Paul Wellstone

Mr. WELLSTONE

Mr. WELLSTONE. Mr. President, may we have order in the Chamber.

Mr. WELLSTONE

Mr. WELLSTONE. Mr. President, today I want to talk about an issue that is of the utmost importance: Health Security. First I want to talk about the problem: Health insecurity. Then I want to talk about the solution: The Health Security for All Americans Act. And finally I want people around the country to hear what they can do to wake up Congress and make Health Security for All Americans a reality. This year has been a hard one for me. Two months ago, we buried one of my dear friends, Mike Epstein. Mike's sons came to be with him for the last few weeks of his struggle with cancer. Devoted sons, they spoke glowingly about their father at a memorial service for him in the Capitol. As any of you who has sat with a dying parent knows, emotions overflow, coping is difficult, and the grief is profound. The last thing a son or daughter, a parent or spouse, needs is to have the additional burden of wondering where will the next dollar for ever mounting health care bills come from; to worry about going into debt; to worry about going bankrupt because of a loved ones health care needs. Mike's sons did not have to worry about that because Mike had health care coverage as good as Congress gets. The wife of my health policy advisor, John Gilman, battled cancer for two and a half years before succumbing one month ago. She had required innumerable sessions of radiation therapy, plus chemotherapy and surgery. John had his hands full with work plus taking care of his wife, both physically and emotionally. It is draining, but can you imagine how much worse it would be if John and his wife, June, had no health insurance. John didn't have to worry about how to pay for the next medical bill because John and his wife had health care coverage as good as Congress gets. People do get ill. As hard as we try and as much as we pray, we can't always cure them. But we certainly can make sure they all have access to high quality, affordable care with dignity. There is no reason why all Americans can't have health insurance as good as everyone of us who serves in the United States Senate. The idea of procuring health security for all Americans is not a new one. Franklin Delano Roosevelt recognized the need for universal health care in the 1930s when we were in the depths of the depression; Harry Truman fought for it in the 1940s when the troops came home from World War II; John Kennedy envisioned it in the midst of the cold war; Richard Nixon had it high on his agenda before events overtook his Presidency. What these 20th century Presidents all understood is that there is a basic human drive for good health, and the good health of the American people is what drives this country and its economy. By 1992 it was far past due for us to recognize that all Americans should have a basic right to quality affordable health care. We had the opportunity in 1993 and 1994 to confer that right on to all of our people--and we lost it, because of differences and failures to compromise, and obstructionists and nay sayers, and failing to keep our eye on the ball: Universal, quality, affordable health care for every American. I began introducing bills to provide universal health care in this country shortly after I arrived in the Senate in 1991. Back then people were aware of the problems of the uninsured--it wasn't being swept under the rug. Do you remember back in 1992, we were coming out of a recession, unemployment was at 7.5 percent, the national debt was increasing each year and 36 million Americans were uninsured, and everyone was talking about some form of health insurance for all. Eight years later, we're told the economy's humming along, unemployment is the lowest its been in 30 years, and there is a budgetary surplus. But despite the fact that there are 45 million Americans without health insurance--10 million more than there were 10 years ago--nobody in Washington is talking seriously about doing anything about it. Incremental change may keep some people from losing their insurance, and may insure some people who would otherwise be uninsured, but incrementalism has not stopped the steady rise in the number of uninsured in America which will soar to 55 million people by 2008. We need to change that. I don't think the fact that 140 million Americans own stocks today should make us forget that 45 million Americans don't have health insurance. And that millions more can't make ends meet because their health insurance is simply too expensive. Make no mistake about it: Not having health insurance has its consequences. And I know some of you know it personally too well. There are some myths out there about not having health insurance that need to be debunked: The first myth is that the uninsured can easily get the care they need. But the fact is: Uninsured Americans needlessly suffer because they don't have access to the care they need. For example, the uninsured are four times more likely to go without needed medical care and to delay seeking care; and are up to four times more likely to experience an avoidable hospitalization and emergency hospital care. The uninsured are more likely to be in fair or poor health and have a higher probability of in-hospital death than the privately insured. The second myth is that the lack of health insurance is usually a temporary condition and that most people get their coverage back quickly. But the fact is otherwise: Nearly 60 percent of people who are uninsured have been uninsured for at least two years. Or put another way: 6 out of 10 people who lose their health insurance this month will still be uninsured in July 2002! Employers used to do more to help assure their workers of coverage. In 1985, nearly two-thirds of businesses with 100 or more workers paid the full cost of health coverage. Last year only one-fourth of businesses did. In 1988, employers asked workers to pay on average 20 percent of the cost through payroll deductions. By 1998, they had raised the average worker's share to 27 percent. Three-fourths of the working uninsured are not offered or eligible for any coverage through their workplace. The third myth is that most people don't have health insurance because they are not working. But the fact is: 75 percent of uninsured Americans hold down full-time jobs or are the dependents of someone who does, and nine out of ten come from working families. What's also a fact is that low wage workers frequently aren't offered insurance at all through their employment or if they are, it is at an unaffordable price. The fourth myth is that most people who don't have insurance could afford it but just choose not to buy it. But the fact is: The high cost of health insurance premiums is the main reason that half the uninsured don't have health insurance. Only 3 percent of people without insurance say the most important reason is because they don't think they need it. Going without health insurance means living in poorer health. Most uninsured adults have no regular source of health care. Most postpone getting care. Three in ten go without needed medical care. A quarter forego getting the medicine they need because they cannot afford to fill their medical prescriptions. Uninsured children are 30 percent more likely to fall behind on well-child care and 80 percent more likely to never have routine care at all. The uninsured are three to four times more likely to have problems getting the health care they feel the need. Uninsured children are at least 70 percent more likely not to get medical care for common conditions--like asthma--that if left untreated can lead to more serious health problems. Uninsured Americans are more likely to end up hospitalized for conditions--like uncontrolled diabetes--that they could have avoided with better health care. In the end, uninsured patients are more likely to die while hospitalized than privately insured patients with the same health problems. Partly because they are less likely to get regular mammograms, uninsured women are nearly 50 percent more likely to die of breast cancer. Our system takes its toll in senseless, random pain and suffering. Without insurance, the medical bills mount quickly. More than one in three uninsured adults have problems paying their medical bills. The uninsured are three times more likely to have problems with their medical bills than the insured. Eight out of ten uninsured people receive absolutely no reduced charge or free health services. The crushing weight of bankruptcy looms on the horizon. One out of four people filing for bankruptcy identified an illness or injury as a major reason for filing; 1 out of 3 had substantial medical bills; and almost 50 percent had both. Even with insurance, low- and middle-income families frequently find themselves in a financial straight jacket. Families with annual incomes of $30,000 or less are spending an inordinate, unaffordable share of their income on health care expenses. And the average family with an income under $10,000 is paying well over 20 percent of its annual income on health care costs. These families can least afford to make that kind of payment. For families with annual incomes of $30,000 or more, the average amount of that income spent on premiums, deductibles and co-pays drops to below 5 percent on average. But these are just averages: many families at every income level spend more than 10 percent of their family income on health care, especially if someone in the family has a serious illness. That is not affordable. That is not fair. Since coming to the Senate, my number one priority has been achieving universal, affordable, comprehensive, quality care for all Americans. That is why I am proud to be introducing today the Health Security for All Americans Act. Let me digress and tell you how I arrived at this legislation. When I was first elected to the Senate and Bill Clinton was elected president two years later, I believed the political winds and tides were aligned for a decade of progressive change for America. I thought I had been elected at just the right time to be a part of this change. When President Clinton, in his State of the Union speech, announced he would veto any health care legislation that did not provide universal coverage, that every citizen must be covered, I jumped to my feet and cheered. This was why I came to Washington, to make this kind of change, and this was a fight I thought we could win. But I had some quick learning to do. When I spoke about my interest in a ``single-payer'' health care plan, similar to the Canadian system where doctors and hospitals remain in the private sector, but where there is just one insurer or payer, I was told by a senior colleague that my plan might be the best proposal. ``But it does not have a chance. The insurance industry hates it and it will go nowhere. It is just not realistic.'' I was completely disillusioned. I could not accept then, and I do not accept now, the proposition that even before the American people have the opportunity to be informed or included, a good proposal is ``dead on arrival'' because the insurance industry opposes it. That isn't supposed to happen in a representative democracy! In spite of the advice, I did introduce the single payer plan with Jim McDermott, a congressman and physician from the state of Washington. I thought first you start with the most desirable, and later on in the process you'll find out what is politically feasible. I refused to admit defeat before we had even begun to fight. And I was hoping that our legislation would pull the debate in a more progressive direction. What happened was just the opposite. The trillion dollar health care industry, led by the insurance companies, went on the attack, not against our plan which ``wasn't realistic'' but against the President's plan which ``was''. ``Harry and Louise'' ads cried out against the horrors of ``government medicine.'' Intensive and expensive lobbying efforts expounded on the same theme. Media coverage, which should have been about the nuts and bolts of different proposals shifted now to focus on strategy rather than substance and head counts rather than hard information. So ordinary citizens no longer had a source of knowledge to form opinions and inform their elected leaders. But the problems were not limited to the insurance lobby and the media. The only way we could have beaten the health care industry would have been with dramatic and effective citizen politics. It never happened. Progressives didn't organize a constituency to fight for health care reform, and the Administration didn't have the political will to stand up to powerful interests and therefore never asked the American people to take on this fight. They tried to win with ``inside politics,'' cutting deals and making compromises with different economic interests. With each accommodation to private power, the President's plan became hopelessly complicated. As a constituent told me at the time, ``How can you be for something you don't understand?'' What started as a noble effort by the President to fill a crucial national need became instead an object of derision. Over the years, as I traveled around the country talking about the need for Universal Health Care and the Single Payer model, I found people turning off--not to the need for health insurance for all, but to the specific mechanism I favored. They wanted universal health care, but they didn't want a national single payer system or they didn't think one was possible here, so they stopped listening. The mood of the country has changed since the early 1990s. In 1990, there were 34 million uninsured. Ten years later, today, there are 45 million, and the number is growing by 100,000 people per month. Numerous polls show that the large majority of Americans want universal affordable comprehensive health care coverage and that they are willing to pay higher taxes for everyone to be covered. The people and the States are ahead of the Federal politicians on this issue. The people want a big change; not an incremental change. In Massachusetts and Washington state, people are pushing for ballot referendums in the fall on universal coverage. Massachusetts and Maryland have already received commissioned cost studies of alternative universal coverage plans. California this past fall legislated a task force to investigate options for universal coverage. Governor Howard Dean (D) of VT (also a physician), whose state presently covers 93.5 percent of its citizens, says it well: ``It is my view that health insurance ought to be universal, the right of every citizen in Vermont.'' And there is bipartisan support in Vermont. ``Health care is not a partisan issue in Vermont,'' state Sen. John Bloomer (R) said, adding that ``it's a bipartisan goal to expand health care access and affordability.'' The Health Security for All Americans Act is a plan for a big change. It builds on the momentum going on in the states of this great Nation. So I decided that rather than trying to tell people how I thought the system should work, what I needed to do was first, to set out what I have found are the common goals of the American people: universal affordable comprehensive health coverage; and second to provide federal matching funds for each state to reach those goals in the way that best fits the needs of that state. So, let me tell you about the Health Security for All Americans Act. First, it is based on the premise that every American--not just everyone in this chamber, but every American--is entitled to have health care coverage as good as the Congress gets. Every Federal employee has that right. Why shouldn't every other American? Second, it is based on the premise that good health care must be affordable. Americans should not go broke trying to keep their bodies fixed. From my experience traveling around the country, Americans all across the income spectrum are willing to be responsible for an affordable fair share of the cost of coverage and care, and a growing number of polls show that a majority of Americans are willing to pay higher taxes so that all Americans will have health coverage. Under the Health Security for All Americans Act, a family's financial responsibilities for health care is based on a percentage of family income. At the lowest end of the income scale, families would be responsible for no more than one-half of 1 percent of family income, so they can have quality health care, and a roof over their head, and 3 square meals a day. While at the higher end of the income scale, families would be responsible for no more than 5 percent or 7 percent of family income. For example, under the Health Security for All Americans Act, a family of four with an annual income of $25,000 would be responsible for no more than $11 a month in total health care costs, while a family of four with $50,000 in annual income would have the security of knowing that its total out-of-pocket health care spending (premiums and cost sharing) could not exceed 5 percent of family income or $2500 per year. Third, it's based on the premise that you have to have access to care when you or your family needs it. That is why the Health Security for All Americans Act includes the Norwood-Dingell Patient Bill of Rights that has been endorsed by over 300 health care organizations. Fourth, it's based on the premise that good health care delivery doesn't just happen. It depends on a well trained, well compensated health care workforce that doesn't have to constantly worry about where the next dollar is coming from. And I am referring to doctors and nurses and orderlies and home health workers, and nursing home workers--all health care workers. If we are going to deliver humane dignified health care to everyone in this country, we need to start by treating the health care workforce with dignity and respect and that starts with affordable health care for all workers. That is why the Health Security for All Americans Act includes health care quality, patient safety, and workforce standards. My experience has taught me that Americans agree with these premises. They want high quality, affordable health care as good as Congress gets, but they are not sure the best way to get there. That is why the Health Security for All Americans Act is a federal state partnership that says here is what Americans want; you--the states--design the plan you want to get your state there; and we the federal government will provide the majority of the funds you need to reach that goal in the manner you chose. States that submit plans early and achieve universal coverage are rewarded with increased federal dollars for their efforts. But all states must have plans in force within four years and coverage for all their residents within five years. States could reach these goals in a variety of ways: with an employer mandate, with a combination of public and private initiatives, with single payer, or some other method. I think this is a good approach because it allows the states flexibility, but it clearly sets out a fair and just goal: Universal coverage; comprehensive benefits as good as Congress gets; quality care guaranteed with patient protections; real income protections; and honoring of health care workers. I am proud today to be introducing the Health Security for All Americans Act and I am proud that this legislation has the backing and support of the Service Employees International Union, America's largest health care union. To my colleagues I say, together we can put universal health care back on the front burner where it belongs. We all know that in 1994, the effort to bring health care coverage to all Americans failed. All of us have heard the reasons why. But what we haven't answered is why did we give up when we knew this was the right thing to do? Why have we become so timid? Why have we only been willing to take half steps? We must not shrink from the task at hand! America's doctors and nurses know how to cure disease better than anywhere else in the world. Well, now it is time to treat America's worst malady--45 million uninsured Americans, and millions more underinsured Americans who are spending far too much of their monthly pay check on health care costs. Martin Luther King, Jr. rightly said, ``Of all the forms of inequality, injustice in health care is the most shocking and inhumane.'' All the doctors and all the nurses and all the other health care providers in America cannot solve this problem nor right this injustice, but we in the Congress can. This is a problem that isn't going away on its own, but there is a solution. So to my colleagues, I say, ``Join me in sponsoring the Health Security for All Americans Act.'' And to members of the American public who are listening, I ask you to join thousands of your fellow citizens who have already written to Members of Congress, and call and write your Senators and Representatives and ask them to join in bringing quality, affordable health care coverage to all Americans. Mr. President, I ask unanimous consent that the bill and additional material be printed in the Record.

Mr. WELLSTONE

Mr. WELLSTONE. Mr. President, I ask unanimous consent that Katherine Ostrum and Ben Wurtmann be granted the privilege of the floor.

Mr. WELLSTONE

Mr. WELLSTONE. I move to waive the Budget Act and ask for the yeas and nays.

Mr. WELLSTONE

Mr. WELLSTONE. Mr. President, since its passage in 1997, the BBA has drastically cut Medicare payments in the areas of hospital, home health and skilled nursing care services, among others. While the reductions were originally estimated at around $100 billion over five years, recent figures put the actual cuts in Medicare payments at over $100 billion. These cuts have consequences. Beneficiaries with medically complex needs face increase difficulty in accessing skilled nursing care. Hospital discharge planners have greater difficulty obtaining home health services for Medicare beneficiaries as a result of the BBA. Rural Hospital margins have dropped four percentage points continuing a dangerous trend that threatens access to care in rural America. Last year, Congress acknowledged that the Medicare savings that resulted from the 1997 Balanced Budget Act went far beyond what we intended, and passed the Balanced Budget Refinement Act (BBRA) but it didn't go nearly far enough. With actual cuts in payment of $200 billion from the BBA, the BBRA reversed at best only 10% of these actual cuts in payment to providers caused by the BBA, My state of Minnesota has been hit very hard by the BBA cuts, and last year's fix hasn't stopped the pain. As I said when I voted against the BBA, the cuts are too harsh and they will hurt our health care system. Both urban safety net hospitals and rural hospitals are feeling the pain. They are cutting back services, they are short staffed, like the hospital in Aurora, MN are faced with closing if they can't find a way to restructure so that their reliance on Medicare is not so great. My colleagues should be aware that in rural Minnesota typically 70% of the revenue for rural hospitals is from Medicare and Medicaid. Hospitals are often the largest employers in these communities and new businesses won't locate in a community if it doesn't have a hospital. You can't blame them. In addition these hospitals are critical to the tourism industry, which in my state is made up largely of mom and pop resorts, restaurants, lodges, canoe outfitters, fishing guides, cross country ski lodges as well as the downhill ski areas, snow mobile trails, vendors who cater to hunters and fishermen and women, bicyclists who use our state trails, the list is a long one. When these folks become sick or are injured while out in the wilderness, on the water, on the ski hill or while hunting, they need a local hospital to treat their injury or illness. In our state of Minnesota these front line health care providers are small rural hospitals in communities like Cook, Grand Marais, Ely and Teo Harbors. We can't fly out all the people with broken bones or heart attacks during a blizzard, or in the fog. We need hospitals there to provide the care. Northwestern Minnesota has been hit again by flooding this year. I don't know how many years in a row this has happened. We need health care there in these communities for farm families who are struggling with the farm economy, the weather and a health care crisis in their family. The hospitals in Northwestern Minnesota are on the razors edge of staying open. These BBA cuts hit them hard and hurt them badly. Southwestern Minnesota is a part of my state that relies on the farm economy. When families are not making any money at farming like this year and last year, whether it be collapsed hog prices, milk, or grain prices, through no fault of their own they don't have money to buy good insurance, the counties' revenue from property taxes that supports the rural county hospitals can't keep up and if Medicare isn't there with a fair level of reimbursement, they face the possibility of closing as well. There has been a tremendous number of closings in home health care in Minnesota. The cuts we made were extreme. People who could be taken care of at home are now kept longer in the more costly hospital setting simply because there is no one to provide the home care. But let me focus on the White Community Hospital in Aurora, Minnesota. This is a hospital that serves an iron ore mining community in Northeast Minnesota. The miners in this community and others in communities across Minnesota's iron range mined the ore that was turned into steel and built our cites in the twentieth century, made the cars, and the rails. They are the hear and soul of America. They or their parents came to this country, fleeing oppression in many European countries, they have a strong patriotism, a powerful work ethic and a community second to none in the United States. When I visited them last week to hear about the struggle they are engaged in to keep their hospital open I didn't over promise, but I did promise I would do everything I could to help them in their fight. And I will. The BBA is hurting them. It is an anchor around the neck of their hospital. They are fighting for their hospital and we can't turn our back on them. I have co-sponsored numerous pieces of legislation to restore additional funds to Medicare providers, but what we need is comprehensive BBA relief and our constituents, our hospitals, our nursing homes, and our home health agencies cannot wait. When Medicare fails to pay its share, it threatens health care for all patients. Reduced Medicare payments are contributing to decisions by many providers and insurers that threaten Medicare beneficiaries' access to care, including staff layoffs, reductions in services, or even outright facility closures or decisions to withdraw from the Medicare program. As we all know, entire communities suffer when such actions take place. We need comprehensive and substantial relief for community hospitals, teaching hospitals, rural hospitals, home health agencies, and skilled nursing facilities, among others--and we need it now, before Congress adjourns before the August recess. This amendment simply sates that it is the sense of the Senate that by the end of the 106th Congress, Congress shall revisit and restore a substantial portion of the reductions in Medicare payments to providers caused by enactment of the BBA of 1997 I wish to let colleagues know that I am going to call for a vote on an amendment Monday evening that deals with the drastic reduction of Medicare payments in the areas of hospital and home health care, and also skilled nursing care. In 1997, we passed the balanced budget amendment, and the reductions in Medicare over a 5-year period were estimated to be around $100 billion. The recent figure is going to be about $200 billion. Last year, we tried to do a ``fix,'' and we passed what was called the Balanced Budget Refinement Act. But basically what it did was restore about 10 percent of the actual cuts that we have made. I could say this in a more complete way, but what I want to do right now is just say to colleagues that my amendment is going to deal with these cuts. Either it is going to be a sense of the Senate that says by the end of the session, we have to restore some of this assistance, some of this money to our providers and to our patients and to the consumers, and/or I could have another amendment that says if we do not do that, there needs to be a freeze in the cuts. I am sure the Presiding Officer has heard of this in Alabama. I think you hear it in Nevada. I hear it in Minnesota. You hear it all across the country. In Minnesota, especially in our rural communities, whether it is White Hospital in the Iron Range in the White Lakes, whether it is southwest Minnesota, whether it is west central Minnesota, especially in our rural communities--we are going to lose these hospitals. They lost anywhere from 50 to 70 percent of their payment on Medicaid and Medicare. Colleagues, in 1997, I don't know what we were thinking when we voted for this. I think it was a big mistake. I did not vote for it. Others voted for it in good faith. Right now, what we are hearing is that these hospitals are not going to be able to provide the care. They are going to go under. These nursing homes are not going to be able to make it. We have seen severe cuts and cutbacks of services in home health care. The point is this: Yes, it is true the hospitals and nursing homes are important employers in these communities, so there are jobs. Yes, it is true the same thing could be said for home health care. But the worst part of it is we are talking about a dramatic decline in the quality of care for people. In a lot of communities, especially in rural America, this is the death knell for our communities. It is hard enough for people to struggle to earn a decent living, but people can't stay in the communities if there is not good health care and if there is not good education available. Right now, we do not have that, if these hospitals shut down. This amendment is an amendment that speaks to these cuts. It will be an amendment based upon many meetings I have had with community people all across Minnesota. I think it is an amendment that all my colleagues, hopefully, will support because when Medicare does not pay its share, it is a threat to the health care for patients and it also has a dramatic negative effect on our communities as well. I want to bring this to the attention of colleagues. I hope there will be a strong vote for this amendment. There is some discussion we are not going to do anything about this. But we never should have voted for cuts that are this severe. This has had just the harshest consequences. It was a mistake and we have to restore this funding.

Mr. WELLSTONE

Mr. WELLSTONE. Mr. President, I want to bring something to the attention of the Senate today. Even though most Senators are gone, I want to do this because I think it should be done in as public a way as possible. I bring to the attention of colleagues a piece in the New York Times. It is a front-page story, ``Colombians Tell of Massacre, as Army Stood By.'' When you read this story, there will be tears in your eyes. I don't know whether they will be tears of sadness or tears of anger. I will read just the first few paragraphs: El Salado, Colombia.--The armed men, more than 300 of them, marched into this tiny village early on a Friday. They went straight to the basketball court that doubles as the main square, residents said, announced themselves as members of Colombia's most feared right-wing paramilitary group, and with a list of names began summoning residents for judgment. A table and chairs were taken from a house, and after the death squad leader had made himself comfortable, the basketball court was turned into a court of execution, villagers said. The paramilitary troops ordered liquor and music, and then embarked on a calculated rampage of torture, rape and killing. ``To them, it was like a big party,'' said one of a dozen survivors who described the scene in interviews this month. ``They drank and danced and cheered as they butchered us like hogs.'' By the time they left, late the following Sunday afternoon, they had killed at least 36 people whom they accused of collaborating with the enemy, left-wing guerrillas who have long been a presence in the area. The victims, for the most part, were men, but others ranged from a 6-year-old girl to an elderly woman. As music blared, some of the victims were shot after being tortured; others were stabbed or beaten to death, and several more were strangled. Yet during the three days of killing last February, military and police units just a few miles away made no effort to stop the slaughter, witnesses said. At one point, they said, the paramilitaries had a helicopter flown in to rescue a fighter who had been injured trying to drag some victims from their home. Instead of fighting back, the armed forces set up a roadblock on the way to the village shortly after the rampage began, and prevented human rights and relief groups from entering and rescuing residents. While the Colombian military has opened three investigations into what happened here and has made some arrests of paramilitaries, top military officials insist that fighting was under way in the village between guerrillas and paramilitary forces--not a series of executions. They also insist that the colonel in charge of the region has been persecuted by government prosecutors and human rights groups. Last month he was promoted to general, even though examinations of the incidents are pending. I ask unanimous consent the entire article be printed in the Record.

Mr. WELLSTONE. We just voted, with essentially no strings attached, to be involved in a military operation in Colombia with the money going for a military operation, to a military that does not lift a finger while these paramilitary death squads go in and massacre innocent people. I say to Senators, Democrats and Republicans, this is no longer Colombia's business. This is our business because we now have provided the money for just such a military, which is complicit, not only in human rights violations--I spoke about this on the floor of the Senate--but in this particular case in the murder of innocent people, including small children. I ask unanimous consent to have printed in the Record a letter I sent to Secretary Albright.

Mr. WELLSTONE. I conclude this letter: During this debate surrounding Plan Colombia, the Administration and the Colombian government pledged to work to reduce the production and supply of cocaine while protecting human rights. The continuing reports of human rights abuses in Colombia confirm my grave reservations regarding the Administration's ability to effectively manage the use of the resources that will be provided while protecting the human rights of Colombian citizens. To that end I respectfully seek answers to the following questions. I respectfully seek answers to the following questions from Secretary Albright. No. 1, How will the Administration ensure a vetting process guaranteeing that Colombians indirectly facilitating human rights violations, as well as those accused of direct violations, will not serve in battalions being trained by the United States military? I want an answer to that question from the Secretary of State. No. 2, What will the Administration do to ensure that the alleged murderers and human rights abuses in El Salado are investigated, and that those responsible are prosecuted? No. 3, How will the Administration address the needs of the victims at El Salado, including the nearly 3,000 residents displaced by the incident? Mr. President, I want to conclude by thanking my colleague, Senator Bryan, for his graciousness, but also by saying to Senators, again, this front-page story--and I just wrote the administration about another massacre just a few days ago in Colombia--this is our business. We support this government. We are supporting the military operation in the south. We are supporting this military with this kind of record, complicity in this kind of slaughter of innocent people. I hope Secretary Albright will respond to this letter in an expeditious way. I will continue to come to the floor of the Senate and speak out about what is going on in Colombia. Senator Durbin is very concerned. Senator Reed is very concerned. Senator Biden is very concerned. He had a different position on this Colombia aid package. All should speak out, whatever our vote was on this legislation, because this is our business. This is being done, if not directly, indirectly, in our name. I thank my colleague from Nevada. I yield the floor.

Mr. WELLSTONE

Mr. WELLSTONE. Mr. President, how much time do we have left?

Mr. WELLSTONE. Mr. President, one thing about this god-awful process is there is not enough time to talk about this legislation. I will take less than 2 minutes, and my colleague from Louisiana will have 2 minutes. Senator Dodd outlined this amendment. Both of us have worked in this area. I think making this tax credit refundable is hugely important. I think the fact that some of the money applies to parents who are at home is hugely important. I think going up from $10,000 to $30,000 and then up from $30,000 to $60,000 cuts across a broad section of the population. I have no doubt that 99.9 percent of the people in Minnesota, if given the choice between the tax break our Republican colleagues are talking about, the estate tax break that goes to the wealthiest 2 or 3 percent of the population, versus a focus on helping families with child care expenses, working families and low-income families--I want to use that label as well--would say let's put the money into child care. That is what this amendment calls for. This is just a matter of priorities. It is just crazy to be talking about this giveaway to the wealthiest 2 or 3 percent and not making the investment in affordable child care for families in our States. I yield the floor.

Mr. WELLSTONE

Mr. WELLSTONE. Mr. President, I thank my colleague from Washington and my colleague from Minnesota for their help.

Mr. WELLSTONE. Mr. President, the pending order of business is amendment No. 3772. I can be very brief. First, I thank my colleague, Senator Grams, for joining me in this effort. We have two amendments, I believe. I say to my colleague from Minnesota, I also join him in his effort. We are both focused on the same question: a storm that happens about once every thousand years, a massive blowdown in northern Minnesota. We are both committed to helping get to the Forest Service the necessary resources to deal with the massive blowdown. There is a lot of important work to be done. This storm has been a nightmare for our State. One very positive outcome of the storm is the way in which the people in Minnesota have come together. I thank Senator Gorton and Senator Byrd for accepting this amendment. It would restore about $7.2 million needed in emergency funding. It is critically important, and I thank my colleagues for their support. People in northern Minnesota will appreciate their support as well. I say to Senator Grams, I have to leave the floor soon, but I also support the amendment he is introducing. I have another engagement. I am proud to be a cosponsor on that amendment with my colleague. It is my understanding this amendment will be approved. I wonder whether we could now voice vote it.

Mr. WELLSTONE. Mr. President, I am sorry.

Mr. WELLSTONE. Mr. President, I ask my colleague from Washington whether we can voice vote my amendment.

Mr. WELLSTONE

Mr. WELLSTONE. Thank you, Mr. President. I am very proud to have worked with Senator Durbin to be a cosponsor and have Senator Kerry here on the floor as well. I think this important amendment requiring more realistic testing of the national missile system is an extremely important step for us to take. First of all, it requires more realistic testing. Second, it calls for the reconvening of the Welch commission to independently evaluate the testing program. Third, it requires a report to the Congress on the adequacy of the program. This is the fourth time since the late fifties that we have talked about a missile defense program. Each time there is a tremendous amount of enthusiasm. Then scientists and independent observers do a careful analysis. After that, the enthusiasm wanes. I do not believe this time will be any different. I am sure every Senator read on Sunday morning that this past Saturday's test was an utter failure. What you may not know is that an earlier test was unsuccessful as well. But regardless of the actual successes and failures of the tests, the fact is, the current testing program does not test the feasibility of the system in the real world. Current testing determines whether or not the system works against cooperative targets on a test range. This methodology is insufficient to determine the technological feasibility of the system against likely threats. At present, even if the tests had been hailed as total successes, they would have proved nothing more than the system is unproven against real threats. At present, we know that this system might work if the other side is not making it hard to detect its weapons. This hardly seems a reason to move forward to deployment. Some might argue that this amendment demands too much. Some might argue that today's testing program is a first step in a long process towards full deployment. But demanding an adequate testing program, which is what this amendment calls for, certainly does not put the bar too far. It sets it where any reasonable person or scientist would put it. We must stick to development and work within the confines of a realistic test before even considering moving to deployment. The aim of the national missile defense is to defend the United States from limited attacks by intercontinental-range ballistic missiles armed with nuclear, chemical, or biological weapons. However, biological or chemical weapons can be divided into many small warheads called submunitions. These submunitions could overwhelm the planned defense, and more importantly, because some munitions allow for more effective dispersal of biological and chemical agents, an attacker would have a strong incentive to use them even in the absence of missile defenses. When it comes to biological warfare and these biological and chemical agents, the greater likelihood is that they will be carried by suitcase into this country. I pray that doesn't happen. Current testing does not take countermeasures into account. An attack could overwhelm the system by using something as simple as ballooned decoys, for example, by deploying nuclear weapons inside balloons and releasing numerous empty balloons along with them. Or an attacker could cover its nuclear warheads with cooled shrouds which would prevent the interceptor from detecting it. We are talking about testing which takes into account these countermeasures. That is what we would have to deal with. Current testing does not take these countermeasures into account. The Pentagon assessment will consider only whether the first phase of the system would be effective against a threat with no credible countermeasures. It will not consider whether the full system would be effective against a threat with realistic countermeasures. Any decision on whether or not the United States should deploy a national missile defense should take into account how effective that system is likely to be in the real world, not just whether or not it works against cooperative targets on a test range. Unfortunately, the technological feasibility of the proposed national defense system, which will be determined in the Pentagon's upcoming deployment readiness review, will be assessed precisely on the basis of such test results. Even worse, it will be based upon only a few tests. The administration requested that the Pentagon provide an estimate of whether a national missile defense can be deployed in 5 year's time. General Kadish, the head of the Pentagon's ballistic missile defense program, has described the 2005 timetable as ``high risk.'' He has made it clear that the timetable is much faster than military planners would like. The recommendation of the Pentagon's own Office of the Operational and Test Evaluation Program stated clearly that the deployment readiness review ``is a strongly `schedule driven' approach'' rather than one based upon results. Is it too much to ask that we be certain that this system works before we move ahead with deployment? That is what this amendment is about. If the proposed national missile defense system is to have any possibility of enhancing U.S. security, it must work, and it must work well. At present, the evidence isn't there to prove that it does, and the tests underway to establish that proof are simplified and unrealistic. We must demand that any deployment decision on national missile defense be postponed until the system has been tested successfully against real-world realistic threats. Last year, I voted against a resolution urging the administration to make a decision to deploy a national missile defense system. I believed then, as I do now, that a decision to deploy before a decision is made there needs to be a careful evaluation of the effectiveness of the system. I also believe that we need to look at this in the context of overall U.S. security needs. The goal should be to increase U.S. security--not to undermine it. Deploying a system now, I fear, does the opposite. It threatens to disrupt the current arms control regimen and undermine the credibility of our commitment to nonproliferation. Deployment of a national missile defense system would be a violation of the ABM Treaty. Are we prepared to discard this arms control regimen? I worry--and I think every Senator, Democrat and Republican alike, worries--about proliferation of these weapons of mass destruction. If this regimen of arms control breaks down with Russia-- and, perhaps even more importantly, breaks down with China, then there is India, then there is Pakistan, then there is South Korea, then there is Japan--I fear the direction in which we are moving. Colleagues, for 40 years the United States of America has led international efforts to reduce and contain the danger from nuclear weapons. We must not now renounce the responsibilities of that leadership with a hasty and shortsighted decision that will have lasting consequences. We must answer a number of questions before we proceed: Does it make sense to unilaterally deploy a system now if the result might be to put the American people at even greater risk? Should we take the time to work with allies and others to find a mutually acceptable nonthreatening way of proceeding? Have the threats to which we are responding been exaggerated and more driven by politics than accurate threat assessments and hard science? Is the technology there to deploy a system that would actually work in the real world? This amendment speaks directly to that last question. I urge my colleagues to demand to know more about the complexities of a national missile defense system prior to deploying that system. I don't think that is an unreasonable request. The failure of Saturday's test is only a fraction of the real story. Even a successful test would prove nothing given the current testing conditions. I urge my colleagues to support this amendment requiring a more realistic testing of the national missile defense system, reconvening the Welch panel to independently evaluate a testing program, and requiring a report to the Congress on the adequacy of the program. We should not commit ourselves blindly to a program that can cost billions of dollars and could very well decrease our overall security rather than to enhance it. Our future and our children's children's future could depend on the decision we make on this amendment. Let's do the right thing. I hope we can have a strong vote on this amendment.

Mr. WELLSTONE. Mr. President, I say to my colleague I can't imagine the Secretary of Defense doing that, either. My plea was to Senators. I said we must not proceed blindly and I urge all Members to understand the complexity of this testing and to at least call for a thorough evaluation to make sure that this system will really work. My comments were not directed to Secretary Cohen. I also say to my colleague, I don't believe the Secretary of Defense has made a final recommendation to the President.

Mr. WELLSTONE. In light of the failure of this past week, I don't know what the Secretary's decision will be. I think all Members are just making the reasonable request that before we go forward with deployment, let's have the kind of operational testing that will prove that this system will work in the real world against credible threats, and let's have an independent evaluation by the Welch commission and have at least a report to the Congress. That is what I am referring to, I say to my colleague from Virginia. I am glad he asked the question. In no way would I direct these comments toward the Secretary of Defense.

Mr. WELLSTONE. I probably need not respond. I appreciate my colleague's comments. One final comment in response to his comments. One of the things I have liked best about preparing for this amendment for me as a Senator has been the way I imagined Senate work to be. I tried to immerse myself on this issue and get the best security briefings from the Pentagon, get other briefings from other people in the Pentagon, and talked to a whole range of experts. The Welch Commission report is a very interesting report. This amendment certainly says we need to make absolutely sure that we are involved in the kind of testing that will show this system will work before we move forward. That is true. That is certainly the premise of this amendment. I think this is a reasonable premise. Senators ought to raise these kinds of questions. That is why we are here. That is why I think this amendment is important.

Mr. WELLSTONE. Mr. President, I also thank the chairman for making this a very important substantive debate. I thank the ranking minority member.

Mr. WELLSTONE

Mr. WELLSTONE. Mr. President, I thank the Senator from California. I think it would be a good idea if we could work out an order, and I am pleased to do so.

Mr. WELLSTONE. Reserving the right to object, I wonder whether I could ask unanimous consent that I be allowed to speak since I have been here all morning, when we come back from the break.

Mr. WELLSTONE. I will not object.

Mr. WELLSTONE

Mr. WELLSTONE. Mr. President, let me, first of all, mention to colleagues when we look at this estate tax bill, the Center on Budget and Policy Priorities--and I think their work has been impeccable-- points out that fewer than 1.9 percent of the 2.3 million people who died in 1997 had any tax levied on their estates. We are talking about 1.9 percent. This repeal that my colleagues on the other side of the aisle are proposing helps the wealthiest 2 percent of Americans. I ask unanimous consent the full study from the Center on Budget and Policy Priorities be printed in the Record.

Mr. WELLSTONE. Last week, President Clinton pointed out the cost of this repeal, helping the top wealthiest 2 percent of our population. It amounts to $100 billion over the first 10 years and then $750 billion over the next decade. I will speak for some period of time, and I know other Senators will speak as well, about what we could be doing and should be doing instead of repealing this inheritance tax helping the top 2 percent of the population. Instead of this repeal helping the top 2 percent of the population, we could help renew our national vow of equal opportunity for every child. We could start by making sure families in our country are helped with affordable child care. I can't think of a more important issue, especially for younger working families. I don't know how many times in Minnesota, or anywhere I go in the country, I have people coming up to me--maybe they make $40,000 a year or $35,000 a year, and the child care expenses range anywhere from $6,000 a year to $12,000 a year. We could have a refundable tax credit. It could be for families under $30,000. You could put it on a sliding fee scale basis. We could go up to $30,000, $40,000, $50,000 a year, which would help families afford child care. Why don't we do that? The Federal Government--that means the Senate, that means the House of Representatives--could be a real player in pre-K education. By the way, child care--whether a family provider, whether in a child care center, or whether or not a child is at home with a parent--is all about education. Those children who are able to receive developmental child care, who were nurtured, who were intellectually stimulated, will come to kindergarten ready to learn and they will do well. For many families, and not only low-income families, this is a salient issue. The way this is drafted right now, going to the wealthiest 2 percent of Americans, we could--and I intend to have an amendment that focuses on this--have some tax credits that go to families so they can afford child care. This is an emergency situation in many of our States. At best, 20 percent of the children in 20 percent of these families are receiving any help whatsoever. There was a powerful piece in the Washington Post last weekend talking about the fact that not only can families not afford this, but there is almost a 40-percent turnover of child care providers every year. I ask unanimous consent that this article, ``Burdened Families Look for Child Care Aid,'' be printed in the Record.

Mr. WELLSTONE. Mr. President, instead of the repeal of the inheritance tax going to the wealthiest 2 percent, we could provide some tax credit assistance for working families so they could better afford child care for their children. Why can't we do that? The evidence is irrefutable. The evidence is irreducible. These are the critically important years. Families in our States tell us how important this is. What are we doing moving forward on repealing an inheritance tax for the wealthiest 2 percent of Americans, not targeting it to family farmers and small businesses but across the board, instead of using some of this money--$100 billion over the first 10 years, but $750 billion over the second 10 years--to make sure families in our country can afford good child care for their children? By the way, even when I talk about tax credits invested in affordable child care, it breaks my heart because this will not even be near enough. The truth is, we have to get serious about good developmental child care, and that means men and women who work in this field should not make $8 an hour or $6 an hour with no benefits at all, but we should value the work of adults who work with children; that we not continue to pay men and women who work in child care centers half of what we pay men and women who work in zoos taking care of animals. As a Senator from Minnesota, I am absolutely confident that I am reflecting the priorities of Minnesotans when I say repeal of this estate tax, now crafted in such a way that it goes to the wealthiest 2 percent of Americans, is hardly a priority for people in Minnesota or people in the country. I would prefer to see us make the investment in child care. I intend to offer an amendment that deals with additional tax credits which will provide help for working families. I will not use statistics, but every Senator, Democratic and Republican, knows intuitively that in today's economy, one of the most important indicators of whether or not a young person--or not such young person, since many of our students are no longer 18 and 19 living in a dorm but they are 40 and 50 years of age going back to school--can succeed is whether or not they are able to complete higher education. Yet we have this huge gap between the number of young people, or not such young people, from low- and moderate-income backgrounds who are able to complete college versus those who come from upper-income or upper-middle-income families, and it is because of the cost of higher education. We have not fully funded the Pell Grant Program where we get the most bang for the buck, and when we passed the Hope Scholarship Program and said there would be a $1,500 tax credit for students to afford the first 2 years of school, it was not a refundable tax credit. So for a lot of the students in the community colleges in Minnesota, if they come from families with incomes under $30,000 a year, $28,000 a year, they do not get any benefit because it is not a refundable tax credit. What could we be doing instead of moving forward on an agenda that repeals this inheritance tax that benefits the wealthiest 2 percent of the population? What we could do instead is provide refundable tax credits for our students so they can afford to go on to colleges and universities and do better for themselves and do better for their children. I say better for their children because, again, I have reached the conclusion, having spent a lot of time on campuses in Minnesota, that the nontraditional students have become the traditional students, and probably the majority of our students are now in their thirties and forties with children going back to school so they can do better for their kids. Are we committed to education? Here is where we could be a player. Instead of repeal of this estate tax that the majority party wants us to move forward on, why are we not talking about a commitment to education? Why are we not, as Senators, making a difference where we can make a difference? Yes, we can make a difference in kindergarten through 12th grade, but we can make a huge difference, it is our role to make a difference prekindergarten: to make a commitment to affordable child care so children coming into kindergarten are ready to learn; to make sure every child has an opportunity to do well; to make sure our students can go on and afford higher education so they can do better by themselves. Why are we not making this commitment to education? What are we doing out here, trying to move forward this piece of legislation that is going to cost $100 billion over the first decade and then up to $750 billion over the next decade, with all of this money and all of these benefits flowing, roughly speaking, to the wealthiest 2 percent of the population? I have a bill, as does Barney Frank in the House of Representatives, that basically says: What we can do is agree that we are talking about, by definition, very wealthy Americans; that we are trying to repeal this inheritance tax. We are saying--and I quote Barney Frank--``If you're old, rich, and dead, we're with you. If you're old, sick, and middle class, you're out of luck.'' I do not know that I would put it quite that way, but basically we could take this $750 billion over the second 10 years, $100 billion over the first 10 years, and finance prescription drug benefits so seniors will be able to afford prescription drugs. I come from a State where fully 65 percent of senior citizens have no prescription drug coverage at all. All of us can talk about people who are spending up to $300, $400, $500 a month to cover prescription drug costs, and maybe their total monthly budget right now, based upon what benefits they have, is $1,000 or $1,200. We can talk about people who cut pills in half, though that is dangerous. We can talk about people who are faced with the choice: Can I afford prescription drugs or can I afford to eat but not both? What in the world are we doing trying to proceed on a piece of legislation which is not at all targeted, which provides huge benefits, which basically busts our budget and robs our ability to invest in other decisive areas that are so important to people in our States and provides the benefits to the wealthiest 2 percent? This debate is really a debate about our priorities and, and I will draw a bit from the Center on Budget and Policy Priorities: In 1997, the estates of fewer than 43,000 people--fewer than 1.9 percent of the 2.3 million people who died that year--had to pay any estate tax. That is 1.9 percent, roughly speaking, among the wealthiest 2 percent in the United States of America. It is going to cost us $100 billion over the first 10 years, and it is going to cost us $750 billion over the next 10 years. You know what. If we had an unlimited amount of money, and we did not have other needs--such as affordable child care, making sure we have health security for families, making sure people have a pension, making sure young people and not so young people can go on and afford higher education, and making sure families can do well by their kids so they can do well by their country--I might be all for it. But what about these other decisive needs? Don't they come first?