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Frankly, I am very hopeful that our bill has served a purpose. There has been a nice debate. There is nobody here who needs the Senate any more
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I thank the Senator. It is good to get an opportunity to comment.
Mr. KENNEDY addressed the Chair.
The PRESIDING OFFICER (Ms. COLLINS). The Senator from Massachusetts.
Mr. KENNEDY. Madam President, I will not take much time.
The Senator has it absolutely right. We built in the program the ability to provide the medical and some income for people who have the disabilities and said that if they make over $500, they lose the insurance and they lose the additional kind of insurance, that they would be able to receive income, and they are just dropped out.
Very few of the families can be assured they can get a job after a training program where they would be able to offset their total medical expenses if they are able to get health insurance. They probably are not able to get it because they have a disability. The fact of the matter is, the insurance companies, by and large, do not include them.
I have a son who lost his leg to cancer and is a very healthy young person, but there is not a chance in the world he can get insurance. He has insurance only as a part of a much larger group. That happens to individuals who have any kind of disability. So they are out behind the 8-ball.
What we are saying is, continue their health care. OK, we can phase out or eliminate their income. They would be willing to take a chance on that. They will go out and try to pull their own weight. They are glad to do it. They will do it, and they will do it very well.
They have a desire to do it and the ability to do it. We have provided these incentives and training programs to enable them to be more creative to do it. There are more examples in a number of the States about how to do it. There are a number of examples in different countries on how to do it. We are going to do it in ways that are financially responsible.
The Senator made an excellent statement. I thank him for his sponsorship, as well as the Senator from Nevada.
I yield the floor.
Mr. DOMENICI addressed the Chair.
The PRESIDING OFFICER. The Senator from New Mexico.
Mr. DOMENICI. Madam President, before Senator KENNEDY leaves the floor, I will just make a comment. He mentioned those disabled because of severe mental illnesses: manic depression, schizophrenia, severe chronic depression.
I say to the Senator, I introduced the parity bill with Senator WELLSTONE to try to get more insurance coverage resources applied to these serious illnesses. I want to share with the Senator, since we are talking about disabilities, a notion that came to me with reference to severely mentally ill people.
I said, what would happen if the United States, by definition, had decided we would not cover, under health insurance, illnesses of the heart because we did not want to cover illnesses of the brain? The complicated vessels are the heart and the brain. What if 30 years ago, as we produced the list of coverable illnesses, we said no coverage for heart conditions. Guess what would have happened. None of the breakthroughs in treating the heart would have ever occurred because there would not have been enough resources going into it for the researchers and the doctors to make the breakthroughs.
As a matter of fact, we would not have invented angioplasty and all those other significant techniques. What would have happened in the meantime is that hundreds of thousands of Americans would be dying earlier than they should. That would be along with what I just said.
When we say insurance companies should not cover schizophrenics, who have a brain disease, diagnosable and treatable, that we should not cover them, then are we not saying the same thing about a very serious physical frailty that hits between 5 and 15 million Americans during any given year, from the very young to the very old, with the highest propensity between 17 and 25 years of age for schizophrenia, manic depression, and the like?
It seems to me that sooner or later, if we are going to call something ``health insurance,'' it ought to cover those who are sick, wouldn't you think?
Mr. KENNEDY. Absolutely.
Mr. DOMENICI. Why do we call health insurance ``health insurance'' and leave out a big chunk of the American population? Because the definition chooses to will away an illness. You define it so it does not exist, right? No. It exists. Families go broke. Their kids are in jails instead of hospitals. Because once they get one of these diseases, there is no way to help them, because there are no systems, because there are not enough resources. The resources come from the mass coverage by insurance. That is what puts resources into illnesses and cures.
So I just want to assure you, we are going to proceed this year. We are going to proceed with this parity bill. We are going to have a vote here. I do not know which bill yet, but we are going to have a good debate. We are asking the business community to get the price tag. We do not want to hear any of this business that it is going to break us.
We want to know, based on history, what is it going to cost? Then we are going to let the Senators and the public decide: Is that too much? What if it isn't too much in the minds of most Americans and Senators? Then it seems to me the marketplace will have to adjust to it.
Obviously, if I have a chance, I would like to talk about this. I would like to do it on the floor of the Senate so a lot of other Americans hear about it. I would like to do it when somebody is here to talk about the significance of this.
This is important business, the disabled in this country, whether they are disabled physically or disabled mentally. If we are going to have a real society that is proud of being free--and we have put so much emphasis on that--then we cannot leave out big chunks of the public with arbitrary laws or a failure to have insurance companies take care of the responsibilities of health coverage for disabled Americans.
I yield the floor.
Mr. KENNEDY addressed the Chair.
The PRESIDING OFFICER. The Senator from Massachusetts.
Mr. KENNEDY. As the good Senator knows, we have such coverage for all Members of the Senate. Federal employees have it, over 11 million have it, and other groups have that as well. We find that it is suitable for Members of Congress and for the administration, other Federal employees.
I underline that I do not think we have health insurance worth its name if it doesn't meet the standard that the Senator from New Mexico has outlined here. I think it is basic and fundamental. There may have been troubles with the Clinton health insurance program, but the President has recently announced that he will issue an executive order to provide mental health parity .
I say to the good Senator, my friend--I have heard him speak eloquently, as well as our friend Senator WELLSTONE, and others speak on this issue--I pledge to him that I look forward to working with him. I think it is enormously important. I commend the Senator for what was initiated previously when we were dealing with this issue in related form on the Kassebaum-Kennedy legislation a few years ago. We want to see that and other legislation actually implemented. I commend him and look forward to working with him.
Finally, I would like to state my support for the efforts of my good friend and colleague from Nevada, Senator REID, who has long been a champion of the need for better and more comprehensive approaches to suicide prevention. Suicide claims over 30,000 lives each year in this country; it is the eighth leading cause of death overall and the third major cause of death amongst teenagers from 15-19. It is an issue clearly associated with mental health parity . If better access to mental health services were available for all persons who have psychiatric conditions, the suicide rate would be dramatically reduced. It is time to provide mental health parity and to prevent these unnecessary family tragedies.
I thank the Senator.
Mr. REID addressed the Chair.
The PRESIDING OFFICER. The Senator from Nevada.
Mr. REID. Madam President, even though this is the energy and water
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An area I have worked on that is now receiving more attention is suicide. Thirty-one thousand people each year in the United States kill themselves. What if 31,000 people were killed in some other manner? We would focus a lot of attention on it.
There are almost as many people killed in car wrecks every year. We have airbags and we have speed limits. We do all kinds of things to prevent people from being killed in automobile accidents. We have even done a much better job in recent years trying to stop people from driving under the influence of alcohol.
Suicide is a very difficult problem in America today. During the time we have been on this bill--it is now 3:30 eastern time; we started at 1--about 12 people in the United States have killed themselves. So it is an issue I hope we will spend more time on.
For the first time in the history of the country we are spending money to find out why people commit suicide. We don't know why. An interesting fact is that the 10 leading States in the United States for suicide are western United States, States west of the Mississippi. We don't know why this is, but it is now being studied by the Centers for Disease Control. We appropriated money last year to try to focus on this.
Not only is this, of course, terrible for the person who dies, but what it does to the victims, the people who are the survivors.
I am happy to hear the discussion this afternoon about mental health generally. I want to talk about suicide specifically. It is an area that we really have to focus some attention on and get Members of the Congress to agree that we have to do something about this. It is an issue that is crying for an answer. I hope that in the years to come we can do much more than we have done in the past, which wouldn't take very much, but it is an area in which we need to do much more. I hope we can do that.
Madam President, I suggest the absence of a quorum.
Mr. DOMENICI. Will the Senator withhold?
Mr. REID. I will withhold.
The PRESIDING OFFICER. The Senator from New Mexico.
Mr. DOMENICI. I say to my good friend, the ranking member on this subcommittee, we have a good, bipartisan bill. I hope we can make the point that we worked together to make it bipartisan, because I think that is the way we get a bill that we can get through here and can sustain.
Commenting on your last statement and your efforts with reference to suicide, that is not unrelated to what I was discussing at all.
Mr. REID. That is right.
Mr. DOMENICI. I don't know the numbers, but I am going to guess that 60 to 70 percent of the suicides are probably found to be caused by a mental illness, most of them by severe depression. Frankly, one of the reasons we have so many suicides is because we have not created a culture among our medical people and among those who help our medical people of properly diagnosing such things as depression.
One of the reasons we don't have a culture that does the diagnosis right is because it is not covered by insurance. As a consequence, there are not enough resources put in at the grassroots where doctors are getting paid for this and universities can do research on it, because it is worthwhile to the doctors to become experts in this. We are doing a little more than we did in the past but not enough from the standpoint of real mass involvement.
Young people in particular are the majority victims of the suicide numbers, which is such a shame. Many of those 21,000 are kids; right?
Mr. REID. Thirty-one thousand.
Mr. DOMENICI. Teenagers, 31,000; they are not in the senior citizen numbers. There is a small percentage, but the big percentage are in the absolute throes of starting a great life. If we could do a better job with diagnosing depression, we would have medication and therapy preventing many of those 31,000.
Mr. REID. Will the Senator yield?
Mr. DOMENICI. Yes, indeed.
Mr. REID. I think one of the reasons we have made more progress on suicide and other mental health problems in recent years is because people who have problems with depression, people who are survivors of suicides are willing to talk about it. It wasn't many years ago----
Mr. DOMENICI. That is true.
Mr. REID.--For example, my father, who committed suicide, wouldn't have been able to be buried in the cemetery. My father would have to have been buried someplace else because suicide was considered sinful, wrong.
Mr. DOMENICI. Right.
Mr. REID. So I believe clearly that the Senator is absolutely right. The Senator and I, as an example, are willing to talk about some of our experiences with mental health problems. As a result of that, it is not something people tend to hide as much as they used to. We recognize that depression is a medical condition.
Mr. DOMENICI. You have it.
Mr. REID. It is no different than if you have pneumonia. Depression is like pneumonia. We are learning how to cure depression. We learned some time ago how to cure pneumonia. So the more that we talk about this, the more people are willing to say: I think I am just depressed. I need some help. Is there somebody who can help me.
The fact of the matter is, as the Senator said, we did some hearings on depression and suicide. With suicide, they had really an interesting program in the State of Washington where one city developed an outreach program with mail carriers. When someone would go to deliver mail, especially in areas where there were senior citizens--sometimes the only contact a senior would have was with the mail carrier--the mail carrier was trained to recognize symptoms of depression and, consequently, suicide and saved a lot of people.
I remember a hearing we had in the Aging Committee; a woman who wrote poems came in. She showed us a poem she wrote when she was depressed and when she wanted to kill herself and a poem she wrote afterwards. I can't remember the poem--I am not like Senator BYRD--but I can remember parts of it where she talked about the snow was like diamonds in her hair.
If we could do a better job of recognizing depression, talk about that one, mental illness, depression, think of the money we would save. We would have a much more productive society. The workforce would be more productive. The gross national product would go up as a result of that.
Mr. DOMENICI. Madam President, I suggest the absence of a quorum.
The PRESIDING OFFICER. The clerk will call the roll.
The legislative assistant proceeded to call the roll.
Mr. WELLSTONE. Madam President, I ask unanimous consent that the order for the quorum call be rescinded.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. WELLSTONE. I thank the Chair.
Madam President, having just returned from Minnesota, I want to speak on the floor for a few short minutes, first of all, in support of the amendment that my colleague, Senator KENNEDY, introduced, which is really the Work Incentives Improvement Act, S.331, which he has done so much work on, along with Senator JEFFORDS.
My understanding is--it could be that my colleague, Senator REID of Nevada, spoke about this--Senator KENNEDY came to the floor and said: ``Listen, we want some action on this bill.'' We do want action on this. We have 78 Senators who are cosponsors of the Work Incentives Improvement
Seventy-eight consponsors means, by definition, that this is a strong bipartisan effort.
The reason for this bill, with all of its support, is really all about dignity. For Senators who talk about self-sufficiency and self-reliance and people being able to live lives with dignity, that is what this is about.
I am sure the Chair has experienced this, when you are back home and you talk to people in the disabilities community over and over again, you hear people telling you that they are ready to go to work if only they could be sure they wouldn't lose their health insurance--insurance they literally need to live. I don't know, but I think the unemployment rate among people with disabilities is well above 50 percent; the poverty rate is also above 50 percent. The problem is, when people in the disabilities community work, they
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What this piece of legislation says is that we want people to be able to live at home in as near a normal circumstance as possible, with dignity. That is what the Work Incentives Improvement Act is all about.
I come to the floor to say to my colleague, Senator KENNEDY, that if he wants to force the issue on this bill that we have before us, the Energy and Water Appropriations bill, I am all for that. If we can get some kind of a commitment from Senators as to whether we can bring this piece of legislation up freestanding, have an up-or-down vote--78 Senators are cosponsors--then I am for that.
Those of us who feel strongly about this issue and have met with people back home and heard their pleas really want to respond to the concerns and circumstances of their lives. It is very moving to meet with people in the disabilities community, to have people say to you: If you could do this, it would help us so much.
We are running out of patience; we really are. For colleagues who are blocking this and getting in the way of our being able to bring this to the floor and having a vote on this, be it unanimous consent, or be it 78 to 22, or 99 to 1 or whatever the case might be, so be it. I do not mind the 1; I have been on the losing end of a couple 99 to 1 votes in the last two months. If a Senator feels strongly about that, and it is his or her honest opinion that this legislation shouldn't pass, fine. He or she has the right to speak out, to try to persuade others and to vote his or her conscience. What I don't like is the way in which this piece of legislation has been held up so that it is not possible to debate it and vote on it at all. That, I think, is unconscionable.
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