Ron Wyden

Mr. WYDEN

Mr. WYDEN. Mr. President, today I am introducing legislation which was actually authored by Senators Nickles and Hatch, and which they have entitled the ``Pain Relief Promotion Act.'' Their bill which I am now introducing is identical to H.R. 2260 as reported out of the Judiciary Committee on April 27, 2000, as amended. Today, it has been referred by the Senate Parliamentarian to the Committee on Health, Education, Labor, and Pensions (HELP). While I remain steadfastly opposed to the ``Pain Relief Promotion Act of 2000,'' I am introducing this bill for one reason: to call the Senate's attention to the fact that a far-reaching health policy bill-- which many experts believe has the potential to sentence millions of sick and dying patients across the nation to needless pain and suffering--was mistakenly referred to a committee with insufficient health policy resources and no health policy jurisdiction. It is that bill which the Judiciary Committee reported and which, without consideration by the committee with health expertise, the Republican leadership wants to bring to the floor. The unintended consequence of this could be the tragic decline of the quality of pain care across our nation. Some historical context might help my colleagues and their staff better understand how the Senate finds itself in this unfortunate situation, and the important issues that are at stake. On two separate occasions, the State of Oregon passed a ballot measure that would allow terminally ill persons, with less than six months left to live, to obtain a physician-assisted suicide if they met a variety of safeguard requirements. As a private citizen, I voted twice with the minority of my state in opposition to that measure. In response to Oregon's vote, several of our congressional colleagues, including Senator Nickles, Senator Lieberman, and Congressman Henry Hyde, promptly undertook legislative and other efforts to overturn Oregon's law. I do not, for the purposes of today, debate the merits of the Oregon law, or the merits of physician- assisted suicide, generally. The original ``Pain Relief Promotion Act,'' S. 1272, was introduced in the Senate by Senator Nickles, and referred to the Committee on Health, Education, Labor and Pensions (HELP) on June 23, 1999. That committee held one inconclusive hearing on October 13, 1999, at which time it was reported that Senators on both sides of the aisle wished to investigate the matter more thoroughly before acting on the legislation. Then, on November 19, 1999, Bob Dove, the Senate Parliamentarian, made what he termed ``a mistake'' when he referred H.R. 2260-- the virtually identical House-passed version of the ``Pain Relief Promotion Act''--to the Senate Judiciary Committee. Over the course of my service in the Senate, I have come to know Mr. Dove to be a man of integrity and fairness, and one of the most dedicated and enduring public servants in Washington, D.C. When he discovered his mistake, to his great credit, Mr. Dove did something all-too-rare in this town; he simply acknowledged his error. According to an article by the Associated Press on December 7, 1999, Mr. Dove stated plainly that he had mistakenly referred the bill to the Judiciary Committee, instead of the HELP Committee. Lord knows I've made a few mistakes in my day, so I want to make clear that I harbor nothing but respect for Mr. Dove, and that I do not for one second question Mr. Dove's motives. But the mistake made on November 19, 1999, if left uncorrected, threatens unspeakably negative and long-lasting consequences for the future of health care in this nation. The jurisdiction of the HELP Committee over the ``Pain Relief Promotion Act'' is clear. The Senate Manual describes the jurisdiction of this committee as including ``measures relating to education, labor, health, and public welfare''. The Senate Manual also describes the HELP Committee as having jurisdiction over aging, biomedical research and development, handicapped individuals, occupational safety and health, and public health. According to the Senate Manual, the jurisdiction of the Judiciary Committee includes bankruptcy, mutiny, espionage, counterfeiting, civil liberties, constitutional amendments, federal courts and judges, government information, holidays and celebrations, immigration and naturalization, interstate compacts generally, judicial proceedings, local courts in territories and possessions, measures relating to claims against the United States, national penitentiaries, patent office, patents, copyrights trademarks, protection of trade and commerce against unlawful restraints and monopolies, revision and codification of the statutes of the United States, and state and territorial boundary lines. The committee jurisdiction is not a close call, in this case. As the Senate's leading expert on jurisdiction has now demonstrated, this bill is fundamentally an issue of medical practice, which clearly is within the jurisdiction of the HELP Committee. Congress has heard conflicting messages from respected medical experts on both sides of this debate about whether the ``Pain Relief Promotion Act'' may, in fact, have a chilling effect on physicians' pain management, thus actually increasing suffering at the end of life. Under the legislation, federal, state, and local law enforcement could receive training to begin scrutinizing physicians' end-of-life care. Many believe that the legislation sends the wrong signal to physicians and others caring for those who are dying, noting the disparity between the $5 million allotted for training in palliative care and the $80 million potentially available for law enforcement activities. In addition, there is considerable concern that this legislation puts into statute perceptions about pain medication that the scientific world has been trying to change. Physicians often believe that the aggressive use of certain pain medications, such as morphine, will hasten death. Recent scientific studies show this is not the case. Dr. Kathleen M. Foley, Attending Neurologist in the Pain and Palliative Care Service at Memorial Sloan-Kettering Cancer Center and Professor of Neurology, Neuroscience and Clinical Pharmacology at the Cornell University, had this to say about the Nickles-Hatch legislation, ``In short, the underpinnings of this legislation are not based on scientific evidence. It would be unwise to institutionalize the myth into law that pain medications hasten death.'' Renowned medical ethicist, and Director of the Center for Bioethics at the University of Pennsylvania, Arthur L. Caplan, Ph.D., also appeared before the Senate Judiciary Committee on April 25, 2000. He testified that: ``Doctors and nurses may not always fully understand what the law permits or does not, but when the issue requires an assessment of intent in an area as fraught with nuances and pitfalls as end of life care then I believe that this legislation will scare many doctors and nurses and administrators into inaction in the face of pain.'' Dr. Scott Fishman, the Chief of the Division of Pain Medicine and Associate Professor of Anesthesiology at the University of California Davis School of Medicine wrote of the Hatch substitute: ``It is ironic that the `Hatch substitute', which seeks to prevent physician assisted suicide, will ultimately impair one of the truly effective counters to physician assisted suicide, which is swift and effective pain medicine.'' Dr. Foley, who also assisted the Institute of Medicine committee that wrote the report ``Approaching Death,'' further testified that, ``The Pain Relief Promotion Act, by expanding the authority of the Controlled Substances Act, will disturb the balance that we have worked so hard to create. Physician surveys by the New York State Department of Health have shown that a strict regulatory environment negatively impacts physician prescribing practices and leads them to intentionally undertreat patients with pain because of concern of regulatory oversight.'' The New England Journal of Medicine editorialized against these legislative approaches to overturning Oregon's law out of concern for its impacts on pain management nationwide, saying: ``Many doctors are concerned about the scrutiny they invite when they prescribe or administer controlled substances and they are hypersensitive to `drug- seeking behavior' in patients. Patients, as well as doctors, often have exaggerated fears of addiction and the side effects of narcotics. Congress could make this bad situation worse.'' It is worth noting that many people and organizations with expertise in pain management and palliative care are both opposed to physician assisted suicide and opposed to the Nickles-Hatch bill. There are over thirty organizations representing doctors, pharmacists, nurses, and patients who oppose the legislation, including: American Academy of Family Physicians; American Academy of Hospice and Palliative Medicine, American Academy of Pharmaceutical Physicians; American Geriatrics Society; American Nurses Association; American Pain Foundation; American Pharmaceutical Association; American Society for Action on Pain; American Society of Health-System Pharmacists; American Society of Pain Management Nurses; College on Problems of Drug Dependence; Hospice and Palliative Nurses Association; National Foundation for the Treatment of Pain; Oncology Nursing Society; Society of General Internal Medicine; Triumph over Pain Foundation; California Medical Association; Massachusetts Medical Society; North Carolina Medical Society; Oregon Medical Association; Rhode Island Medical Association; San Francisco Medical Society; Indiana State Hospice and Palliative Care Association; Hospice Federation of Massachusetts; Kansas Association of Hospices; Maine Hospice Council; Maine Consortium of Palliative Care and Hospice; Missouri Hospice and Palliative Care Association; New Hampshire State Hospice Organization; New Jersey Hospice and Palliative Care Organization; New York State Hospice Organization; and, Oregon Hospice Association. Physician-assisted suicide is not a cry for help from people experiencing the failure of patents, copyrights and trademarks. Physician-assisted suicide is a cry for help from people who, in many cases, are experiencing a failure in the health system. And those failures occur across our nation; not just in Oregon. In one study reported in the August 12, 1998, issue of JAMA, over 15 percent of oncologists admitted to participating in physician-assisted suicide or euthanasia. The February 1997 New England Journal of Medicine published a report finding that 53 percent of physicians in a large, San Francisco-based AIDS treatment consortium admitted assisting in a suicide at least once. Personally, I am troubled and saddened that so many of our loved ones are so dissatisfied with their end-of-life options that they seek physician-assisted suicide, instead. Whether or not this Congress decides to overturn Oregon's law, I believe it is critical that whatever we do must result in a reduced demand for physician-assisted suicide, not only in Oregon, but across our nation. Many reputable experts believe the ``Pain Relief Promotion Act'' will cause physicians--far beyond Oregon's borders--to provide less aggressive pain care to their suffering and dying patients. If this occurs, not only will millions of our elderly and dying constituents suffer needlessly, we may unwittingly increase the demand for suicide at the end of life. I urge my colleagues, regardless of where they stand on the issue of Oregon's law, to join with me in supporting the restoration of the HELP Committee's jurisdiction. It would be unconscionable for the Senate to fail to correct an honest mistake that could contribute to a devastatingly significant change in health policy. With so much at stake, shouldn't we follow the regular order of the Senate? Shouldn't we insist that the Senate's best qualified health policy experts fully consider the complex policy implications before taking such an extraordinary risk for our constituents, our friends, and our families? Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. WYDEN

Mr. WYDEN. Mr. President, today I am introducing legislation which was actually authored by Senators Nickles and Hatch, and which they have entitled the ``Pain Relief Promotion Act.'' Their bill which I am now introducing is identical to H.R. 2260 as reported out of the Judiciary Committee on April 27, 2000, as amended. Today, it has been referred by the Senate Parliamentarian to the Committee on Health, Education, Labor, and Pensions (HELP). While I remain steadfastly opposed to the ``Pain Relief Promotion Act of 2000,'' I am introducing this bill for one reason: to call the Senate's attention to the fact that a far-reaching health policy bill-- which many experts believe has the potential to sentence millions of sick and dying patients across the nation to needless pain and suffering--was mistakenly referred to a committee with insufficient health policy resources and no health policy jurisdiction. It is that bill which the Judiciary Committee reported and which, without consideration by the committee with health expertise, the Republican leadership wants to bring to the floor. The unintended consequence of this could be the tragic decline of the quality of pain care across our nation. Some historical context might help my colleagues and their staff better understand how the Senate finds itself in this unfortunate situation, and the important issues that are at stake. On two separate occasions, the State of Oregon passed a ballot measure that would allow terminally ill persons, with less than six months left to live, to obtain a physician-assisted suicide if they met a variety of safeguard requirements. As a private citizen, I voted twice with the minority of my state in opposition to that measure. In response to Oregon's vote, several of our congressional colleagues, including Senator Nickles, Senator Lieberman, and Congressman Henry Hyde, promptly undertook legislative and other efforts to overturn Oregon's law. I do not, for the purposes of today, debate the merits of the Oregon law, or the merits of physician- assisted suicide, generally. The original ``Pain Relief Promotion Act,'' S. 1272, was introduced in the Senate by Senator Nickles, and referred to the Committee on Health, Education, Labor and Pensions (HELP) on June 23, 1999. That committee held one inconclusive hearing on October 13, 1999, at which time it was reported that Senators on both sides of the aisle wished to investigate the matter more thoroughly before acting on the legislation. Then, on November 19, 1999, Bob Dove, the Senate Parliamentarian, made what he termed ``a mistake'' when he referred H.R. 2260-- the virtually identical House-passed version of the ``Pain Relief Promotion Act''--to the Senate Judiciary Committee. Over the course of my service in the Senate, I have come to know Mr. Dove to be a man of integrity and fairness, and one of the most dedicated and enduring public servants in Washington, D.C. When he discovered his mistake, to his great credit, Mr. Dove did something all-too-rare in this town; he simply acknowledged his error. According to an article by the Associated Press on December 7, 1999, Mr. Dove stated plainly that he had mistakenly referred the bill to the Judiciary Committee, instead of the HELP Committee. Lord knows I've made a few mistakes in my day, so I want to make clear that I harbor nothing but respect for Mr. Dove, and that I do not for one second question Mr. Dove's motives. But the mistake made on November 19, 1999, if left uncorrected, threatens unspeakably negative and long-lasting consequences for the future of health care in this nation. The jurisdiction of the HELP Committee over the ``Pain Relief Promotion Act'' is clear. The Senate Manual describes the jurisdiction of this committee as including ``measures relating to education, labor, health, and public welfare''. The Senate Manual also describes the HELP Committee as having jurisdiction over aging, biomedical research and development, handicapped individuals, occupational safety and health, and public health. According to the Senate Manual, the jurisdiction of the Judiciary Committee includes bankruptcy, mutiny, espionage, counterfeiting, civil liberties, constitutional amendments, federal courts and judges, government information, holidays and celebrations, immigration and naturalization, interstate compacts generally, judicial proceedings, local courts in territories and possessions, measures relating to claims against the United States, national penitentiaries, patent office, patents, copyrights trademarks, protection of trade and commerce against unlawful restraints and monopolies, revision and codification of the statutes of the United States, and state and territorial boundary lines. The committee jurisdiction is not a close call, in this case. As the Senate's leading expert on jurisdiction has now demonstrated, this bill is fundamentally an issue of medical practice, which clearly is within the jurisdiction of the HELP Committee. Congress has heard conflicting messages from respected medical experts on both sides of this debate about whether the ``Pain Relief Promotion Act'' may, in fact, have a chilling effect on physicians' pain management, thus actually increasing suffering at the end of life. Under the legislation, federal, state, and local law enforcement could receive training to begin scrutinizing physicians' end-of-life care. Many believe that the legislation sends the wrong signal to physicians and others caring for those who are dying, noting the disparity between the $5 million allotted for training in palliative care and the $80 million potentially available for law enforcement activities. In addition, there is considerable concern that this legislation puts into statute perceptions about pain medication that the scientific world has been trying to change. Physicians often believe that the aggressive use of certain pain medications, such as morphine, will hasten death. Recent scientific studies show this is not the case. Dr. Kathleen M. Foley, Attending Neurologist in the Pain and Palliative Care Service at Memorial Sloan-Kettering Cancer Center and Professor of Neurology, Neuroscience and Clinical Pharmacology at the Cornell University, had this to say about the Nickles-Hatch legislation, ``In short, the underpinnings of this legislation are not based on scientific evidence. It would be unwise to institutionalize the myth into law that pain medications hasten death.'' Renowned medical ethicist, and Director of the Center for Bioethics at the University of Pennsylvania, Arthur L. Caplan, Ph.D., also appeared before the Senate Judiciary Committee on April 25, 2000. He testified that: ``Doctors and nurses may not always fully understand what the law permits or does not, but when the issue requires an assessment of intent in an area as fraught with nuances and pitfalls as end of life care then I believe that this legislation will scare many doctors and nurses and administrators into inaction in the face of pain.'' Dr. Scott Fishman, the Chief of the Division of Pain Medicine and Associate Professor of Anesthesiology at the University of California Davis School of Medicine wrote of the Hatch substitute: ``It is ironic that the `Hatch substitute', which seeks to prevent physician assisted suicide, will ultimately impair one of the truly effective counters to physician assisted suicide, which is swift and effective pain medicine.'' Dr. Foley, who also assisted the Institute of Medicine committee that wrote the report ``Approaching Death,'' further testified that, ``The Pain Relief Promotion Act, by expanding the authority of the Controlled Substances Act, will disturb the balance that we have worked so hard to create. Physician surveys by the New York State Department of Health have shown that a strict regulatory environment negatively impacts physician prescribing practices and leads them to intentionally undertreat patients with pain because of concern of regulatory oversight.'' The New England Journal of Medicine editorialized against these legislative approaches to overturning Oregon's law out of concern for its impacts on pain management nationwide, saying: ``Many doctors are concerned about the scrutiny they invite when they prescribe or administer controlled substances and they are hypersensitive to `drug- seeking behavior' in patients. Patients, as well as doctors, often have exaggerated fears of addiction and the side effects of narcotics. Congress could make this bad situation worse.'' It is worth noting that many people and organizations with expertise in pain management and palliative care are both opposed to physician assisted suicide and opposed to the Nickles-Hatch bill. There are over thirty organizations representing doctors, pharmacists, nurses, and patients who oppose the legislation, including: American Academy of Family Physicians; American Academy of Hospice and Palliative Medicine, American Academy of Pharmaceutical Physicians; American Geriatrics Society; American Nurses Association; American Pain Foundation; American Pharmaceutical Association; American Society for Action on Pain; American Society of Health-System Pharmacists; American Society of Pain Management Nurses; College on Problems of Drug Dependence; Hospice and Palliative Nurses Association; National Foundation for the Treatment of Pain; Oncology Nursing Society; Society of General Internal Medicine; Triumph over Pain Foundation; California Medical Association; Massachusetts Medical Society; North Carolina Medical Society; Oregon Medical Association; Rhode Island Medical Association; San Francisco Medical Society; Indiana State Hospice and Palliative Care Association; Hospice Federation of Massachusetts; Kansas Association of Hospices; Maine Hospice Council; Maine Consortium of Palliative Care and Hospice; Missouri Hospice and Palliative Care Association; New Hampshire State Hospice Organization; New Jersey Hospice and Palliative Care Organization; New York State Hospice Organization; and, Oregon Hospice Association. Physician-assisted suicide is not a cry for help from people experiencing the failure of patents, copyrights and trademarks. Physician-assisted suicide is a cry for help from people who, in many cases, are experiencing a failure in the health system. And those failures occur across our nation; not just in Oregon. In one study reported in the August 12, 1998, issue of JAMA, over 15 percent of oncologists admitted to participating in physician-assisted suicide or euthanasia. The February 1997 New England Journal of Medicine published a report finding that 53 percent of physicians in a large, San Francisco-based AIDS treatment consortium admitted assisting in a suicide at least once. Personally, I am troubled and saddened that so many of our loved ones are so dissatisfied with their end-of-life options that they seek physician-assisted suicide, instead. Whether or not this Congress decides to overturn Oregon's law, I believe it is critical that whatever we do must result in a reduced demand for physician-assisted suicide, not only in Oregon, but across our nation. Many reputable experts believe the ``Pain Relief Promotion Act'' will cause physicians--far beyond Oregon's borders--to provide less aggressive pain care to their suffering and dying patients. If this occurs, not only will millions of our elderly and dying constituents suffer needlessly, we may unwittingly increase the demand for suicide at the end of life. I urge my colleagues, regardless of where they stand on the issue of Oregon's law, to join with me in supporting the restoration of the HELP Committee's jurisdiction. It would be unconscionable for the Senate to fail to correct an honest mistake that could contribute to a devastatingly significant change in health policy. With so much at stake, shouldn't we follow the regular order of the Senate? Shouldn't we insist that the Senate's best qualified health policy experts fully consider the complex policy implications before taking such an extraordinary risk for our constituents, our friends, and our families? Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. WYDEN

Mr. WYDEN. Mr. President, I am introducing legislation today to help retain a unique environmental recycling program launched by Nike, a home-grown Oregon business, which involves recycling running shoes rather than dumping them in a landfill. The bill would resolve an issue on which the U.S. Customs Service has taken inherently conflicting positions: whether a duty drawback can be claimed on an item that has no commercial value and is no longer an item in United States commerce but which is recycled rather than destroyed. I believe recycling should be promoted and not punished, and that is what this legislation does. Under existing U.S. Customs law, an importer is entitled to import duty drawback on products that are returned to the importer because they are defective. The point of this provision is to safeguard against an import duty being imposed on a product that does not end up in United States commerce. Customs law and regulation ensures that a product will not end up in U.S. commerce by requiring that the product be completely destroyed to the extent that the product has no commercial value, or that it be exported from the United States. In certain cases Customs has allowed duty drawback: for example, alcohol salvaged from destroyed beer and malt liquor which was sold as scrap rather than dumped as waste was accorded duty drawback. Consistent with Customs' requirements, for a number of years Nike destroyed the shoes and placed them in a landfill. This amounted to thousands of tons of non-biodegradable shoes being dumped in landfills. Because shoes are not biodegradable, Nike developed a new, more environmentally-sustainable way to dispose of the defective shoes by chopping them into small pieces, called ``re-grind,'' and giving the regrind without charge or compensation to manufacturers of sport surfaces. The re-grind became part of playground, basketball and other surfaces that was used primarily for charitable purposes in poor urban centers around the country. The program, called the ``Re-Use A-Shoe,'' is one of the many initiatives Nike has undertaken to incorporate environmental sustainability into its operations. The issue Customs has been grappling with is whether the re-grind is ``destroyed with no commercial value'' so as to qualify the destroyed shoes for duty drawback treatment. For several years Customs granted the re-grind shoes duty drawback, but a Customs audit team recently determined that the re-grind was not ``destroyed,'' as it had commercial value for court manufacturers and Customs recommended retroactive denial of Nike's drawback claims, totaling $11.6 million. Because Customs had already refunded the drawback, the audit team recommended that Nike repay the $11.6 million to Customs. It is clear from Customs' decisions that an article is considered destroyed when it has been rendered of no commercial value and is no longer an article of commerce. In this case, the defective footwear, once shred, is valueless and of no commercial interest to anyone. Even when the shredded material is subsequently processed by Nike to recover some material of limited use, the recovered material is not saleable to anyone and therefore has no commercial value. Mr. President, it seems to me that the position taken by the Customs audit team is not consistent with the intent of the duty drawback provision. There is no commercial value to Nike in the re-grind; the shoes have been destroyed. Nike gives the product to the manufacturer without charge or compensation, and the manufacturers have confirmed they would not pay for the material. I have copies of letters from each of the manufacturers attesting to the fact that they would not pay for the re-grind and that it is not commercially viable. It appears that the Customs audit team believes a more desirable outcome is to have Nike dump some 2 million pairs or 3.5 million pounds of shoes into a landfill rather than recycle the destroyed material. The outcome is the same: the shoes no longer have commercial value, nor are they a product in U.S. commerce. It would seem to me there is no public policy benefit in forcing Nike to dump the shoes in a landfill; but that there is much to be gained from recycling millions of pairs of shoes that would otherwise be dumped in a landfill. The legislation I am introducing today resolves the question in favor of recycling, in favor of the environment and in favor of a rational duty drawback policy. I ask unanimous consent that a copy of the legislation be printed in the Record.

Mr. WYDEN

Mr. WYDEN. Mr. President, I am here today to introduce legislation that will allow a valuable member of the Portland, Oregon, community to become a permanent resident of the United States of America. Rose-Marie Barbeau-Quinn, a native of Canada, has lived in Portland since 1976. Together with her husband, Michael Quinn, she ran the Vat and Tonsure Tavern, a unique and popular restaurant that was a favorite of many of my constituents. While Ms. Barbeau-Quinn and her husband, an American citizen, were together for over 16 years, their marriage did not take place until shortly before Michael's death in 1991. Since Rose-Marie and Michael were not formally married for the two years required by immigration law, and despite their 16 years together living as husband and wife, Rose-Marie has not been able to file for permanent residency in this country. This legislation will correct their injustice, and allow Rose-Marie to be a permanent resident of the country she loves and has called home for over 20 years. I first learned of Ms. Barbeau-Quinn's situation from Senator Hatfield when I joined the Senate in 1996. Senator Hatfield championed her cause in the 104th Congress, and, as his request and the request of many of my constituents, I am attempting to complete the work that Senator Hatfield started. We both firmly believe that Rose-Marie would be a model United States resident. I urge my colleagues to support this legislation, so that Rose-Marie Barbeau-Quinn can continue her place as a valuable member of our community for many years to come. I ask unanimous consent that the text of this bill be printed in the Record.

Mr. WYDEN

Mr. WYDEN. Mr. President, I am here today to introduce legislation that will allow a valuable member of the Portland, Oregon, community to become a permanent resident of the United States of America. Rose-Marie Barbeau-Quinn, a native of Canada, has lived in Portland since 1976. Together with her husband, Michael Quinn, she ran the Vat and Tonsure Tavern, a unique and popular restaurant that was a favorite of many of my constituents. While Ms. Barbeau-Quinn and her husband, an American citizen, were together for over 16 years, their marriage did not take place until shortly before Michael's death in 1991. Since Rose-Marie and Michael were not formally married for the two years required by immigration law, and despite their 16 years together living as husband and wife, Rose-Marie has not been able to file for permanent residency in this country. This legislation will correct their injustice, and allow Rose-Marie to be a permanent resident of the country she loves and has called home for over 20 years. I first learned of Ms. Barbeau-Quinn's situation from Senator Hatfield when I joined the Senate in 1996. Senator Hatfield championed her cause in the 104th Congress, and, as his request and the request of many of my constituents, I am attempting to complete the work that Senator Hatfield started. We both firmly believe that Rose-Marie would be a model United States resident. I urge my colleagues to support this legislation, so that Rose-Marie Barbeau-Quinn can continue her place as a valuable member of our community for many years to come. I ask unanimous consent that the text of this bill be printed in the Record.

Mr. WYDEN

Mr. WYDEN. Mr. President, as a member of the Senate Diabetes Caucus, I am concerned with the need for further research for a cure for diabetes. Recently, I had several meetings with constituents from Portland, Eugene, and Lake Oswego, Oregon concerning diabetes research funding. All of these constituents are young children or young adults living with this disease. One young woman told me that she has already lost three friends to this disease. For fiscal year 2000, the National Institutes of Health (NIH) received a $13.3 million increase over last year's funding for diabetes. This increase brings the total amount for diabetes research to $462.3 million. For those who have to live every day with diabetes and for those who are the parents of a child living with disease, and who have to worry every day about the long-term toll diabetes disease takes on their child, this is not enough. Diabetes can destroy nerves, harm eyesight, and cause a host of other deleterious effects on the body. While I am pleased that there was an increase in the funding of NIH for diabetes research last year, I believe we can and should do more to assure that we find a cure. While funding has increased from $134 million in fiscal year 1980, this only represents approximately 2 percent growth per year when adjusted for inflation. Considering the widespread and devastating effects of this disease, we should continue to support the funding increases for NIH research of diabetes. I know that many of my colleagues feel strongly about this issue as well. I hope we can work in a bipartisan manner to assure an increase in research funding to find a cure.

Mr. WYDEN

Mr. WYDEN. Mr. President, before I begin I want to thank Chairman Helms for his courtesy. There is no Senator more gracious. I particularly appreciate the Senator giving me the opportunity to speak today at this time.

Mr. WYDEN

Mr. WYDEN. Mr. President, this morning there is fresh evidence that millions of our older Americans cannot afford their prescription medicine. I have come to the floor of this Senate on more than 20 occasions now to make this point. But the news this morning comes at an especially important time. On both sides of Capitol Hill efforts are underway to develop a practical approach to making sure older people can get prescription drug coverage under the Medicare program. I have had the opportunity for many months now to work with colleagues on both sides of the aisle, and I am especially appreciative of the efforts of Senator Daschle to try to bring Members of the Senate together to find common ground in this session to get prescription drug coverage for older people. Under Senator Daschle's leadership, principles have been developed that every Member of the Senate would find appealing and attractive to. We have talked, for example, about how this program would be voluntary. No senior citizen who is comfortable with their prescription drug coverage would be required to do anything if they chose not to. That is something that would be attractive to both parties. We have talked about making sure this is a market-oriented approach, that we use the kind of forces that are available to individuals receiving coverage in the private sector through private insurance and through health maintenance organizations. We want to make sure the benefit is available in all parts of the United States. There are areas of this country where there may not be big health plans, but as long as there is a telephone, a pharmacy, and a mailbox, we are going to be able to get the medicine to those older people in an affordable way. Finally, many of my colleagues and I believe coverage ought to be universal. It ought to be available to all people on the Medicare program. The most important point--and it is why I come to the floor today--is that we have fresh evidence that millions of seniors can't afford their medicine. We have to take steps to make the cost of medicine more affordable to the elderly. There is a right way to do this and a wrong way to do this. The wrong way is to institute a regime of private controls, a Federal one-size-fits-all approach because that involves a lot of cost shifting to other groups of citizens. If we just have Federal price controls for the Medicare program, a lot of women who are 27, single, with a couple of kids will see their prescription drug bill go through the roof. We will have to develop a market-oriented approach along the lines of what Members of Congress receive through the Federal Employees Health Benefits Plan. That way we can give senior citizens the kind of bargaining power that folks have in a health maintenance organization or in a private plan. We could do it without price controls that produce a lot of cost shifting. This is an important date in the discussion about prescription drugs. Our older people don't get prescription drug coverage under the Medicare program. That has been the case since it began in 1965. When they walk into a pharmacy and don't have coverage, in effect, they are subsidizing the big buyers--the health maintenance organizations and the private plans. I hope we can come together in the Senate to find common ground. Senator Daschle is trying to bring Members of the Senate together. I know there are colleagues on the other side of the aisle who feel exactly the same. Let's not let this issue go off as campaign fodder for the 2000 election. Let's not adjourn this session without coming together and enacting this important benefit for the elderly. I don't believe America can afford not to cover prescription medicine. A lot of these drugs today might cost up to $1,000, such as an anticoagulant drug that is so important for the elderly. That is certainly a pricey sum. If a senior citizen can get anticoagulant medicine to prevent a stroke that would cost upwards of $100,000 or $150,000, it is pretty clear that prescription drug coverage is a sensible and cost-effective approach for the Senate to take. I intend to return to the floor in the future, as I have done on more than 20 occasions, in an effort to bring the Senate together. I am especially appreciative of Senator Daschle's patience in our effort to try to find common ground. I know there are colleagues on the other side of the aisle who feel the same. I yield the floor.

Mr. WYDEN

Mr. WYDEN. Mr. President, budgets aren't just about charts and graphs and cold figures on a sheet of paper. Budgets are about the hopes and aspirations of the American people and our core values. In my view, if the Senate passes the Robb amendment this morning, it will send a message to the millions of senior citizens and families across this country that their hope of prescription drug coverage under Medicare is a priority for the Senate. If the Senate passes the Robb amendment, it will be a chance to build on the progress that was made on the prescription drug issue in the Budget Committee. I particularly thank my colleagues, Senator Snowe and Senator Smith. In the Budget Committee, we were able to lock in a hard figure of $40 billion to start this prescription drug program. Just as important, in the Budget Committee, there is a stipulation that if the Finance Committee doesn't act on the prescription drug issue on or about September 1 of this year, it is possible for any Member of this Senate, without points of order, to come directly to the floor. So we have been able to register our commitment behind the urgency of prescription drug coverage for older people. The Robb amendment recognizes that the revolution in modern health care has bypassed the Medicare program. Every major private sector player in the health care field understands that pharmaceuticals are essential because they help to keep people well. Medicare Part A, on the other hand, will pay thousands of dollars for senior citizens' hospital bills, but Medicare Part B will not pay for outpatient prescription drug coverage to help older people stay well. So that is why this is so important to the American people, and the Robb amendment says to all of those senior citizens who are breaking their pills in half because they can't afford their medicine or taking two pills when they ought to be taking three, who ought to be taking a drug such as Lipitor to deal with cholesterol and blood pressure and can't afford it, we have heard that, we understand how important this coverage is to older people. If we pass the Robb amendment, it will not be possible for Members of this body to get to the end of the session and then say, gee, there just wasn't time to deal with this issue that is so important to seniors and families. This amendment is critical to the hopes and aspirations of the American people. They are asking that prescription drug coverage be added to this program. I yield the floor.

Mr. WYDEN

Mr. WYDEN. Thank you, Mr. President.

Mr. WYDEN

Mr. WYDEN. Mr. President, I come to the floor today to talk about a very encouraging development and solution with respect to prescription drugs. I have come to the floor on more than 20 separate occasions over the last several months to talk particularly about how America can no longer afford to deny this critical coverage. Again and again, I cited examples on the floor of this Senate about how our country cannot afford to deny seniors the opportunity to get prescription drug coverage. I have talked, for example, about the exciting anticoagulant drugs. These drugs allow a senior citizen, for example, for perhaps $1,000 or $1,500, to prevent a stroke which might end up costing more than $100,000. What is so exciting about these prescription medicines is that they don't just help older people when they are very ill, but they are absolutely key to keeping older people healthy by lowering blood pressure and cholesterol. They will help senior citizens stay in the community and will keep them from racking up those much larger health care expenses under what is known as Part A of the Medicare Hospital Insurance Trust Fund. Again and again, we have seen examples of how cholesterol-lowering drugs can reduce death and expenses for senior citizens. For example, heart disease is the leading cause of death for persons 65 and older. Beta blockers can reduce long-term mortality by 25 percent, and they cost about $360 a year, or $30 a month. One in five older women has osteoporosis. About 15 percent have suffered fractures as a result this disease. This disease is the leading risk factor for hip fractures. Estrogen replacement can reduce the risk of osteoporosis as well as cardiovascular disease. One commonly used drug costs $20 a month. This is an investment that can help avoid those hip fractures and help avoid the extraordinary medical expenses. I must say that my own mother, who will be 80 years of age very shortly, had a hip fracture recently, and this drove home to me how these prescription medicines can help avoid the kinds of health problems that my mother and scores of others seniors have seen, and how providing coverage now is an investment this Senate cannot afford to pass up. What was exciting about the developments in the budget resolution was, first, that the Budget Committee committed $40 billion would be committed for this important program. For example, on the other side of the Capitol, the House of Representatives talked about $40 billion, but they could spend it on just about anything in the health care arena. The Senate Budget Committee said we are going to make $40 billion available for prescription drugs because it is high time we set in place this important coverage. Second, we provided a date certain to get this job done. Our colleague from Louisiana, Senator Breaux, has been correct to say repeatedly that the Senate Finance Committee has now held 14 hearings on this issue. Clearly there is great interest in that committee in moving forward. The budget resolution says on this point that if the Senate Finance Committee does not come forward with a prescription drug benefit on or before September 1st of this year, any Member of the Senate can come to the floor of this body and bring this issue before the Senate. The Presiding Officer of the Senate, who serves with me on the Senate Committee on Aging, could come to the floor if he had a plan to deal with prescription drugs. Senator Snowe and I have teamed up on a bipartisan basis. We are particularly grateful for the help of Senator Gordon Smith last week in the Budget Committee. The resolution allows any group of Senators to come forward with legislation if the Senate Finance Committee does not report a prescription drug measure on or before September 1st of this year. I think it is critical to note that many Senators in the leadership of both political parties were involved in this effort. Senator Daschle has talked to me almost daily about the importance of the Senate dealing with this issue, and dealing with it this year. He has worked very hard to try to reconcile the various approaches Senators have on this issue. He also has been steadfast in saying how important it is that the Senate not put this off until after another election. There may be some colleagues on the Republican side and some on the Democratic side who will say: Let's just talk about this in the political campaign. I believe we can't afford to deny this coverage to the Nation's senior citizens. Senator Daschle has been resolute in saying we ought to go forward and deal with this issue, and deal with it in this session of Congress. I also want to commend several of my colleagues on the other side of the aisle: Senator Domenici, for example, in the Budget Committee, when this issue got to a flash point; it would have been very difficult even to go forward. Senator Domenici worked with several of us, particularly Senator Snowe and Senator Smith, in order to bring the committee together on this point. We had some bipartisan support last week in the Budget Committee for taking tangible action on this issue. What is really important is that every Senator understands that I and others are going to stay at this issue again and again and again so the Senate does not miss this historic opportunity. Too often, whether dating back to catastrophic health care legislation or the failed efforts in 1993 and 1994 to pass comprehensive health care reform, we have muffed. The Congress has muffed the opportunity to put in place a historic breakthrough in terms of health care in our country. I think we have another such opportunity as a result of the work that was done in the Budget Committee last week. Only about one in four of our senior citizens has prescription drug coverage. Many of them take up to 20 medicines a year. Something like 20 percent of the Nation's senior citizens spend over $1,000 out of pocket now on their prescription medicines. As a result of these and other factors, there is not a single specialist in the health care field and not a Democrat or a Republican who would create a Medicare program today without including prescription drug coverage. That is why the breakthrough we saw in the Budget Committee last week is so important. I think it is absolutely critical that we keep what was done in the Budget Committee throughout this process. It may be challenged on the floor of the Senate this week. My understanding is that there will be Senators opposed to it, but I think we can build on the work that was done last week in the Budget Committee. Again, I commend Chairman Domenici, Senator Snowe, and Senator Gordon Smith, my colleague from Oregon, for working with us on it--we can get this done; we can ensure that action on prescription drugs is tied to reform of the Medicare program. Many of my colleagues have stressed this. I think they are right. I, too, happen to believe it would be better to have comprehensive Medicare reform that includes prescription drug coverage. I think it is also clear--and I stress this because it is so important to this Senator and many on this side of the aisle--that we cannot afford to wait. We want to use competitive purchasing principles for prescription drug benefit. We will use the kind of principles that make sense in private sector health care. We will ensure the benefit is voluntary. No senior would have to choose this particular benefit if they preferred their existing coverage. However, we do want to put in place a universal coverage program. We want to get it done before this Congress adjourns. We are going to fight with all our strength to protect what was done in the Budget Committee last week on the floor of the Senate this week and when it goes to conference and throughout the process so that if the Senate Finance Committee does not act to provide this benefit on or before September 1 of this year, that any Member of this body will be able, without facing points of order, come to the floor of the Senate and force the Senate to deal with this critical issue. I am sure when my colleagues go home and talk to constituents they will find what I have found; that is, the question of prescription drug coverage is one of the two or three most pressing issues our constituents care about. We have families and older people all across this country who are walking on an economic tightrope balancing their food bills against their fuel bills and their fuel bills against their medical costs. I have been bringing to the floor of the Senate cases of older people who are supposed to take three pills and they take only two. They are breaking their lipid-lowering capsules in half--the drugs that help to deal with cholesterol and heart problems--because they cannot afford to take the full pill. I spoke recently about a case from Hillsboro, OR, my home State. A physician actually put an elder person in a hospital for 6 weeks because that elderly man could not afford the medicine on an outpatient basis. Allowing outpatient coverage of medicine is what we are trying to accomplish in the Senate. Seniors could get their medicine without going into the hospital. That older gentleman in Hillsboro, OR, had to be hospitalized for 6 weeks so he could get his medicine paid for under what is known as Part A of the Medicare program. That is a classic example of how, under today's health care system, dollars are wasted by having a person hospitalized rather than getting help in the community and, at the same time, facing the predicament of taking longer to get healthy than if these benefits have been available more promptly on an outpatient basis for the elderly. Last week's developments in the Budget Committee were encouraging. Many predicted the Budget Committee would not adopt binding language with respect to prescription drugs that would allow the Senate to get this program enacted, and get it enacted this year. However, the Budget Committee came together. I commend my colleagues, Senator Snowe and Senator Gordon Smith. They have worked with me for 15 months. We now have funding available in the budget resolution. We have a date certain when it can actually come before the Senate. If the Finance Committee doesn't act on or before September 1, any Senator could bring this issue to the floor of the Senate and it would be tied to the question of Medicare reform. There is a long way to go. We have to get through the discussion this week. Then we will have a conference committee. Then many Members will work closely with the Finance Committee where there are many interested Senators who have devoted time to this prescription drug issue. What was done in the Budget Committee last week was something of a breakthrough. It was a very encouraging development for the millions of seniors and families who are watching how Congress deals with this issue, watching to make sure we do it this year, do it on a bipartisan basis, and not just send it out to be another topic and cannon fodder for the political campaign this fall. As I have made clear, I intend to keep coming back to the floor again and again raising examples of why this Nation cannot afford to deny prescription drug coverage for the elderly. More than 4,000 seniors from Oregon have written me since I have begun this effort. The cases illustrate in a dramatic way how important it is that Congress deal with this issue now. I intend, with my colleagues, to come back again and again and again until we get this coverage for the Nation's older people. This country can no longer afford to have the Congress deny this coverage. With the work done in the Budget Committee, we have an opportunity now to deal with this issue promptly. The seniors who come to our town hall meetings with their prescription drug bills tell how their private insurance doesn't cover their prescriptions. Because they cannot afford prescription medicine, very often they get sicker. They are the ones who have a right to expect this Congress to act. The developments last week for the first time give me a tangible sense that we are going to be able to get this done. It was concrete evidence that the Congress understands how important this issue is. Many of my colleagues have said this is one of their top two priorities for this session of Congress. Certainly it is for this Senator. We are going to keep coming back to this floor, stressing the need for action on their prescriptions until the Senate moves to do what should have been done years ago. When Medicare was enacted in 1965, it did not cover prescription drugs. Now the big buyers, the health maintenance organizations and the health plans, are able to negotiate discounts. That means senior citizens in Alabama, Oregon, and across the country pay more for their medicine because they are not able to get the benefits of the big buyers. Seniors are going to have the power of the big buyers if we can act this session. A number of the key bills before the Senate give older people bargaining power in the marketplace in order to be able to afford their medicine. That is key-- affordability--the ability of senior citizens to afford their prescription medicine so they don't have to give up food, rent, and heat. Making drugs affordable for seniors has been important to all Members who have focused on this issue. Yet there are many seniors who struggle to make ends meet because they cannot get medicine in an affordable way. The budget resolution provides the opportunity now for those seniors to get relief. I will do everything in my power, and there are many of my colleagues who will, as well, to defend what was done in the Budget Committee last week on prescription drugs throughout this process. If we have a floor fight on this measure, those who try to knock out what the Budget Committee did ought to understand how strong Members feel who worked to get that prescription drug coverage in the budget resolution. I hope we will not see that kind of fight. I hope the work done by Senator Snowe and Senator Smith, along with Senator Daschle, Senator Conrad, and myself, the group of Members who worked with the Budget Committee, can be preserved. It ought to be preserved for the Nation's senior citizens. Those are the people who are counting on us to deliver on this critical issue. I intend to keep coming back to this floor again and again and again until we have achieved this major health care reform that the older people of this country richly deserve. Mr. President, I yield the floor and I suggest the absence of a quorum.

Mr. WYDEN

Mr. WYDEN. Mr. President, over the last 3 months I have come to the floor of the Senate on more than 20 occasions to talk about the need to assist the Nation's senior citizens and families under Medicare with help with the extraordinary costs so many of them are experiencing for prescription medicine. I am very pleased to report some very exciting, positive developments that have taken place in the last few hours on this issue as a result of the bipartisan effort in the Budget Committee. I particularly want to commend my colleagues Senators Snowe and Smith. Senators Snowe and Smith have teamed up with me on a bipartisan basis for more than 15 months to address this enormous need of the Nation's older people. Today in the Budget Committee we took a concrete, tangible step to set in place the kind of program that really will provide meaningful relief for the Nation's older people. We did it in a way that will be consistent with long-term Medicare reform, a view that is a view shared by Members on both sides of the aisle. It allows for universal coverage and a program that is voluntary. That is to ensure that older people can make the choices that are good for them. Specifically, what the Budget Committee did is provide legislation that would allocate $20 billion during the next 3 years to put in place a prescription drug program, and then make it possible to add another $20 billion in the next fiscal year, which would be fiscal year 2004- 2005, as part of an effort to ensure solvency, long-term Medicare reform, and to do it in a way that would not cause an on-budget deficit in those later years. I have believed for a long time that at a time when more than 20 percent of our Nation's older people are spending over $1,000 a year out of pocket on their prescription medicine, when we have millions of seniors with an average of 18 prescriptions a year, that it is important we put in place, on a bipartisan basis, meaningful relief for the Nation's older people. Today, on a bipartisan basis, the Budget Committee said the Finance Committee should report a plan on or before September 1 of this year to help older people with their prescription drug medicine to ensure that $20 billion would be available for fiscal years 2001, 2002, and 2003, and, accompanied by real reform of the Medicare Program, there could be $20 billion for fiscal years 2004 and 2005. This required, frankly, compromise on both sides. For example, one of the stipulations in what was done by the Budget Committee today was a stipulation that there could not be transfers of new subsidies from the general fund to extend solvency. Frankly, some of my colleagues on the Democratic side of the aisle had supported those kinds of transfers in the past. I think after many months of debate, and certainly a lot of prognosticators saying it was not possible in this session of Congress to make real headway on the prescription drug issue, and, in fact, to get the job done, what the Senate Budget Committee showed this morning in a very significant breakthrough is that we are now on our way to address the needs of older people. In fact, this language would be binding. The language adopted by the Budget Committee, setting out the parameters for the adoption of a prescription drug program for the Nation's elderly under Medicare, would be binding. In addition to my two colleagues Senators Snowe and Smith, I would like to single out a number of others on a bipartisan basis who helped us. Chairman Domenici, for example, was one who, in many conversations with me on this issue, talked about the need to make this program consistent with long-term Medicare reform and to make Medicare more solvent in the future. That is an issue that has been highlighted by Senators Daschle, Lautenberg, and Conrad as well. But the fact that Senator Domenici emphasized that in the last couple of days helped us find common ground this morning. This is a vast improvement on what the House has thus far been able to accomplish on this issue of prescription drugs. Specifically, the Senate made it clear we could launch a prescription drug program that would offer $40 billion of assistance to the Nation's older people, a program that would assist all senior citizens. So the Senate was able, this morning, in the Budget Committee, on a bipartisan basis, to add a significant amount of additional relief. That was important. The House did not address the solvency issue and that is what, in fact, the Senate did. In that sense it is a dramatic improvement. What we did, in terms of the dollars on a bipartisan basis, is today we raised the amount the Senate would make available for the program to $40 billion. Originally that amount was $20 billion. The fundamental point remains. We addressed this issue by adding more money than was originally envisaged in the mark that came out from the Senate. We were able to do it in a way that addressed the Medicare solvency question. The House did not really touch the Medicare solvency question, and we think, on a bipartisan basis in the Senate this morning, that was important. Finally, we know the revolution in American health care has essentially bypassed the Medicare Program. A lot of these medicines today help older people to stay well. They help to lower blood pressure. They help to lower cholesterol. They are medicines that promote wellness. They do not just take care of folks when they are sick. As a result of the work done today, we made a major step forward in modernizing this program and bringing it in line with the rest of the American health care system. I reported on the floor of the Senate recently a case of an older person in Hillsboro, OR, who had to be hospitalized for 6 weeks because Part A of Medicare would pay his prescription drug bill and he could not afford his medicine on an outpatient basis. Today, as a result of what the Senate Budget Committee did, that person will be in a position to get his medicine on an outpatient basis. They will be able to get help because the Senate improved on what the House has been talking about by putting more of a focus on solvency, and we were able to take the amount of the program up to $40 billion beyond what the original discussion had been in the Senate, just $20 billion. Finally, we need to understand there is a long way to go from here. We are going to have to defend what was done by the Senate Budget Committee this morning on the floor of the Senate. Then we will have a conference with the House. I hope we will come out of that discussion with the House ensuring there is $40 billion for the prescription drug program, that it is possible to have universal coverage, that it is voluntary, that it is consistent with Medicare reform, and that it gives older people bargaining power in the private sector to get more affordable medicine. There is a long way to go in the process. This morning's breakthrough was just one step in the process. It was a chance to go forward in a way that is fiscally responsible--$20 billion for the first 3 years to as the first downpayment, as Senator Snowe has characterized it, on prescription drug relief, but then also to say there will be another $20 billion available in 2004 and 2005 when it is accompanied by reform. We also work to ensure solvency, and for the first time, we put real time constraints on getting a prescription drug benefit done . As was pointed out yesterday in the Senate Finance Committee by Senator Breaux, there have been 14 hearings on the issue of Medicare reform and prescription drug coverage for older people. Senator Breaux, along with Senator Frist, has a bipartisan bill supported by a number of Members of the Senate. What we said this morning in the Budget Committee is that we want the Finance Committee, on or before September 1 of this year, to bring us legislation in line with the binding language offered in the Senate Budget Committee under the Snowe-Wyden-Smith amendment. Having come to the floor of the Senate on more than 20 occasions, as I related those stories about older people who had been put in hospitals because they could not afford their medicine on an outpatient basis, older people who were taking two pills a day when they should have been taking three, or breaking their Lipitor capsules--which deals with cholesterol and heart problems--in half, I often thought as I left the floor that we might not be able to make the kind of progress we made today in the Budget Committee. Today, the Budget Committee came together on a bipartisan basis to ensure there would be sufficient funds to jump-start Medicare reform, provide meaningful relief for the Nation's older people and their families, while addressing the solvency question and the need for an approach to be consistent with long-term Medicare reform. We have improved on what is being discussed in the House because they do not have the same focus on solvency. I am very much looking forward--as we bring that legislation to the floor of the Senate and it goes to conference and the work in the Finance Committee--to continue the progress we saw this morning. Suffice it to say, there were a number of moments today when it was likely that it was all going to break down. Had the Budget Committee reported a significantly smaller sum than was finally agreed on, had we not made the kind of changes in the Snowe-Wyden-Smith amendment, we might not have been able to reach a bipartisan agreement on prescription drugs this year in the Congress. As a result of what happened today in the Budget Committee and the important work that was done on a bipartisan basis, we have laid the foundation for making sure that before this Congress adjourns and goes home for the year, we have acted to help the Nation's older people. For all of those seniors and for all the families who are walking an economic tightrope, balancing their food costs against their fuel bills and their fuel bills against their medical bills, my admonition this afternoon is that we have a long way to go, but today we really made progress. Today, as a result of bipartisan work, we have an opportunity to ensure that by fall, on or before September 1, as the amendment adopted in the Budget Committee requires, we have a proposal that is bipartisan, that is one which provides meaningful relief for older people, that is voluntary, offers universal coverage, and is consistent with long-term Medicare reform. We can have that kind of proposal on the floor of the Senate this fall. For the millions of seniors and families who are watching the Congress and looking to see if we can deliver on this issue, progress was made today. I particularly commend Senator Snowe and Senator Smith. Senator Smith made a very constructive suggestion towards the end of the markup when we had a debate about when the Budget Committee was seeking a product from the Finance Committee. Senator Smith offered a very constructive suggestion. If we can continue to build on that bipartisan progress, we can get this job done. I believe--and I will wrap up with this--this country can no longer afford to deny coverage for senior citizens' prescription needs under Medicare. I use those words deliberately. People ask if we can afford to offer the coverage. I am of the view that we cannot afford not to offer this coverage because the revolution in American health care is about these new medicines that help people stay well. I have pointed out repeatedly that one can spend $1,000 or $1,500 on anticoagulant medicines that help prevent strokes and can stop a stroke that costs more than $100,000. Today, we made very significant progress in ensuring that no longer does the revolution in American health care bypass the Medicare program. I look forward to defending what was done in the Budget Committee on prescription drugs on the floor of the Senate when we get to the budget and working with the Finance Committee. Senators Moynihan and Roth have been very gracious in assuring there will be an opportunity for colleagues in both parties to contribute and offer their ideas and suggestions. If we can continue to build on the progress that was made today in the Budget Committee, we will get this done, and we will get it done before the end of this session. In my view, this will revolutionize American health care and provide meaningful relief to older people and their families. Mr. President, I yield the floor and suggest the absence of a quorum.

Mr. WYDEN

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

Mr. WYDEN. I ask consent to speak for up to 15 minutes as in morning business.

Mr. WYDEN

Mr. WYDEN. Mr. President, I am introducing today the Wireless Eavesdropping Protection Act. This bill will enhance the privacy rights of wireless subscribers by strengthening the laws that prohibit eavesdropping wireless communications. Since the early days of wireless communications, Congress has paid particular attention to the privacy rights of wireless subscribers. Unfortunately, despite our best efforts, electronic eavesdroppers have been able to find loopholes in the law. I am pleased to be joined in this effort by the Senator from Montana, Senator Burns. Using the loopholes, electronic eavesdroppers have been able to develop a ``gray market'' for modified and modifiable wireless scanners. Some of these individuals even advertise in magazines and on Internet websites that their products can be altered easily to pick up cellular communications. The information and equipment necessary to make these modifications are also widely advertised, sometimes with blatant offers to unblock the cellular frequencies after the equipment is purchased. The Wireless Eavesdropping Protection Act attacks these problems on several fronts. First, it would expand the definition of the frequencies that may not be scanned to include digital Personal Communications Service (PCS) frequencies as well as cellular ones. The legislation recognizes that some frequencies are shared between commercial mobile services and public safety users, and that the use of scanners to monitor public safety communications may assist in saving lives. As to those frequencies, the Federal Communications Commission (FCC) may adopt such regulations as may be necessary to enhance privacy. Second, the bill would clarify that it is just as illegal to modify scanners for the purpose of eavesdropping as it is to manufacture or import them for this purpose, and it would direct the FCC to modify its rules to reflect this change. The bill also would amend current law to prohibit either the intentional interception or the intentional divulgence of wireless communications, so that either action on its own would be prohibited. Finally, the bill would require the FCC to investigate and take action on wireless privacy violations, regardless of any other investigative or enforcement action by any other federal agency. This provision would help ensure that these newly strengthened privacy protections are full enforced in the future. The millions of Americans who use wireless communications deserve to have their privacy protected. They should be able to enjoy the same privacy protection as landline phone users. The Wireless Eavesdropping Protection Act will help provide those protections, and I urge my colleagues to join Senator Burns and me in supporting this legislation. I ask unanimous consent that a copy of the bill be printed in the Record.

Mr. WYDEN

Mr. WYDEN. Mr. President, I am introducing today the Wireless Eavesdropping Protection Act. This bill will enhance the privacy rights of wireless subscribers by strengthening the laws that prohibit eavesdropping wireless communications. Since the early days of wireless communications, Congress has paid particular attention to the privacy rights of wireless subscribers. Unfortunately, despite our best efforts, electronic eavesdroppers have been able to find loopholes in the law. I am pleased to be joined in this effort by the Senator from Montana, Senator Burns. Using the loopholes, electronic eavesdroppers have been able to develop a ``gray market'' for modified and modifiable wireless scanners. Some of these individuals even advertise in magazines and on Internet websites that their products can be altered easily to pick up cellular communications. The information and equipment necessary to make these modifications are also widely advertised, sometimes with blatant offers to unblock the cellular frequencies after the equipment is purchased. The Wireless Eavesdropping Protection Act attacks these problems on several fronts. First, it would expand the definition of the frequencies that may not be scanned to include digital Personal Communications Service (PCS) frequencies as well as cellular ones. The legislation recognizes that some frequencies are shared between commercial mobile services and public safety users, and that the use of scanners to monitor public safety communications may assist in saving lives. As to those frequencies, the Federal Communications Commission (FCC) may adopt such regulations as may be necessary to enhance privacy. Second, the bill would clarify that it is just as illegal to modify scanners for the purpose of eavesdropping as it is to manufacture or import them for this purpose, and it would direct the FCC to modify its rules to reflect this change. The bill also would amend current law to prohibit either the intentional interception or the intentional divulgence of wireless communications, so that either action on its own would be prohibited. Finally, the bill would require the FCC to investigate and take action on wireless privacy violations, regardless of any other investigative or enforcement action by any other federal agency. This provision would help ensure that these newly strengthened privacy protections are full enforced in the future. The millions of Americans who use wireless communications deserve to have their privacy protected. They should be able to enjoy the same privacy protection as landline phone users. The Wireless Eavesdropping Protection Act will help provide those protections, and I urge my colleagues to join Senator Burns and me in supporting this legislation. I ask unanimous consent that a copy of the bill be printed in the Record.

Mr. WYDEN

Mr. WYDEN. Mr. President, for the last 3 months I have come to the floor of the Senate on more than 20 occasions to talk about the need for this Congress to pass legislation that would cover senior citizens' prescription drug needs under Medicare. I have said again and again that this country can no longer afford not to cover prescription drugs. Before we broke for the work period at home, I talked about a case, for example, from Hillsboro, OR, of a senior citizen who had to be placed in a hospital for more than 6 weeks because he could not afford his medicine on an outpatient basis. Just think about that wasted money. The older person could not get help on an outpatient basis for his medicine, and the doctor said we have no choice but to put that person with a leg infection in the hospital so he can get prescription drug coverage under Part A of the Medicare program. Today, I brought with me a letter from an elderly woman in Phoenix, OR. She receives $1,100 per month in Social Security. Her prescription drug bills run $1,000 a month. She is 74 years old, and she wrote me: What can you do to help? I think it would be a tragedy for this Congress to not go forward on a bipartisan basis and enact meaningful relief for the Nation's older people who are getting clobbered with these prescription drug bills. Again and again, we are hearing from seniors in these instances where they have been hospitalized because they could not afford their medicine on an outpatient basis, where when they are done paying for their prescription drugs for the month, they have only a couple hundred dollars left to pay for food, heat, and housing. In a country as strong and prosperous as ours, we can't allow this kind of tragedy to continue. I think it is absolutely critical that this be addressed on a bipartisan basis. For many months now, I have teamed up with the Senator from Maine, Ms. Snowe, on a bipartisan bill. We use marketplace forces to ensure that older people have bargaining power in the private sector to be in a better position to afford their medicine. Right now, these HMOs get big discounts; they have lots of clout in the marketplace--HMOs and the private sector plans. If you are an older person who walks into a local pharmacy, you in effect have to subsidize those big buyers. You get shellacked twice. Medicare doesn't cover prescription medicine and, in effect, in the marketplace you subsidize the people with clout. The Snowe-Wyden legislation uses private sector bargaining power, along the lines of what we have in the Congress with the Federal Employees Health Benefits system, so that the dollars seniors use for private health insurance are pooled, and they have real negotiating power so they are in a position to get more reasonable prices for their medicine. Some have said we ought to just put the Government in charge of this, sort of have rate regulation. Well, I think that would be a big mistake. The biggest concern I have about that approach is it would cause a lot of cost shifting. You could have the Government be the big kid on the block and drive the system through the Health Care Financing Administration, but you would put all the costs onto somebody who is 27 or 28 and is working hard trying to get ahead, and their prescription drug bill would have gone up because the Congress didn't address this Medicare issue in the right way. Fortunately--and I think he deserves enormous credit--Senator Daschle has been working to try to reconcile the various approaches. He has talked with me about this issue, almost on a daily basis, in an effort to try to have the Senate come together and enact meaningful relief. He stakes out principles that I think can be supported on both sides of the aisle--principles such as making sure the program is voluntary, that no senior citizen be required to do anything; if they wanted to keep their current coverage, they would be allowed to do that. We want to make sure the action we take on prescription drugs is consistent with long-term Medicare reform. I think the approach I have advocated, in terms of creating more choices and more options in the marketplace, is consistent with responsible Medicare reform. We have talked about bargaining power in the private sector, the way the responsible private insurance companies have acted. I think that is something that will attract Members on both sides of the aisle. I think Senator Daschle is absolutely right in terms of trying to bring the Senate together to find the common ground and pass meaningful legislation. We will have a chance this week to make the first significant step in the Senate toward passing this legislation. As the Budget Committee meets--and I sit on the Budget Committee, and Senator Snowe sits on the Budget Committee--we will have a chance to ensure that in this budget, which is not just facts and figures but, really, the hopes and aspirations of the American people--we, in effect, set aside the funds needed to go forward and enact a meaningful prescription drug program for the Nation's older people. I don't want to see this Congress adjourn without making this important addition to the Medicare program. There is not a single expert in the health field--Democrat or Republican--who doesn't believe that if you designed the Medicare program from scratch today, you would not cover prescription drugs. They all think it is something that is essential to meaningful Medicare reform. I intend to keep coming back to this floor again and again and again throughout this session of the Congress to talk about prescription medicine. For about 7 years, before I had the honor of being elected to the other body, I was director of the Gray Panthers at home. We believed that prescription drug coverage in Medicare was important then. But, frankly, it is vastly more important now because the drugs of this century essentially aren't just drugs that, as we saw back then, are primarily to help people when they are sick; the new drugs are absolutely key to helping folks to stay well. They help folks to lower blood pressure and cholesterol. It is a way to hold down Medicare costs. Because of the result of folks being able to stay healthy, they don't land in the hospital and incur enormous costs that are engendered by Part A of the Medicare program. I am going to keep coming to the floor of this body to talk about the need for bipartisan action on prescription drugs, to urge the Senate to follow the counsel of Senator Daschle. I know Senator Snowe and others on the other side of the aisle are interested in finding common ground. I am going to keep urging that we work on this issue and not adjourn this session of Congress until we have provided this relief to the Nation's older people. I come again with a whole sheaf of cases of older people who are writing and asking what we can do to help. They are asking Congress to act this year, not put this off until after the election and use it as a political football again. I think we owe it to the Nation's older people and their families to address this issue, as Senator Daschle suggests, in this Congress; that we come together as Members of the Senate to make this improvement to the Medicare program that is long overdue. I intend to keep coming back to the floor of this body again and again and again reading these direct and very poignant accounts about why this coverage is so important until we get this legislation enacted. I yield the floor.

Mr. WYDEN

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

Mr. WYDEN

Mr. WYDEN. Mr. President, many working Americans fell like they've been left on the sidelines in the high-stakes game of international trade. As U.S. companies expand overseas, corporate profits soar. Workers standby watching for some tangible benefits for their own pocketbooks. A May 1999 Los Angeles Times story captured Americans' skepticism toward trade. The story found just over half the public in March 1994 believed that treaties such as NAFTA would create U.S. jobs, with only 32% fearing jobs loss. But by December 1998, the attitudes had flip-flopped. A Wall Street Journal/NBC News poll found that 58% of Americans believed that trade had reduced U.S. jobs and wages. Nowhere has Americans' growing alienation from the world trading system been more evident than at the November 1999 World Trade Organization (WTO) Ministerial meeting. The nightly news was filled with the pictures of workers protesting the WTO in the streets of Seattle. This sense of alienation will continue to grow unless workers themselves start to see more direct benefits from trade. The legislation I am pleased to introduce today with Senator Baucus is an effort to narrow America's dividend divide in world trade. Our bill, The Working Families Trade Bonus Act, says that when companies win from world trade, workers should win, too. The bill would do this by encouraging companies to give their workers added Trade Bonus stock options--which workers at Fortune magazine's top 100 U.S. companies identified as one of the key reasons they work for the company. And for the millions of working Americans who don't have stock plans--farmers, self-employed and small business people--the bill would allow them to double the maximum allowable annual IRA contribution. The bill specifically targets workers who are often excluded by company stock option plans--those at the lower end of company pay scales. The Trade Bonus program prohibits a company from discriminating in favor of highly compensated employees and requires that all employees be allowed to purchase the maximum amount of stock allowed by law at the lowest price allowed by law. The program would not allow companies to substitute stock options for regular compensation. Together, these safeguards assure that all workers are included in the trade winner's circle. Proponents of free trade, like Senator Baucus and myself, have done a lot of talking about its benefits. Manufactured goods are the centerpiece of our nation's export--accounting for nearly two-thirds of total U.S. exports of goods and services. Exports support about one in every five American factory jobs. These jobs pay about 15 percent more on average than non-export-related jobs, require more skills and are less prone to economic downturns than those accounted for fully one- third of our nation's economic growth, and since 1950, international trade flows have grown twice as fast as the economy. Yet, most workers have few good things to say about free trade because they've never seen any direct benefits from it. It's time to turn the rhetoric about free trade into real benefits for workers. It's time to widen the winner's circle to make sure that American workers share directly in the rewards of free trade. Our legislation would require the Secretary of Commerce to determine annually, beginning with 1998, whether international trade has contributed to an increase in U.S. GDP. This determination would be included in the President's budget for the subsequent fiscal year. For every year in which the Secretary makes a determination that trade has contributed to an increase in the U.S. GDP, employers would be encouraged to contribute additional compensation up to $2,000 per worker per year to employee stock purchase plans. These additional contributions to an employee's stock purchase plan--the Trade Bonus-- would not be subject to capital gains tax. For workers who are not eligible for an employee stock purchase plan Trade Bonus, the bill allows them to double the allowable annual amount of their IRA contribution--to a maximum of $4,000. For employers with 100 or fewer employees that do not have employee stock purchase plans, the bill would give them a significant incentive to create them; the bill offers a one-time tax credit to help offset all the administrative fees directly related to establishing an employee stock purchase plan. It would also provide limited tax credits for three subsequent years for costs directly related to IRS compliance and employee education about the Trade Bonus program. The language of this section is drawn from previous legislation and assures that the tax credit applies only to the actual cost of creating the employee stock purchase plan and not to services that may be related to retirement planning, such as tax preparation, accounting, legal or brokerage services. The bill sets out guidelines for employers establishing or expanding an employee stock purchase plan under the Trade Bonus program, including that employees be eligible for the maximum amount of $2,000 at the lowest price allowed by law; that employers make the plan available to the widest range of employees without discrimination in favor of highly compensated employees; that employers ensure that the trade bonus is in addition to compensation an employee would normally receive (and that safeguards be in place to do so); and that it does not result in lack of diversification of an employee's assets. Here's how the Working Families Trade Bonus Act would work. As under current law, employee stock purchase plans offer stock to participants at a discount. The current minimum purchase price is the lesser of 85% of the value of the stock on the date of the grant of the options (usually the beginning of the purchase period) or 85% of the value of the stock when the option is exercised--usually the end of the purchase period. This means that, in the period during which the stock has appreciated, the employee can get the benefit of the appreciation and, in a period during which the stock has depreciated, the employee might still be able to buy employer stock at a discounted price, or, if the plan provides, could decline to purchase the stock. For example, let's say the President announces in the budget for FY 2001 that international trade contributed to growth in US GDP in 1999. Fleet of Foot Shoes, an athletic shoe manufacturer in Florence, Oregon, decides to award its workers the full $2,000 trade bonus on February 1, 2000. If a share of Fleet of Foot stock is worth $100 on the date of the grant of the option and $200 when the option is exercised, say December 2001, the employees' purchase price can be as low as $85. This means the employee can purchase stock worth $200 for only $85, so the employee is able to purchase more than 40 shares of stock for the price of only 20 shares. Alternatively, if the stock is worth $50 when the option is exercised, the employee is able to purchase stock worth $50 for only $42.50. Here is how the tax benefit would work. Under current law, employees who hold qualified stock at least two years from the date of grant of the option and one year from the purchase of the stock are entitled to a capital gains tax break until the point they sell the stock. If an employee chooses to sell stock purchased through the Trade Bonus and the purchase price was less than the fair market value on the date the option was granted, then the difference between the purchase price and the fair market value will be taxed as ordinary income in the year the stock is sold. Under my proposal, the remainder of the gain that would otherwise be taxed as a capital gain in the same year would not be taxed. So, using the Trade Bonus, if an employee pays $85 to buy a share of stock whose fair market value is $100, holds onto the share for more than the required two years and then sells it for $150, the $15 discount on the original purchase price would be taxed as ordinary income, but the employee would not pay capital gains tax on the $50 increase in the value of the share of stock. About one-half of all American adults own stock today, and stocks are now the largest asset families own, exceeding even home equity. Fortune's January 2000 survey found 36 of the 58 publicly held companies on the top 100 list offer options to all employees. According to a 1998 survey of Oregon technology companies, almost two-thirds of Oregon's technology companies offer stock options. In today's tight employment market where companies compete to attract and retain the best employees, stock purchase plans are becoming increasingly common. The National Center for Employee Ownership estimates that seven and a half million Americans work for companies that make stock options available, and that employees own nine percent of total corporate equity in the United States. A recent Federal Reserve study found that one-third of the firms it surveyed offer stock options to employees other than executives. Our legislation will build upon this trend. The Working Families Trade Bonus Opportunity Act will give workers the chance to share directly in the benefits of free trade. This legislation will help put real money into the pockets of working Americans, and help move stock options out of the corner office and onto the shop floor. I ask unanimous consent that a copy of the bill be printed in the Record.

Mr. WYDEN

Mr. WYDEN. Mr. President, I have come to the floor repeatedly over the last few months to talk about the importance of prescription drug coverage under Medicare for the Nation's senior citizens. Today I want to focus on how the absence of this coverage essentially undermines our entire health care system. What we are seeing is that every day, in the United States, senior citizens who are ailing from a variety of health problems end up getting sicker because they are not able to afford their prescription medicine. Very often these seniors end up being hospitalized and needing vastly more expensive medical services that are made available under what is called Part A of the Medicare program. Today, I want to describe a case I recently learned about in Hillsboro, OR, because it illustrates just how irrational, how extraordinarily illogical, it is to have a health care system for the Nation's senior citizens that does not cover prescription drugs. An orthopedist from Hillsboro, OR, recently wrote me that he actually had to hospitalize a patient for over 6 weeks because the patient needed antibiotics that they were not covered on an outpatient basis. Here you had a frail, vulnerable older person. The physician, and all the medical specialists involved, believed that person could be treated on an outpatient basis with antibiotics, but because there was not Medicare coverage available on an outpatient basis--because there was not the kind of coverage Senator Daschle has been talking about and Senator Snowe and I have made available in the Snowe-Wyden bipartisan legislation--because that coverage was not available to the senior citizen in Hillsboro, OR, that older person had to be hospitalized for over 6 weeks. Here is what the doctor said to me: This method of treatment [the preferred outpatient method of treatment] is cost effective and is preferred by patients and doctors. In this case, the patient is condemned to spend 6 weeks in the hospital solely to receive intravenous antibiotics. To me, this seems like a tremendous waste of money and resources. The patient would be better at home. What this case illustrates is exactly why we need, on a bipartisan basis--the Snowe-Wyden legislation is one approach; our colleagues may have other ideas on how to do it--but this is a case study on why it is so important to cover prescription drugs for older people under Medicare. We are not talking about some abstract academic kind of analysis that comes from one of the think tanks here in Washington, DC. This is a physician in Hillsboro, OR, who had to put a patient, an older person, in a hospital for 6 weeks because they could not afford to get their medicine on an outpatient basis. A lot of our colleagues are here on the floor who are on the Commerce Committee. We look at technology issues at that Committee. The irony is, we can save money, again, through the use of new technology in health care. The kind of treatment that would have been best for this older person in Oregon would have been through an electronic delivery system the older person could have used on their belt for a relatively short period of time had Medicare covered that prescription the older person needed. But because that person could not get coverage for the antibiotics and use that electronic delivery system on an outpatient basis, which they could wear on their belt, they had to go into a hospital for 6 weeks. Colleagues, we are going to hear a lot over this break from senior citizens and families about the importance of this issue. I intend tomorrow, again, to come to the floor and discuss this matter. Senator Daschle has made it very clear to me, and talks about it virtually every day, that he wants to have the Senate find the common ground. He wants Senators to come together and deal with this on a bipartisan basis. The Snowe-Wyden legislation is one approach. Our colleagues have other bills. The point is, let us make sure, in this session of Congress, that in Arkansas, in Washington, and in the State of Nevada, we do not have older people hospitalized unnecessarily for 6 weeks because we have not come together as a Senate to make sure they can get those medicines on an outpatient basis. Science has given us cost-effective, practical remedies for these people in need, remedies that will reduce suffering and will reduce costs to taxpayers. Let us come together, on a bipartisan basis, to make sure we do not adjourn without adding this important benefit to the Medicare program. As I have made clear, I intend to keep coming back to the floor of the Senate until we, on a bipartisan basis, as Senator Daschle has suggested, come together and get this important job done. Mr. President, I yield the floor.

Mr. WYDEN

Mr. WYDEN. Mr. President, I ask unanimous consent to speak for up to 10 minutes on the time allocated to Senator Durbin.

Mr. WYDEN

Mr. WYDEN. Mr. President, this morning, I come to the floor to talk yet again about the issue of prescription drugs. I want to focus on an issue that Senator Daschle has, I think, been so correct in identifying as a priority, which is the issue of going forward with prescription drugs as part of a program that offers universal coverage. Of course, when Medicare began in 1965, the Congress made the judgment that there would be a program available to all eligible seniors, that coverage would be universal for eligible seniors and for disabled folks. I think it has been one of the unifying aspects of social policy in this country that all older people were covered. I think it is absolutely key that as we tackle this issue of prescription drug coverage, and do it in a bipartisan way, we remember how important the principle of covering all seniors is. Now, I know there are colleagues on the other side of the aisle who feel strongly about this issue as well. I am very pleased in having teamed up with Senator Snowe for more than a year. She and I are on a bill together, a bipartisan bill, which offers universal coverage. I also appreciate my colleague from Oregon, Senator Smith, for being supportive of this effort. There are a number of reasons why universal coverage is so important, and Senator Daschle has identified it as a priority for Senators on this side of the aisle. I want to talk for a moment about why I think it is so key in terms of designing a benefit properly. First, it is absolutely essential to ensure that seniors have as much bargaining power in the marketplace as possible. We have all been hearing from our constituents that many of them cannot afford the cost of prescription medicine. I have been coming to the floor of the Senate and reading from letters where older people, after they are done paying prescription drug bills, only have a couple hundred dollars for the rest of the month to live on. We are seeing all across this country that many older people simply can't afford their medicine. If we are going to give them real bargaining power in the marketplace--and right now, to belong to an HMO, you have plenty of bargaining power--they can negotiate a good price for you. But if you are an individual senior walking into a pharmacy, you don't have a whole lot of bargaining power. In fact, you are subsidizing those big plans. If we design a prescription drug benefit so as to offer universal coverage, this gives us the largest available group of older people, the largest ``pool of individuals''-- to use the language of the insurance industry--for purposes of making sure those older folks really do have bargaining power in the marketplace. As we address this issue of bargaining power, I happen to think it is important that we do it in a way that doesn't bring about a lot of cost shifting onto other population groups. That is why the Snowe-Wyden legislation uses the model that Federal employees use for the purposes of their health coverage. As we talk about how to design this prescription drug program, I am hopeful we see universal coverage included. Beyond the fact it is what Medicare has been all about since the program began in 1965, it is absolutely key to make sure older people have the maximum amount of genuine bargaining power in the marketplace. Second, I think if we were to do, as some have suggested-- particularly those in the House--which is essentially to not have a program with universal coverage, but hand off a big pot of money to the States, and they could perhaps design a program for low-income people, we will have missed a lot of vulnerable seniors altogether. Their proposal--those who would hand off the money to the States to design a program for low-income people--as far as I can tell, would leave behind altogether seniors, say, with an income of $21,000 or $22,000, essentially a low- to middle-income senior. In most parts of the country, by any calculus, my view is that sum of money is awfully modest altogether. I see these proposals that hand a sum over to the States for low-income people as leaving a lot of seniors with $22,000, $25,000, or $28,000 incomes behind altogether. If those individuals are taking medicine, say, for a chronic health problem--they might have a chronic health problem due to a heart ailment or something of that nature--they could be spending somewhere in the vicinity of $2,500 per year out of pocket on their prescription medicine. One out of four older people who have chronic illnesses such as the heart ailment are spending $2,500 a year out of pocket on their medicine. As far as I can tell, if they were in that lower- or middle- income bracket, they would simply be left behind altogether under these proposals that would just hand over a pot of money to the States and use this money for low-income people. Many of the elderly people I described in income brackets of $22,000 or $28,000 and paying for chronic illnesses are the people we are hearing from now saying: If I get another increase in my insurance premium, I am going to simply have to leave my prescription at the pharmacist. My doctor phones it in, and I am not going to be able to afford to go and pick it up. I think it is extremely important that the design of this program be built on the principle of universal coverage. That is what Medicare has been all about since the program began in 1965. It is what is going to ensure that the seniors have the maximum amount of bargaining power. We can debate issues within that concept of universal coverage so as to be more sensitive to those who have the least ability to pay. I have long believed Lee Iacocca shouldn't pay the same Medicare premium as a widow with an income of $14,000. I think we can deal with those issues as we go forward, if we decide early on that the centerpiece of an effective prescription drug benefit ought to be universal coverage. There are other important issues we are going to have to discuss. I think there is now growing support for making sure this program is voluntary. When it is voluntary, you avoid some of the problems we are seeing with catastrophic care and ultimately you empower the consumer. It is going to be the consumer's choice in most communities to choose whether they want to go forward participating in this prescription drug program, or perhaps just stay with the coverage they may have. We estimate that perhaps a third of the older people in this country have coverage with which they are reasonably satisfied. If they are, under the kind of approach for which I think we are starting to see support in the Senate, those are folks who would not see their benefits touched; they could simply stay with the existing prescription drug coverage they have today. Let's go forward. I think Senator Daschle in particular deserves credit for trying to bring the Senate together and for trying to reconcile the various bills. Let's make sure we don't lose sight of the importance of universal coverage. It is key to giving older people real bargaining power in the marketplace--not through a government program but through marketplace forces, the way HMOs and insurance plans do. Focus on keeping the program voluntary. I know there are colleagues on the other side of the aisle who share similar sentiments as the ones I voiced today. I particularly want to commend my colleagues, Senators Snowe and Smith. They have teamed up with me for more than a year now on a proposal that I think can win bipartisan support. In fact, we already have evidence of bipartisan support from the other side of the aisle because we got 54 votes on the floor of the Senate about a year ago for a plan to fund this program. I intend to keep coming back to the floor of the Senate. Today, I thought it was important to express what Senator Daschle spoke on recently, which is universal coverage. I intend to keep coming back to the floor of this body again and again in an effort to build bipartisan support for making sure vulnerable seniors can get prescription drug coverage under Medicare. I yield the floor.

Mr. WYDEN

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

Mr. WYDEN

Mr. WYDEN. Mr. President, since the fall, I, and other Members of the Senate, have come to the floor of this body to talk about the need for prescription drug coverage for older people under Medicare. As we look at this issue, I am especially pleased that Senator Daschle has been trying to reconcile the various legislative proposals that have been introduced on this issue. I know colleagues on the other side of the aisle have good ideas, as well. I particularly commend my colleague, Senator Snowe of Maine. She and I have teamed up, on a bipartisan basis, for more than a year now. Senator Daschle is trying to bring these bills together and make it possible for us to go forward and address this vital issue for seniors in a bipartisan way. What I am struck by, and what I want to touch on for a moment or two this morning, is how significant the ramifications are with respect to this prescription drug issue. For example, one issue I have not talked about in connection with this prescription drug matter is how it is directly and integrally tied to the matter of medical errors. Many of our colleagues were astounded at the end of last year when the Institute of Medicine produced a landmark study--a truly landmark study--documenting the problem of medical errors today in American health care. These medical errors end up injuring many of our citizens, of course. They cost vast amounts of money. What is striking is how many of them are tied to problems connected with prescriptions. For example, we know when a senior cannot afford to take their prescription or ends up only taking two pills, when three of them are essentially recommended by their physician, that can constitute a breakdown in our health system or, in fact, what amounts to a medical error. I think I have been coming to the floor of the Senate and talked on the issue of prescription drugs something like 26 times in the last few months, for example, talking about instances where folks at home in Oregon are actually breaking up their pills, their cholesterol-lowering pills, because they cannot afford to take the entire pill. They believe if they break up the pill they can stretch it. These are the kinds of medical tragedies we are seeing across this country. They are errors that we can correct if we go forward and address this issue--prescription drug coverage--in a bipartisan way. It seems unconscionable to think that, in a Nation as rich and good and powerful as ours, with all of these older people walking on an economic tightrope, balancing their food costs against their fuel costs, fuel costs against their medical bills, we can't go forward, as Senator Daschle has suggested, and reconcile these various bills that have been introduced on this issue and enact a comprehensive program to help older people with their prescription drug bills, reduce the kinds of errors the Institute of Medicine found, and help a lot of families in our country. I think there really are three principles we ought to zero in on in terms of trying to address this issue. First, I think there is general agreement now that this program be voluntary. I think many Members of Congress remember the ill-fated catastrophic care legislation, with a lot of older people believing at that time that they were being forced to pay for catastrophic benefits they were already receiving under their existing private health coverage. Now I believe there already is a bipartisan consensus--Senator Daschle has touched on this a couple of times recently--that a prescription drug program ought to be voluntary for older people and voluntary for the various providers, insurers, and pharmaceutical benefit managers who might decide to participate in the program. I think that minimizes the possibility that older people and families will believe they are being coerced by Government to pay for something they are already receiving. That voluntary aspect of such a program is one area where there already is bipartisan agreement. Second, I think there is a general belief that rather than inventing an entirely new structure for this program, it must be integrally tied to the existing Medicare program and, in particular, fit with an agenda for Medicare reform. What the legislation I have worked on--the Snowe-Wyden legislation-- does is allow the administrative body--called the SPICE board, because our bill stands for Senior Prescription Insurance Coverage Equity or SPICE--to contract with a variety of entities, insurance companies or pharmaceutical benefit managers or nonprofit agencies--anybody who was authorized under State law to administer a program. That way, we are not creating a whole new structure for dealing with this program; we are building on Medicare as it exists today. At the same time, we are doing something else which is critical; that is, adding more choice to the Medicare program. I personally think the effort to make this program voluntary, to build on existing Medicare coverage, which makes the benefits available to all seniors--universal coverage for those eligible for the program-- and then, in addition to those principles, add new choices to the Medicare program. The reason that is so important is, providing choices is what is going to generate the competition that can help hold down the prices of medicines for our older people. We see so many seniors who can't afford their medicine. There is a great debate going on in the country now about whether it is the research costs of these drugs that have contributed to it. There are a variety of reasons being offered for why older people cannot afford their prescription drugs. I am interested in debating those. What I am most interested in is making sure older people have the kind of bargaining power necessary to drive down the costs of their medicine. It seems to me they can get that bargaining power through an approach based on choice, such as we have, as Members of Congress, through the Federal Employees Health Benefits system. I am very hopeful that that expanded array of choices will be a key invisible part of a bipartisan effort to go forward and address this issue in the Senate. As we head to a period of town meetings and discussions with folks at home, I know my colleagues are going to hear accounts from older people and families about horrible, tragic instances where older people cannot afford medicine and often end up getting sicker and needing much more expensive care when they cannot get those essential prescriptions. I think we have made a lot of progress in the last 2 or 3 months, with Senator Daschle having taken the lead, many colleagues on the other side of the aisle trying to bring the Senate together to find the common ground. I think we made a lot of progress. I am hopeful that when the Senate reconvenes after this break to visit with folks at home, when the Budget Committee goes forward--and Senator Snowe and I both sit on the Budget Committee--that with the bipartisan leadership of Senator Domenici and Senator Lautenberg, we can get a generous earmark in the budget to cover prescription drugs and, in effect, continue the progress we have made towards getting a bipartisan prescription drug program enacted in this session of the Senate. I have talked with Senator Lautenberg, ranking Democrat, Senator Conrad, others who have been involved in this issue on our side, and with Senator Domenici on the other side of the aisle. I think there is a real openness to making sure there is a generous earmark in that budget for a prescription drug program we would enact this year. After we get over that hurdle, the challenge will be, as Senator Daschle has outlined, to reconcile the various approaches that have been offered. As I mentioned, Senator Snowe and I have one we think makes sense, but we do not believe we have the last word. We think the last word ought to belong to the American people. The American people are saying: We want you to deliver on this prescription drug issue. We want it done this session. We do not want it to go through yet another campaign season as campaign fodder through the fall. We want you to get it done this year. Take the steps necessary to provide older people the relief they need and deserve. I look forward to being part of that effort in a bipartisan fashion. I yield the floor.

Mr. WYDEN

Mr. WYDEN. Before he leaves, I commend the distinguished minority whip for speaking out on some of these excesses in campaign finance. He mentions his small State spending more than $20 million.