Paul Wellstone

Mr. WELLSTONE

Mr. WELLSTONE. I thank the Chair.

Mr. WELLSTONE. Madam President, I withdraw my amendments.

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 Madam President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. WELLSTONE. Madam President, this is not an amendment, and I know the managers are not here. It is not really a debate I am trying to generate here. I thought I would take a little bit of time, while I have the floor, to thank the managers of the bill for their work. Really, I think they have done a very, very impressive job, especially when you consider what they have been able to put into this bill. These amendments that I have introduced have more to do with what is not in the bill, and we will be debating that later. I want to also thank the managers of the bill for including an important item in this appropriations measure. This bill, on the Senate side, it is my understanding, includes the full amount requested by the President for the budget of the Department of Labor's Mine Safety and Health Administration. As the ranking member of the Labor Committee's Subcommittee on Employment and Training, I am very interested in this whole area of occupational health and safety. But, today, what I want to do is talk about one aspect of this policy, and that is the sampling of coal mine dust and its relation to black lung disease. Madam President, this is of particular interest to me because of a recent trip that I took to eastern Kentucky. I met with a number of coal miners, and I do think that their story deserves to be told. It is a story that I intend to follow, hopefully, as we in the Congress take further steps to make sure that the Federal Government lives up to its responsibility regarding miners' health and safety. Mining has been really one of the most dangerous professions, and the Federal Government has done much to correct or address some of its hazards. But what I want to focus on is the Mine Safety and Health Administration and a request for new staff and money--which we have on the Senate side, it is my understanding--to increase the Federal Government's sampling for respirable coal mine dust. The request is modest, but it is significant; it calls for 24 new full-time employees and $1.7 million. Madam President, though it is a small amount of money, I think it is very important that we keep this in conference. Last year, there was an advisory committee appointed by the Secretary of Labor, which recommended that a key step that the Federal Government could take toward eliminating black lung disease would be to increase the responsibilities of the Mine Safety and Health Administration for coal mine dust compliance sampling. Simply speaking, that is a measurement of coal mine dust levels to determine whether or not they are a threat to the miners' health. Madam President, the problem is that the majority of the dust sampling is done by the mineowners themselves--that is to say the coal companies. When I was in east Kentucky last week, what I heard over and over again were really miners describing conditions that I think many Senators would feel like they were in a time warp and they were really living 50 years ago. We are talking about too many miners who work in crawl spaces about this high for 12 or 14 hours a day and can't see 6 inches in front of them because of the dust level. So the problem is, when you depend upon the companies to actually do the measurements of the dust levels, there is a pretty obvious conflict of interest. As a Senator, I am not naive to these conditions. Most of my work has been in communities around the country, starting in Minnesota, with hard- pressed people. I met a woman--to expand this discussion--whose husband had begged the company over and over again to please give him some relief from his particular work situation. He was afraid he was going to be electrocuted. Basically, the position of the company was: Look, if you don't like the job, leave. When there aren't a lot of $20-an-hour jobs, people don't have much of a choice. She spoke. She was 27 years of age. Her husband was electrocuted. He lost his life. I met other miners suffering from black lung. I met one woman, and she is the only woman who is a deep mine miner. I said, ``Aren't you afraid * * *''--the common complaint is that most of the mines are nonunion, and if people complain, they lose their jobs. I said, ``Aren't you afraid * * *''--since there were TV cameras in Hazard, KY--I said, ``Aren't you afraid that you are going to lose your job?'' She said, ``I don't think I will because I am the only woman miner. I don't think they will let me go. I feel like I am speaking for a lot of other miners that aren't here.'' I said to her and to the other 12 or 14 miners sitting around talking, ``Look, I have to ask you this question. Can you tell me very honestly and truthfully, if all of your friends and coworkers could be here, without fear of losing their jobs, would they be saying the same thing, or are you exaggerating in any kind of way?'' All of them, starting with this woman miner said, ``They would say the same thing to you, except that people are afraid they may lose their jobs.'' I will tell you, it was a very, very powerful meeting. So this is a small step here to make sure there is some additional money for at least some compliance of the dust sampling. But it is terribly important. Let me read from the testimony of Earl Shackleford, Jr., from Wallins Creek in Harlan County, KY. He was 36 years old last year. This was presented last year to the Secretary of Labor's advisory committee on the elimination of black lung disease. He had been working as a miner 17 years, though he is only 36. His testimony indicates that he, his father, his grandfather, and other friends and relatives all suffer from black lung disease. Someone from my wife Sheila's family from Cumberland in Harlan County, KY, also suffered from black lung disease. I will read four sentences from the conclusion of Mr. Shackleford's testimony: There is nothing more terrible to me than watching a fellow coal miner smother to death, one slow gasp at a time. There is nothing anybody can do for a dying miner but pray for him. But we can do something for the miners who labor in the mines today. We can make sure that the coal dust they breathe is accurately monitored by a Government that cares about their health and safety. Madam President, this bill takes a step toward better Federal monitoring of coal mine dust sampling. I hope we can keep this additional funding in the conference committee. At the same time, I point out that I agree with the recommendation of the Secretary's advisory committee on the elimination of black lung disease, which is that the Federal Government should take more responsibility in this area--perhaps full responsibility--of dust sampling. I am going to be working with other colleagues. Eventually, I want to come to the floor and push very hard on this. The story of these Kentucky coal miners cannot be ignored. I had a chance to talk to Senator Ford, who has cared about these issues and about what the miners are facing. The testimony of Earl Shackleford, Jr., and others, cannot be ignored. I would like to thank the managers again of this bill for putting money in here for at least some compliance work. I hope we can keep that in conference committee. I want to say to colleagues that one of the best things about getting a chance to travel sometimes outside of your State--not necessarily to another country, but in other communities --and for me, focusing on poverty in the country has been a tremendous education and very important. I met a lot of people who should be famous, a lot of strong people who, under incredibly difficult conditions, can still manage to survive and not only survive but flourish. But of all the meetings I have been to and of all the things I have seen--and I have seen a lot of children and a lot of pain, and I have seen a lot of housing that nobody should ever have to live in, and I have seen schools that are just as dilapidated as the schools that we talk about, where you can walk in the hallway and you can smell the stench of urine, and you can go into the bathrooms where the toilets don't even work, I have seen all that and more than I want to see. But this meeting with these coal miners in eastern Kentucky was jolting. I asked one of the journalists that was there, off the record, to tell me whether or not she thought they were exaggerating. She said, ``Absolutely not.'' My guess is that in some of the investigative work that I hope will be done by journalists, we are going to see more reports of these conditions. We are talking about conditions that these coal miners are working under that we thought existed 50 years ago-- people not able to see 6 inches in front of them because of the dust levels, which not only means people are gone to go suffer from and die from black lung, it also means, it is my understanding, that when you have that high concentration of dust levels, you have the ingredients for all kinds of possibilities of explosions within the mine. And then somebody will talk about a mine accident as if it were impersonal and random and never should have happened. We have a huge problem here because the coal mine operators, the companies, are actually the ones doing the measurement of the dust levels. I don't see how we can really get an independent and accurate measurement of the dust levels and how that affects these miners, unless we do much better by way of expanding the responsibility or at least the resources for the Department of Labor's Mine Safety and Health Administration. I am sure other people in the Senate would say the same thing. But it is very difficult to meet with people and have a couple of people talk about loved ones who were killed in the mines. I still cannot remember. She is 27 years old. Her husband was 28 years old when he was electrocuted. I have met a lot of the older miners who were suffering with black lung. For reasons I don't actually understand the actual motive for being turned down when they applied for disability, which is something I want to know more about. But at the very least, I think we have to make sure that somehow the clock has not been turned back 50 years. People ought not to have to work under conditions which are uncivilized. People have every right in our country to be able to focus on how they earn a decent living and how they have a job that pays a decent wage under civilized working conditions. The miners in eastern Kentucky, or some of the miners and the miners that I met with, should not be in a situation where if they should speak up about this, they lose their jobs. The choice for them is whether you do and, if you work, you work under these uncivilized conditions and it is going to take years off your life, possibly kill you, or you don't work and you lose your job. I know that some of these issues are just like off the radar screen here in the Senate. But I think really this should be part of our focus. Madam President, I yield the floor. I suggest the absence of a quorum.

Mr. WELLSTONE. Madam President, I ask unanimous consent that the amendment be temporarily laid aside.

Mr. WELLSTONE. Madam President, I ask unanimous consent that reading of the amendment be dispensed with.

Mr. WELLSTONE. Madam President, I send an amendment to the desk and ask for its immediate consideration.

Mr. WELLSTONE. Madam President, I ask unanimous consent that the amendment be temporarily laid aside.

Mr. WELLSTONE. Madam President, I ask unanimous consent that reading of the amendment be dispensed with.

Mr. WELLSTONE. Madam President, I send an amendment to the desk and ask for its immediate consideration.

Mr. WELLSTONE. Madam President, I ask unanimous consent that the amendment be temporarily laid aside.

Mr. WELLSTONE. Madam President, I ask unanimous consent that reading of the amendment be dispensed with.

Mr. WELLSTONE. Madam President, I send an amendment to the desk and ask for its immediate consideration.

Mr. WELLSTONE

Mr. WELLSTONE. Mr. President, today I rise to introduce legislation that will ensure that private health insurance companies pay for substance abuse treatment services at the same level that they pay for treatment for other diseases. In other words, it is meant to guarantee that insurance coverage for substance abuse treatment is provided in a nondiscriminatory manner. This bill, the Substance Abuse Parity Act of 1997, provides this assurance. For too long, the problem of substance abuse has been viewed as a moral issue, rather than a disease. A cloak of secrecy has surrounded this problem, as people who have this disease are often ashamed and afraid to admit their problem, for fear that they will be seen as admitting a weakness in character. We have all seen portrayals of alcoholics and addicts that are intended to be humorous or derogatory, and only reinforce the biases against people who have problems with substance abuse. Can you imagine this type of portrayal of someone who has a cardiac problem, or who happens to carry a gene that predisposes them to diabetes? Yet it has been shown that some forms of addiction have a genetic basis, and we still try to hide the seriousness of this problem. We forget that someone who has a problem with drugs or alcohol can look just like the person we see in the mirror, or the person who is sitting next to us on a plane. In fact, it is unlikely that any of us have not experienced substance abuse within our families or our circle of friends. The statistics concerning substance abuse are startling. In a recent article in Scientific American, December 1996, it was reported that excessive alcohol consumption is estimated to cause more than 100,000 deaths in the United States each year. Of these deaths, 24 percent are due to drunken driving, 11 percent are homicides, and 8 percent are suicides. Alcohol contributes to cancers of the esophagus, larynx, and oral cavity, which account for 17 percent of the deaths. Strokes related to alcohol use account for another nine percent of deaths. Alcohol causes several other ailments such as cirrhosis of the liver. These ailments account for 18 percent of the deaths. We know that alcohol and other drugs contribute to other problems as well. Addictive substances have the potential for destroying the person who is addicted, their family and their other relationships. In a 1993 Report to Congress on Alcohol and Health, the Secretary of Health and Human Services stated that ``Alcohol is associated with a substantial proportion of human violence, and perpetrators are often under the influence of alcohol.'' There are high rates of alcohol and other drug involvement in domestic violence and child abuse. For example, in 1987, 64 percent of all reported child abuse and neglect cases in the city of New York were related to alcohol and other drug abuse. With respect to domestic violence, a study of over 2,000 American couples demonstrated that rates of domestic violence were almost 15 times higher in households where husbands were often drunk as compared to those households in which they were never drunk. And, alcohol has been shown to be present in over 50 percent of all incidents of domestic violence. In addition, substance use itself may result from direct experience with interpersonal violence, as demonstrated by a study of 472 women. This study showed that 87 percent of alcoholic women had been physically or sexually abused as children as compared to 59 percent of the nonalcoholic women in the study. We know that over 40 percent of motor vehicle crash fatalities are alcohol-related, and that many of the alcohol drinkers involved in these crashes have had long standing problems with alcohol abuse. It is estimated that over 25 percent of emergency department visits may be alcohol related, and that alcohol and other drug use accounts for at least 40 percent of hospital admissions. Data from the 1996 National Household Survey on Drug Abuse, which is conducted by the Substance Abuse and Mental Health Services Administration, provide the following estimates of substance use in the United States: Alcohol There were about 9 million current alcohol, including beer, wine, and distilled spirits, drinkers under age 21 in 1996. Of these, 4.4 million were binge drinkers, including 1.9 million heavy drinkers. Marijuana In 1996, an estimated 10.1 million Americans were current, past month, marijuana or hashish users. This represents 4.7 percent of the population aged 12 and older. Marijuana is by far the most prevalent drug used by illicit drug users. Approximately three-quarters, 77 percent of current illicit drug users were marijuana or hashish users in 1996. Cocaine The number of occasional cocaine users, people who used in the past year but on fewer than 12 days, was 2.6 million in 1996, similar to what it was in 1995. The number of users was down significantly from 1985, when it was 7.1 million. Hallucinogens The rate of current use of hallucinogens among youth age 12-17 has nearly doubled in 2 years, 1.1 percent in 1994, 1.7 percent in 1995, and 2.0 percent in 1996. Heroin There were an estimated 141,000 new heroin users in 1995, and there has been an increasing trend in new heroin use since 1992. A large proportion of these recent new users were smoking, snorting, or sniffing heroin, and most were under age 26. The rate of heroin initiation for the age group 12-17 reached historic levels. We know what the problems are, and we can document them. But we have done little to treat the problems or prevent them. In order to decrease the violence, the domestic violence, child abuse, homicide, suicide, the motor vehicle crashes, the cancers and the other illnesses and deaths due to alcohol and drug use, we must treat the alcohol and drug abuse problems. But right now, even if treatment is available and accessible, it is often unaffordable, as many health plans do not pay for treatment for substance abuse at the same rate at which they pay for treatment of other diseases. This seems counterintuitive, given the relationship between substance use and other diseases. It would only seem logical that if we are willing to pay for the treatment of substance abuse, we would decrease costs of treatment for other diseases in the long run, as we would decrease the occurrence of those diseases that are related to substance abuse. SAMHSA has summarized the importance of substance abuse treatment as follows: Substance abuse adds substantially to the nation's total health care bill. Numerous studies show that providing adequate and accessible treatment for those with alcohol and illicit drug problems is the most effective method to improve the health of drug abusers and relieve the growing burden of drug-related health care costs. Treatment is a sound, long- term and cost-effective investment in America's future. Substance Abuse and Health Care Costs Approximately 35 percent of all AIDS cases are related to intravenous drug use, and over 60 percent of all pediatric AIDS cases are related to maternal exposure to HIV through drug use or sex with a drug user. On the average, untreated alcoholics generally incur general health care costs that are at least 100 percent higher than those of the non-alcoholic. In the last 12 months before treatment, the alcoholic's costs are close to 300 percent higher. More than 5 percent (221,000) of the 4 million women who give birth each year use illicit drugs during their pregnancy. The Health Insurance Association of America estimates an expenditure of from $48,000 to $150,000 in costs of maternity care, physicians' fees and hospital charges for each delivery that is complicated by substance abuse. The number of methamphetamine (speed)-related emergency room episodes increased by 35 percent (from 7,800 to 10,600) between the first half of 1994 and the first half of 1995. Health Care and Treatment Chicago's Women's Treatment Center offers a wide variety of residential and outpatient programs for adolescent girls, pregnant women and women with young children. The Center has the only crisis nursery in Chicago, which provides care 24 hours a day to the infants and children of women undergoing medically supervised detoxification. As a result of the Women's Treatment Center's focus on responsible parenting, 67 drug-free babies have been born to women in treatment. Substance abuse treatment reduces overall hospital admission rates by at least 38 percent. Hospital admissions for drug overdose decreased by 58 percent among those who had been treated. Ninety-five percent of women reported uncomplicated births, free of illicit drugs, after one year of treatment. The state Alcohol and Other Drug Authority in Minnesota has reported that, for chemical dependency clients, the state has saved approximately $22 million in annual health care costs by providing treatment. So, it is apparent from these data that substance abuse treatment works, and can help reduce health care costs and costs to society. We need to ensure that health care insurance providers do not discriminate in their coverage of substance abuse treatment services. The Substance Abuse Treatment Parity Act of 1997 provides for nondiscriminatory coverage of substance abuse treatment services by private health insurers. It does not require that substance abuse benefits be part of a health benefits package, but establishes a requirement for parity in coverage for those plans that offer substance abuse coverage. Mr. President, my bill would prohibit private insurance providers from imposing caps, copayments, and deductibles and day and visit limits for substance abuse treatment services that differ from those that are described for other covered illnesses. In other words, private health insurers must treat substance abuse like any other disease. Covered services include inpatient treatment, including detoxification; nonhospital residential treatment; outpatient treatment, including screening and assessment, medication management, individual, group and family counseling and relapse prevention; and prevention services, including health education and individual and group counseling to encourage the reduction of risk factors for substance abuse. Mr. President, the Substance Abuse Treatment Parity Act of 1997 is designed to take a large step toward decreasing the problem of substance abuse and its consequences. We can't afford not to provide this coverage. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. WELLSTONE

Mr. WELLSTONE. I thank the Senator.

Mr. WELLSTONE. Reserving the right to object, Mr. President. I want to ask a question. On Labor-HHS, amendments laid down by Monday, are you saying all amendments have to then be dispensed with and voted on by Tuesday?

Mr. WELLSTONE. That is not part of the agreement. I am sorry.

Mr. WELLSTONE

Mr. WELLSTONE. If the Senator will yield.

Mr. WELLSTONE. Will the Senator yield? Mr. LOTT addressed the Chair.

Mr. WELLSTONE. Will the Senator yield?

Mr. WELLSTONE. In 1989. I have quoted Attorney General Thornburgh on this. The idea was, look, this was, as my colleague from Maryland has said, an unprecedented situation. We were talking about corruption. We were talking about workers who want to have a fair election. And we finally had, after 30 years, an agreement here. Now, this election has not yet been certified. The Kennedy amendment made no judgment about expenditure of money. But the idea of essentially trying to overturn this consent agreement, to interfere directly with the judicial branch, to really preempt what kind of ruling a judge might make before any kind of ruling has been made, and to do this on an appropriations bill, is profoundly mistaken. It is not prudent. So there are a number of Senators who have come to the floor and have raised a whole set of questions. The Senator from Kentucky, Senator Ford, raised some questions having to do with the judicial appointments being blocked here--now, yet, a kind of threat to interfere with the judicial branch of Government--and whether or not this just was not the kind of political interference which is very inappropriate. He made the point that he felt that, as a Senator, if you were going to make a wise decision about this you would have to be in opposition to this amendment. Senator Kennedy started out tonight talking about both the context of this, the UPS workers and the successful effort on the part of the Teamsters, and now this--what is this all about? Just raising questions about the timing of it. But, then, more important, or just as important, Senator Sarbanes has been on the floor and he has, I think, provided many of us his view--I certainly include myself, and this was essentially the position I think the Senator from Pennsylvania has taken--which is this is just an overreach. I mean, to just try to overturn or basically contradict or subvert this consent agreement, to interfere with the judicial branch, is a profound mistake. So, my colleague from Alabama is correct. The point was that there would be a vote after Senators had a chance to fully discuss this. But, from my point of view, there are now three sets of questions that have been raised that I think are extremely important. Other Senators may want to discuss this as well. Or we might be able to reach some kind of agreement as to how we proceed. But, I think this is something that, if the Senate is a deliberative body, then we need to be very deliberative about this. We had an agreement with a Republican administration, the Bush administration, which really dealt with 30 years' history. It was important. It was an effort to root out corruption. We had an agreement that was, I think, a very important step forward. Now what we have is an effort to essentially overturn that agreement. Now what we have is an effort to directly intervene or interfere with the judicial branch. Now we have an effort, which I think on political grounds, and probably on constitutional grounds, though I am not a lawyer, I am not even sure that, from a constitutional point of view--I believe the Senator from Pennsylvania may have raised this question--we should even be doing this, and for that reason there are a number of us who have been out on the floor and have been speaking about this. If other Senators want to speak, I have had an opportunity several times tonight to raise these concerns. Senator Sarbanes was on the floor a long time, I think really zeroing in on what the implications of this are, just in terms of branches of Government and separation of powers and what our constitutional system is about, which I think are pretty important questions. And one more time, as a Senator from Minnesota who had a chance to see what these workers were able to do and who strongly supported, I think, the justice, the justice goals of the strike--I have raised concerns about. I don't think it looks good. I don't think it's the right thing to do for the Senate to be involved in such an overreach, taking such drastic action, which I think, unfortunately, certainly looks like--I don't know what the motivations are of Senators--that it is very connected to this UPS workers' strike. Mr. President, I will not speak any longer on the floor of the Senate. I will yield the floor. Mr. FORD addressed the Chair.

Mr. WELLSTONE. Mr. President, I say in response to my colleague from Iowa, I think there are Senators who want to speak on it. I don't know whether or not there will be time tonight in order to accommodate different people who want to comment on this amendment. But as I understand it, and I will just try to summarize, there are two different sets of concerns I have. One set of concerns which I would repeat has to do not with the intentions of colleagues at all but has to do just with the sequence of events, the chronology. I just think that there is a great deal of discussion about what the UPS workers did. This was a Teamsters strike. There was a focus on the need to have more full-time jobs as opposed to part-time jobs. There was a focus on living-wage jobs. The interesting thing is that I think the public really rallied behind the UPS workers. I think that the public felt that what the workers were talking about, what this union was talking about, was how you earn a decent living and how you are able to give your children the care you know they need and they deserve. I think that this amendment, the Nickles-Craig amendment, is such an overreach because now what we have, just on the heels of this successful effort on the part of Teamsters to bargain collectively, is an effort--and now I have listened to this; I am not a labor lawyer-- but an effort which essentially overturns a consent decree which was extremely important and essentially says we are going to go right to the heart of the judiciary and go back to an agreement which goes back, what, 30 years or thereabouts. I am sorry, this was initially agreed to in--I had it before me. Might I ask the Senator from Massachusetts a moment, the original agreement with the Bush administration was in 1989?

Mr. WELLSTONE

Mr. WELLSTONE. I thank my colleagues, and especially Senator Coats, for their courtesy. I was not able to come to the floor earlier, and sometimes if we feel strongly about an issue we will have a chance to speak before the vote. I thank him, and I thank Senator Stevens and others as well. I do not know quite where to start. Last night we passed an amendment, and this was work I was fortunate enough to get a chance to do with Senator McCain, and I think we had 97 votes to expand funding for Parkinson's disease. It was an enormous victory. I believe that kind of strong vote will serve us very well in conference committee, and I believe finally we will be able to get some funding. There has been so little funding. It has not been fair, and people who have been struggling with this disease have been here for several years now. They have become their own advocates. The only reason we had such a strong vote last night was because of their work. My colleague, Senator Coats, was gracious enough to raise his concern through this amendment separately from that vote. He is someone here in the Senate that I believe in. I think he speaks for what he thinks is right. This amendment he introduces in very good faith. I will be the opposite of shrill in my opposition. I think the amendment is profoundly mistaken. We have gone through this whole debate about fetal tissue research, and I again want to make it clear that not only have we not seen one instance of abuse, not one example, but we really have very, very stringent and clear protections. A woman may not be approached for consent to donate aborted tissue. The donor may not be paid for donation of the tissue. The donor may not designate who will be the recipient of the tissue. Violations of these restrictions are a Federal felony, punishable by 10 years in Federal prison. I say all that because I want to make it clear how strict the guidelines are. I also want to make it clear that I do not think this issue is really about using the labels pro-choice or pro-life, but it has to do with another question, which is whether or not people who are struggling with the disease are going to be able to look to a day where there will be a cure. If this amendment passes, we are essentially wiping out one very promising avenue of research. I think that would be a very crucial thing to do. That is certainly not the intention of the amendment. I say to my colleagues, because I have been active in this work dealing with Parkinson's since I came to the Senate, I know something about it, having had two parents who struggled with Parkinson's. I know something about it, having spent a great deal of time with people in the Parkinson's community, that given the strict guidelines and given the fact that we do not see examples of abuse, and given the fact that this really is not about pro-choice and pro-life, and also given the fact that if this kind of amendment is going to be raised it ought not to be focused on one disease, I just hope that my colleagues will oppose this amendment. I think it is profoundly mistaken. Now, Mr. President, just forget all of the statistics, except to say, and I think my colleagues will believe me, that if you talk to people in the medical research community they will tell you that fetal tissue transplant research is one of the very promising approaches. I do not think we want to ``defund'' that. We do not want to be in a position of, on the one hand, finding resources for research, and then essentially wiping out one of the very important modes of research to find a cure for the disease. We do not want to do that. It really undercuts part of the very important vote that took place last night. Maybe the best way for me to summarize my view, because we will vote in just a few minutes, is to talk about a woman that some of you have come to know. Her name is Joan Samuelson. I have not asked for permission to do this, but Joan has been so visible and so vocal I do not think she will object. I first met her a number of years ago when she was testifying before our committee, the Labor and Human Resources Committee. I think she was speaking about the need to have at least a little bit more by way of resources for research, but I think she was talking about, if my memory serves me correctly, about this fetal tissue research. What I remember was I kept thinking about my parents. My father was almost 60 when he found out he had Parkinson's and he lived to be 84, though at the very end I will tell you, if you do not know this disease, he was so alert. He was a brilliant man. I am not objective, he was my father. He spoke 10 languages fluently but it did not help. He spoke 10 languages fluently, but because of Parkinson's he could not speak. He could not walk. And really the truth of the matter is he intensely wanted to die. That is exactly what he indicated to me. When Joan Samuelson testified, I kept thinking, gee, she is in her thirties. What is going to be her future? If you are lucky, this disease runs a slow progression, but you never know. You do not want to find out you have Parkinson's when you are in your thirties. By the way, it is a myth that this is a disease that only afflicts the elderly. When Joan Samuelson testified, more than anything what she was saying is, ``Look, for me and many others, time is not neutral. How can you say to me that you are only willing to invest about $30 per person for the 1 million of us who struggle with Parkinson's? How can you look at me in the eye and say that? This is my life or whether I will have a life.'' The reason I raise this is I remember hearing her testify and thinking about my parents and sort of just then starting to have tears in my own eyes because I was thinking I don't want someone like Joan Samuelson to get to the place where my dad did. I don't want that to happen to her. Now, I am not a doctor. I cannot guarantee there will be a cure to this disease tomorrow. But when I spoke to Joan Samuelson two nights ago, she is out in California, she said to me, ``The way I look at this debate on fetal tissue research is this is the particular research that I think could very well lead to a cure for me.'' That is the point. Please, everybody, that is the point. Whatever your position is on the general question of pro-choice, pro- life, that is not what this debate is about. To someone like Joan Samuelson, this is one avenue of research that could very well lead to a cure for this disease. That is of central importance to her. That is of central importance to the lives of many other people struggling with Parkinson's. I think that is what this vote is about. So, Mr. President, I urge my colleagues to please vote against this amendment. I feel like I have to, in good faith, conclude by saying, even though I hope there will be a strong vote against this amendment, one more time I want to make it crystal clear that Senator Coats is doing what he thinks is right. Senator Coats has supported this effort to expand the funding for Parkinson's. Senator Coats knows this disease all too well. I believe his father had Parkinson's. Senator Coats, when he does something on the floor of the Senate does it because he believes in it. He does it because he thinks it is the right thing. I deeply appreciate the support he has given Senator McCain and myself on our efforts, but I think this amendment is a mistake. Actually, I want to say I know this amendment is a mistake, because I really believe it is all about someone like Joan Samuelson. We ought not to vote for the Mo Udall Parkinson's Research Act, the amendment last night introduced by Senator McCain and myself, and then turn around and essentially defund one of the important avenues of research that potentially could lead to a cure for this disease. I think that would be an injustice to Joan Samuelson and many other women and men who struggle with this disease. I hope my colleagues will vote against this amendment. I yield the floor.

Mr. WELLSTONE. Might I inquire, do we have a vote scheduled at noon?

Mr. WELLSTONE

Mr. WELLSTONE. Mr. President, today I rise to introduce legislation that will ensure that private health insurance companies pay for substance abuse treatment services at the same level that they pay for treatment for other diseases. In other words, it is meant to guarantee that insurance coverage for substance abuse treatment is provided in a nondiscriminatory manner. This bill, the Substance Abuse Parity Act of 1997, provides this assurance. For too long, the problem of substance abuse has been viewed as a moral issue, rather than a disease. A cloak of secrecy has surrounded this problem, as people who have this disease are often ashamed and afraid to admit their problem, for fear that they will be seen as admitting a weakness in character. We have all seen portrayals of alcoholics and addicts that are intended to be humorous or derogatory, and only reinforce the biases against people who have problems with substance abuse. Can you imagine this type of portrayal of someone who has a cardiac problem, or who happens to carry a gene that predisposes them to diabetes? Yet it has been shown that some forms of addiction have a genetic basis, and we still try to hide the seriousness of this problem. We forget that someone who has a problem with drugs or alcohol can look just like the person we see in the mirror, or the person who is sitting next to us on a plane. In fact, it is unlikely that any of us have not experienced substance abuse within our families or our circle of friends. The statistics concerning substance abuse are startling. In a recent article in Scientific American, December 1996, it was reported that excessive alcohol consumption is estimated to cause more than 100,000 deaths in the United States each year. Of these deaths, 24 percent are due to drunken driving, 11 percent are homicides, and 8 percent are suicides. Alcohol contributes to cancers of the esophagus, larynx, and oral cavity, which account for 17 percent of the deaths. Strokes related to alcohol use account for another nine percent of deaths. Alcohol causes several other ailments such as cirrhosis of the liver. These ailments account for 18 percent of the deaths. We know that alcohol and other drugs contribute to other problems as well. Addictive substances have the potential for destroying the person who is addicted, their family and their other relationships. In a 1993 Report to Congress on Alcohol and Health, the Secretary of Health and Human Services stated that ``Alcohol is associated with a substantial proportion of human violence, and perpetrators are often under the influence of alcohol.'' There are high rates of alcohol and other drug involvement in domestic violence and child abuse. For example, in 1987, 64 percent of all reported child abuse and neglect cases in the city of New York were related to alcohol and other drug abuse. With respect to domestic violence, a study of over 2,000 American couples demonstrated that rates of domestic violence were almost 15 times higher in households where husbands were often drunk as compared to those households in which they were never drunk. And, alcohol has been shown to be present in over 50 percent of all incidents of domestic violence. In addition, substance use itself may result from direct experience with interpersonal violence, as demonstrated by a study of 472 women. This study showed that 87 percent of alcoholic women had been physically or sexually abused as children as compared to 59 percent of the nonalcoholic women in the study. We know that over 40 percent of motor vehicle crash fatalities are alcohol-related, and that many of the alcohol drinkers involved in these crashes have had long standing problems with alcohol abuse. It is estimated that over 25 percent of emergency department visits may be alcohol related, and that alcohol and other drug use accounts for at least 40 percent of hospital admissions. Data from the 1996 National Household Survey on Drug Abuse, which is conducted by the Substance Abuse and Mental Health Services Administration, provide the following estimates of substance use in the United States: Alcohol There were about 9 million current alcohol, including beer, wine, and distilled spirits, drinkers under age 21 in 1996. Of these, 4.4 million were binge drinkers, including 1.9 million heavy drinkers. Marijuana In 1996, an estimated 10.1 million Americans were current, past month, marijuana or hashish users. This represents 4.7 percent of the population aged 12 and older. Marijuana is by far the most prevalent drug used by illicit drug users. Approximately three-quarters, 77 percent of current illicit drug users were marijuana or hashish users in 1996. Cocaine The number of occasional cocaine users, people who used in the past year but on fewer than 12 days, was 2.6 million in 1996, similar to what it was in 1995. The number of users was down significantly from 1985, when it was 7.1 million. Hallucinogens The rate of current use of hallucinogens among youth age 12-17 has nearly doubled in 2 years, 1.1 percent in 1994, 1.7 percent in 1995, and 2.0 percent in 1996. Heroin There were an estimated 141,000 new heroin users in 1995, and there has been an increasing trend in new heroin use since 1992. A large proportion of these recent new users were smoking, snorting, or sniffing heroin, and most were under age 26. The rate of heroin initiation for the age group 12-17 reached historic levels. We know what the problems are, and we can document them. But we have done little to treat the problems or prevent them. In order to decrease the violence, the domestic violence, child abuse, homicide, suicide, the motor vehicle crashes, the cancers and the other illnesses and deaths due to alcohol and drug use, we must treat the alcohol and drug abuse problems. But right now, even if treatment is available and accessible, it is often unaffordable, as many health plans do not pay for treatment for substance abuse at the same rate at which they pay for treatment of other diseases. This seems counterintuitive, given the relationship between substance use and other diseases. It would only seem logical that if we are willing to pay for the treatment of substance abuse, we would decrease costs of treatment for other diseases in the long run, as we would decrease the occurrence of those diseases that are related to substance abuse. SAMHSA has summarized the importance of substance abuse treatment as follows: Substance abuse adds substantially to the nation's total health care bill. Numerous studies show that providing adequate and accessible treatment for those with alcohol and illicit drug problems is the most effective method to improve the health of drug abusers and relieve the growing burden of drug-related health care costs. Treatment is a sound, long- term and cost-effective investment in America's future. Substance Abuse and Health Care Costs Approximately 35 percent of all AIDS cases are related to intravenous drug use, and over 60 percent of all pediatric AIDS cases are related to maternal exposure to HIV through drug use or sex with a drug user. On the average, untreated alcoholics generally incur general health care costs that are at least 100 percent higher than those of the non-alcoholic. In the last 12 months before treatment, the alcoholic's costs are close to 300 percent higher. More than 5 percent (221,000) of the 4 million women who give birth each year use illicit drugs during their pregnancy. The Health Insurance Association of America estimates an expenditure of from $48,000 to $150,000 in costs of maternity care, physicians' fees and hospital charges for each delivery that is complicated by substance abuse. The number of methamphetamine (speed)-related emergency room episodes increased by 35 percent (from 7,800 to 10,600) between the first half of 1994 and the first half of 1995. Health Care and Treatment Chicago's Women's Treatment Center offers a wide variety of residential and outpatient programs for adolescent girls, pregnant women and women with young children. The Center has the only crisis nursery in Chicago, which provides care 24 hours a day to the infants and children of women undergoing medically supervised detoxification. As a result of the Women's Treatment Center's focus on responsible parenting, 67 drug-free babies have been born to women in treatment. Substance abuse treatment reduces overall hospital admission rates by at least 38 percent. Hospital admissions for drug overdose decreased by 58 percent among those who had been treated. Ninety-five percent of women reported uncomplicated births, free of illicit drugs, after one year of treatment. The state Alcohol and Other Drug Authority in Minnesota has reported that, for chemical dependency clients, the state has saved approximately $22 million in annual health care costs by providing treatment. So, it is apparent from these data that substance abuse treatment works, and can help reduce health care costs and costs to society. We need to ensure that health care insurance providers do not discriminate in their coverage of substance abuse treatment services. The Substance Abuse Treatment Parity Act of 1997 provides for nondiscriminatory coverage of substance abuse treatment services by private health insurers. It does not require that substance abuse benefits be part of a health benefits package, but establishes a requirement for parity in coverage for those plans that offer substance abuse coverage. Mr. President, my bill would prohibit private insurance providers from imposing caps, copayments, and deductibles and day and visit limits for substance abuse treatment services that differ from those that are described for other covered illnesses. In other words, private health insurers must treat substance abuse like any other disease. Covered services include inpatient treatment, including detoxification; nonhospital residential treatment; outpatient treatment, including screening and assessment, medication management, individual, group and family counseling and relapse prevention; and prevention services, including health education and individual and group counseling to encourage the reduction of risk factors for substance abuse. Mr. President, the Substance Abuse Treatment Parity Act of 1997 is designed to take a large step toward decreasing the problem of substance abuse and its consequences. We can't afford not to provide this coverage. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.