicare Prescription Drug Coverage Act of 1999, a bill that calls for a full prescription drug benefit for all of America's senior citizens within the Medicare program. This bill is the Senate companion to H.R. 886, which was introduced by Congressman Barney Frank of Massachusetts earlier this month and which already has 22 House cosponsors. One of the beauties of the Medicare Prescription Drug Coverage Act of 1999 is its simplicity. The Act does four things. First, it directs the Secretary of Health and Human Services to study the establishment of an outpatient prescription drug benefit under Medicare that provides for full coverage of outpatient prescription drugs. Second, the Secretary will determine the sufficiency of the estate tax to fund the costs of that outpatient drug benefit. Third, the Secretary must submit a report to Congress within six months that includes a legislative proposal to provide for full coverage of outpatient prescription drugs. Finally, the bill transfers Federal estate tax revenues to the Medicare Hospital Insurance Trust Fund where those monies will be placed in a separate Outpatient Prescription Drug Account to pay for this coverage. Mr. President, now more than ever, a Medicare prescription drug benefit is needed. When Medicare was first adopted the program was designed to reflect typical private health insurance which often did not include outpatient prescription drugs. Then and since, the pharmaceutical industry has opposed a prescription drug benefit in order to protect its profits without regard to America's senior citizens. Even today, the industry is unwilling to shed some of its profits to allow all senior citizens access to needed prescription drugs. But the time has come for Congress to say ``no'' to the undue influence of drug companies in Washington and ``yes'' to Medicare prescription drug coverage. Why has the need for the Medicare Prescription Drug Coverage Act of 1999 because so acute? The reasons are well known. First, the cost of prescription drugs has skyrocketed in recent years. Last year alone, prices increased an estimated 17%. This increase in drug costs hits seniors disproportionately. A 1998 study by the minority staff of the House Government Reform Committee found that older Americans without prescription drug insurance pay on average twice as much as the discounted prices drug companies offer large scale purchasers like HMOs, pharmaceutical benefit managers and government agencies. Even more astounding are comparisons that show the price of some drugs are up to 15 times higher for seniors. Recalcitrance on the part of the pharmaceutical industry and the Congress has not only forced seniors to the pay for drugs out of their own pockets, but the price seniors pay is a national disgrace. The burden on seniors is hard for them to avoid. More than \3/4\ of Americans aged 65 and over are taking prescription drugs. The average senior citizen takes more than four prescription drugs daily and fills an average of 18 prescriptions a year. Older Americans take significantly more drugs on average than the under-65 population. One- third of all drugs are prescribed for senior citizens even though seniors account for only 12% of the population. Not only do older Americans spend almost three times as much of their income (21%) on health care as do those under the age of 65 (8%), but prescription drugs are the largest single source of out-of-pocket expenses for health services paid for by the elderly-- more than doctor visits or hospital admissions. The primary reason for this is that Medicare does not cover outpatient prescription drugs. It is totally unacceptable that 37% of seniors, nationally, have no prescription drug coverage and another 15-20% have totally inadequate coverage. In my state of Minnesota, where Medicare HMO drug coverage without additional cost is virtually nonexistent, close to 65% of seniors have no outpatient drug coverage at all. The result of this drug pricing inequity and excessive cost burden frequently leads seniors to discontinue their medications against medical advice, to lower the dose they take to make their prescriptions last longer, or to take their medicines as prescribed but then skimp on food and other necessities. Whichever path is taken results in a decrease in health and an increased likelihood of an expensive hospital intervention. That is why we need the Medicare Prescription Drug Coverage Act of 1999. Not to provide this benefit is being penny-wise and pound foolish. Minnesota seniors and others who live in states adjacent to Canada and Mexico often travel hundreds of miles and cross international borders to obtain drugs at prices only available in this country when negotiated by volume purchasers. Mildred Miller, a 78 year old constituent of mine from Minneapolis, found it necessary to travel to Canada and to send a friend to Mexico in order to afford the Tamoxifen her doctor in Minnesota had prescribed. And she is not alone. For some seniors the high price of outpatient prescription drugs has not yet been a burden. They are the lucky ones who are members of Medicare HMOs in counties where the Medicare reimbursement rate to HMOs has been high enough to allow a prescription drug benefit, or are fortunate to be wealthy and healthy enough to be able to purchase one of the three Medigap policies that include a prescription drug benefit, or have drug coverage under health insurance benefits provided by former employers. But for those for whom the high price of drugs has not yet been a burden, the future isn't particularly bright. Medicare HMO reimbursement rates are being reduced and many HMOs have cut back or completely cut out their drug benefit. Medigap policies that cover prescription drugs are expensive, have high $250 deductibles, 50% copays, and caps on benefits of $1250 or $300 per year. Health care benefits offered by former employers are becoming less and less common and less generous. The good alternatives today are out of reach of most senior citizens. For example, in Minnesota, a Medicare-Choice prescription drug coverage option with 20% copay, no deductible, and no cap costs $130 per month. It is no wonder that from Maine to Minnesota to the state of Washington and down to Texas, America's senior citizens are forced to leave the country so they can afford to take the medicines they need. What they find are essentially the same prescription drugs at half of price. With the Medicare Prescription Drug Coverage Act of 1999, they won't have to flee their own country. What is needed is a comprehensive prescription drug benefit that includes outpatient drugs--the same sort of prescription drug benefit available to members of Congress--with no cap, reasonable deductibles and reasonable copays. That is what this legislation calls for. An important aspect of the Medicare Prescription Drug Coverage Act of 1999 is that it calls for a full prescription drug benefit--not one capped at a certain limit. Medicare today doesn't limit the number of necessary doctor visits or the number of needed operations--and it shouldn't. Prescription drugs now are as critical as those doctor visits or operations and it is unconscionable for necessary drugs not to be covered just as fully. If we limit the maximum benefit, we penalize the sickest and most frail elderly who have the greatest need and require the greatest number of prescription medications. I expect that other Medicare prescription drug bills will be offered in this Congress, but I fear they will not provide the full protection seniors really need. If you have a major life threatening illness or multiple chronic diseases (something that is hard to predict before it happens), your monthly drug bill will quickly exceed the oft cited figure of a $1500 annual maximum. With such coverage, the sickest and most needy seniors will quickly find themselves out of the benefit. As I travel about the state of Minnesota, I frequently hear stories of elderly citizens saddled with prescription drug costs in excess of $300 per month who are trying to make ends meet on a monthly income of $1,000. That is why full drug coverage is so important. What is also important to know is that the cost of providing a full prescription drug benefit is affordable and not that much more than the cost of a limited benefit. In 1998, the Lewin Group estimated that a Medicare prescription drug benefit in 1999 with a $250 deductible, a 20% copay and a $1500 annual cap would cost $13 billion. The same plan with no annual cap, providing full protection, would cost $17 billion. Revenues from the estate tax, which will fund the benefit, are estimated to be in the $19 billion to $23 billion range. That is more than enough to provide full coverage the full benefit. Finally, Mr. President, let me say a few words about why using the estate tax to pay for a Medicare prescription drug benefit makes a lot of sense. Many members of Congress have argued that the estate tax is no longer needed for general revenue. If so, there is a great deal of logic in using it for a prescription drug benefit under Medicare. The estate tax today applies only to individual estates that are worth more than $650,000 and to estates of married couples worth more than $1 million. Over the next seven years the amount exempt from the estate tax will rise to $1 million for individuals and $2 million for couples. Well over 90% of the estate tax comes from wealthy individuals who were 65 or older at the time of their death. Most of these people were receiving medical care and benefiting from Medicare coverage. Thus, this bill recycles back into the Medicare program--for badly needed prescription drug coverage for all--money from people who benefited from their Medicare entitlement but were not in financial need of it. That only makes sense. For it is more important to preserve and expand the Medicare program than it is to provide tax cuts for the richest Americans. Mr. President, it is unconscionable that America's senior citizens have such difficulty obtaining the fruits of the scientific advances made by America's pharmaceutical industry. Every day we delay, millions of senior citizens struggle to determine how they will be able to afford their next prescription refill. The time to end that struggle is now. That is why I am introducing the Medicare Prescription Drug Coverage Act of 1999 today. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. WELLSTONE

Mr. WELLSTONE. Mr. President, I thank my colleague for his response and would like to make it clear that I believe my support would be based upon these kinds of objectives.

Mr. WELLSTONE. Mr. President, as a member of the Senate Foreign Relations Committee, I have for months been closely monitoring the situation in Kosovo, hoping and praying for a peaceful resolution to the crisis. I traveled there about 5 years ago, and have seen for myself the conditions under which millions of ethnic Albanians have struggled under increasing Serb repression. I have seen and visited with U.S. military personnel posted along the Macedonian border-- including some very young men from my home State--and I am well aware of the stakes involved in this debate. I and some of my colleagues have been briefed by Secretary Cohen, National Security Advisor Berger, Secretary Albright, Joint Chiefs of Staff Chairman Shelton and others recently about the very fluid and violent situation there. Now that the Albanian Kosovars have signed the Rambouillet agreement, and the Serbs have forcefully rejected it, it is clear that the crisis has moved into a new phase. And now that the Serbs have in the last few days begun--slowly, brutally, methodically--to expand their grip on Kosovo with a massive force of an estimated over 40,000 Serb police and army regulars, the situation becomes more urgent with every passing hour. Those Serb forces have been burning homes, taking the lives of innocent civilians along with KLA insurgents, and forcing tens of thousands of innocent civilians to flee their homes without food and shelter. Just in the last few days, tens of thousands more civilians have been forced from their homes, with Serbian forces leaving their villages smoldering and in ruins behind them in what appears to be their brutal final offensive. While reports have been barred from many areas by Serb forces, it is clear what is going on there. Atrocities of various kinds have become the signature of Serb military forces in Kosovo, just as it was for years in parts of Bosnia. In recent days, including in his press conference last Friday, the President has begun to articulate more clearly to Americans what he believes to be at stake there. The humanitarian disaster that's been unfolding of months, and has now been accelerated by the recent Serb onslaught, coupled with the serious concern that increased violence in Kosovo could spread throughout the region, must be addressed forcefully. While I know some of my colleagues believe strongly that the administration has not articulated forcefully, consistently and clearly the mission and goals of this use of force, and I still have some unanswered questions about the administration's military plans-- including the precise timing and strategy for withdrawing U.S. and NATO forces from the region once their mission is accomplished, provisions made to protect United States forces against sophisticated Serb air defense systems, and likely casualties expected from any military action--I believe there is little alternative for us but to intervene with airstrikes as part of a NATO force. I come to this conclusion, as I think many Americans have in recent days, reluctantly, and recognizing that all of the possible courses of action open to the United States in Kosovo present very serious risks. But I am pleased that we are finally having a real debate on this question on the Senate floor. As Senators, I believe we should make it clear on the record what we believe our policy should be in Kosovo. I have agonized over this decision, and consulted widely with those in Minnesota whom I represent, with regional political and military experts, and with others, and have tried to place in historical perspective what is at stake here for our Nation. I have tried, as I know my colleagues have, to weigh carefully the costs of military action in Kosovo against the dangers of inaction. Mr. President, one thing that is clear is that the situation on the ground in Kosovo today is unacceptable and likely to worsen considerably in the coming weeks. The ongoing exodus as refugees flee this latest major military operation mounted by the Yugoslav Army over the last 3 weeks must be contained. This conflict has created, by some estimates, more than 400,000 refugees. A spokesman for the United Nations High Commission for Refugees estimated that 20,000 have been displaced just in the last week by military operations, most of them in the mountain range just northwest of Pristina. As we all know, Milosevic has already carried out numerous massacres and other atrocities in Kosovo, including the killing of more than 40 ethnic Albanian civilians in the village of Racak in January. Right now, there are tens of thousands of refugees on the move in Kosovo. These refugees are facing very basic problems of survival. They lack shelter. They need blankets and stoves. The fighting has knocked out the electricity and water supplies. There are people right now huddling in cellars, and in unfinished houses, with their families. According to an account in the New York Times, people who are refugees themselves are giving shelter to refugees. One family is giving shelter to 80 people. Serbian forces that have been massed on the border of Kosovo are on the march, and it is widely believed that they are planning to accelerate their advance west into the heartland of the rebel resistance and the base of its command headquarters. The people of Kosovo are terrified of such a massive offensive. It is almost certain that we will soon be hearing more stories of massacres and displacements, of women and children and elderly men being summarily executed, and of further atrocities. I have called for months for tougher action by NATO to avert the humanitarian catastrophe that has now been re-ignited by the latest Serb attacks. I find it hard to stand by and let Milosevic continue with his relentless campaign of destruction. But I also recognize the grave consequences which may follow if the U.S. leads a military intervention into this complicated situation. The airstrikes proposed by NATO, if Milosevic does not relent and sign on to the peace agreement, will represent a very serious commitment. If NATO carries out these airstrikes, U.S. pilots will confront a well-trained and motivated air defense force that is capable of shooting down NATO aircraft. Serbian air defense troops are knowledgeable about U.S. tactics from their experience in Bosnia, are protected by mountainous terrain and difficult weather conditions, and are well-prepared and equipped to endure a sustained bombardment. Air Force Chief of Staff Gen. Michael Ryan told the Senate Armed Services Committee last week that casualties are a ``distinct possibility,'' and Marine Commandant Gen. Charles Krulak said. ``It is going to be tremendously dangerous.'' We not only risk losing our own pilots, but, even if our attacks are carefully circumscribed, we run the risk of killing innocent Serb civilians. Before we decide to send our pilots into harm's way we must be certain that we have exhausted all diplomatic options and that we essentially have no other choice. As I have grappled with this decision, I have tried to reduce it to its simplest form: Will action now save more lives and prevent more suffering than no action. Despite the dangers, I have concluded that the NATO airstrikes which may soon be underway will save more lives in the long run than they will cost. I hope and pray that we do not suffer any American casualties in these air operations, and that innocent civilian casualties on both sides are kept to a minimum, but I fear that if we do not act now thousands will lose their lives in the coming months and years. A decision to use force is also justified by reasons that go beyond humanitarian concerns. It has been argued by the Administration that an intense and sustained conflict in Kosovo could sent tens of thousands of refugees across borders and, potentially, draw Albania, Macedonia, Greece, and Turkey into the war. We will not be able to contain such a wider Balkan war without far greater risk and cost. And we could well face a greater humanitarian catastrophe than we face now. I am not just talking about a geopolitical abstraction, the stability of the region. I am talking about the human cost of a wider Balkan conflict. So as I see it, the immediate goal of NATO airstrikes would be to degrade Serbian military forces so that they could not seriously threaten the ethnic Albanians in Kosovo and also to force Milosevic into signing a peace agreement that could end the fighting in Kosovo and bring stability to the region. I am not a Senator who supports military action lightly. I still hope this conflict can be settled without an actual military engagement. But I feel that we simply must act now to forestall a larger humanitarian crisis. Mr. President, in the end my support for airstrikes in this situation arises from my deep conviction that we cannot let these kinds of atrocities and humanitarian disasters continue if we have ti in our power to stop them. I believe that it is our duty to act. In this case we cannot shirk our responsibility to act. We cannot stand idly by. That's why I intend to support the President's decision. Mr. President, I have agonized over this vote. But I very honestly and truthfully believe that if we do not take this action as a part of the NATO force that we will see a massacre of innocent people--men, women, and children. I do not believe that we or the international community can turn our gaze away from that. Therefore, I rise tonight with concern, but, nevertheless, I want to say it as honestly and as truthfully as I can as a Senator from Minnesota. I do support this resolution. I hope and pray that our forces will be safe. I hope and pray that there will be minimum loss of civilian life. And I hope and pray that by our actions we can prevent what I think otherwise will be an absolute catastrophe. I yield the floor. I thank my colleague.

Mr. WELLSTONE. I thank my colleague. Could my colleague, for the purposes of the legislative record, spell out the objective? The President is authorized to ``conduct military operations.'' Could my colleague spell out what his understanding is?

Mr. WELLSTONE. May I ask the Senator a question?

Mr. WELLSTONE

Mr. WELLSTONE. Reserving the right to object. I am not clear what the request is.

Mr. WELLSTONE

Mr. WELLSTONE. I thank my colleague. Mr. President, I rise to speak today on the floor of the U.S. Senate to express my opposition to this resolution that is before us. I may be standing alone on this vote. I hope not. I appreciate the efforts of my colleague from Louisiana to offer an amendment that would ensure that this bill states, or this resolution, because that is really what it is, that it is still the policy of the United States to pursue arms reduction negotiations. I think that was an important statement. I do not honestly and truthfully believe that that amendment is enough. It does not directly tie a decision to deploy a national missile defense directly to its impact on arms reduction agreements. That is what I am worried about. I think my good friend, the Senator from Michigan, had it right in his substitute amendment--before a decision to deploy, the administration and the Congress should review the impact of that decision on nuclear arms reductions and on arms control agreements. I think this is right. The decision to deploy--and that is what this resolution instructs us to do--should be made carefully, at the right time, after we are sure of its impact on important arms control and arms reduction decisions. I know my colleague from Michigan, who I think is one of the truly great Senators, has concluded that the Landrieu language is sufficient, but I have to respectfully disagree. This resolution talks about deploying missile defense. I have supported in the past efforts to develop such a system to at least do research, but I have never voted for a resolution that says we go forward with deployment. I would not oppose, again, the research and the focus on the possibility of needing a missile defense system if this was done hand in hand with an emphasis on the importance of arms reduction agreements. But I do not believe that this resolution before us is at all evenhanded in this respect. Our colleague from Mississippi, a colleague for whom I also have a great deal of respect, Senator Cochran, was quoted in the Washington Times today saying that the Landrieu amendment was an important step-- and he meant this in very good faith; he means everything in good faith--of an important national security goal. But the inclusion of the national missile defense policy and arms reduction policy in the same bill ``does not imply that one is contingent on the other.'' I think they should be, and that is why I do not think the language is sufficient. That is why I will vote against this bill. Actually, I do not know whether to call it a bill or a resolution. There is no money. It is just a statement. We say this will be the policy. It is a declaration by the Senate. We ought to be focusing on the reduction of existing missiles. We ought to be focusing on nonproliferation efforts to stop the spread of existing technology of weapons of mass destruction. We should not be saying that it is the policy of the United States to spend billions of dollars on unproven systems to defend ourselves against phantom missiles from hypothetical rogue states. We have spent already $120 billion on this antimissile defense system. I heard my colleague from Arizona, who is a colleague for whom I have tremendous respect, talking about some of the ways in which he thinks the administration has been a bit disingenuous about how we can balance the budget and spend money here or do this, that, and the other. I understand what my colleague was saying. In all due respect, I have to raise questions about this. First of all, I have to say that I believe that this vote today is a profound mistake. I think the vote today, if it is an overwhelmingly strong vote for this resolution, jeopardizes years of work toward achieving nuclear arms control and arms reduction, and that will not increase our security. That will not increase the security of my children or my grandchildren. I am very concerned about our national defense. I am very concerned about our security. I am very concerned about the security of my children and my grandchildren. I believe the best single thing we can do to assure that security is to maintain a commitment to arms control agreements. Some of my colleagues do not agree with what we did with the ABM Treaty. They are not so focused on where we need to go with the START agreements. I argue that these arms control agreements and everything and anything we can do to stop the proliferation of these weapons and to engage the former Soviet Union--Russia today--in arms control agreements, reducing the nuclear arsenals, less missiles, less warheads, less of a possibility of a launching of these weapons is what is most in our national security. I do not believe that this resolution takes us in that direction at all. There is a distinction between talking about the development of a missile defense system and actually the language in this resolution which talks about deploying. There is a distinction between saying we only go forward, but before a decision to deploy, the administration and the Congress should review the impact of this decision on nuclear arms reductions and arms control agreements. There is a distinction between such language, and I believe what the amendment that my colleague from Louisiana offered yesterday, which says that it is our policy to pursue arms reduction negotiations--oh, how I would like to see a connection. Oh, how I want to see a nexus. You cannot imagine how much I want to vote for a resolution like this, which is going to have such overwhelming support, and I would if I did not believe that what is only a resolution will be used next year when we come to authorization and appropriations to say that there was unanimous--no, there won't be unanimous support; there will be at least one vote against it--near unanimous support to go forward with missile defense. And then the request will come in for the money. What will the cost be? This resolution, or this piece of legislation, should be called the ``Blank Check Act,'' because that is what we are doing. We are authorizing a blank check for tens of billions, maybe hundreds of billions of dollars for all I know, for a missile defense system in the future. At what cost? Mr. President, $120 billion already, tens of billions of dollars a year, I don't know how long in the future, is going to go for a missile defense system, and this vote is going to be used as the rationale for doing so. Maybe not with this administration, because I think the administration has made it clear it is committed to an arms control agreement. But what about the next administration? I hope it will be a Democratic administration, but I do not know and I do not want to vote for a blank check for tens of billions of dollars for such a system which I think puts into jeopardy arms control negotiations and arms control reductions. Mr. President, for a senior citizen in the State of Minnesota who cannot afford to pay for a drug that has been prescribed by her doctor--this is a huge problem for elderly people in our country, many of whom are paying up to 30 percent of their annual monthly budget just for prescription drugs--for that senior citizen to not be able to afford a prescription drug that her doctor prescribes for her health is a lot bigger threat to her than that some missile is going to hit her in the near future or in the distant future. Yet, we are being told that we cannot afford to make sure we have prescription drug costs for elderly citizens in this country. But now what we are going to do, I fear, is adopt a resolution that will be used later on as a rationalization and justification for spending tens of billions of dollars on top of $120 billion for unproven systems to defend us against phantom missiles from hypothetical rogue states. Our focus should be on the arsenal of nuclear weapons that Russia has now and how we can have arms control agreements with Russia. We ought not to be putting ABM and START in jeopardy. We ought not to be putting arms control in jeopardy. We ought not to be putting our efforts at stopping the proliferation of weapons of mass destruction in jeopardy, and I believe that is what this resolution does. That is my honestly held view. The administration has apparently changed its position. I wish they had not. My colleague from Michigan, Senator Levin, has a different interpretation. I think he believes that this resolution puts the emphasis that needs to be there on arms control reductions. I hope and pray he is right. I think he believes this resolution has language, through the annual review process in appropriations bills, that makes it clear that this has to be technologically feasible to go forward. I hope he is right. But, quite frankly, I do not think that is really what this resolution says. I am not going to err on the side of voting for a resolution that now gives credibility to spending tens of billions of dollars, over the years to come, on a questionable missile defense system that puts arms control agreements in jeopardy and does not speak to the very real national security that we have in our own country. I would like to finish this way, Mr. President. Since I heard some of my colleagues on the other side talk about the President's budget, I would like to ask my colleagues, What exactly do you propose to do with your budget caps, your tax cuts, and wanting to increase the Pentagon budget $140 billion over the next 6 years? And that goes for far more than just increasing the salaries of our men and women in the armed services, who should have their salaries increased; and that is much more far-reaching than just dealing with quality-of-life issues for men and women in the armed services, who deserve all our support in that respect. Now we are talking about laying the groundwork, on top of $120 billion that has already been spent, for tens of billions of dollars. This could end up being $40 billion-plus just for this missile defense system. So my question is, After we do this, what do you say to senior citizens in your State who say, ``Can't you make sure that we can afford prescription drug costs?'' I know what you are going to say. ``We can't afford it.'' What are you going to say to people who say, ``Can't you invest more in our children in education?'' We are going to say, ``We can't afford it.'' What do you say to people in the disabilities community who were in my office yesterday, saying, ``Can't you invest in home-based health care so that we can live at home in as near as normal circumstances as possible with dignity?'' We are going to say, ``We can't afford it.'' What are we going to say to people who say, ``We can't afford affordable housing''? We are going to say, ``We can't afford it.'' I will tell you something; the real national security of our country is not to vote for this resolution that could very well put arms control agreements in jeopardy. And I am not willing to err on that side. If we do that, it will be a tragic mistake. It will be a tragic mistake for all of our children. The real national security for our country is to not spend billions of dollars on unproven systems to defend us against phantom missiles from hypothetical rogue states. The real national security for our country will be the security of local communities, where there is affordable child care, there is affordable health care, there is affordable housing, people find jobs at decent wages, and we make a commitment to education second to none so that every boy and every girl can grow up dreaming to be President of the United States of America. That is the real national security of our country. Mr. President, I think this resolution is a profound mistake. And if I am the only vote against it, so be it, but I will not vote for the resolution. I yield the floor. Mr. President, my colleague, Senator Stevens, had made the request he be able to speak right after I finished. I do not see him right now, but could I ask unanimous consent that he be allowed to speak next? I know he was anxious to do so. He should be here in a moment.

Mr. WELLSTONE. Mr. President, was there a unanimous consent agreement that the Senator from Mississippi wanted to propound?