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   Mr. KERRY. I say to my colleague from Nebraska, he is again perceptive in seeing the extraordinary contradiction in the actions taken by the majority party, the Republicans in Congress, compared to what their own nominee for President is suggesting is the appropriate way to proceed. Indeed, the very criticism leveled by George Bush against AL GORE that he is, in fact, trying to target appropriately--appropriately, I underline ``appropriately''--is really critical because what the Republicans are doing here is targeting, which is precisely what their candidate has criticized, but they are targeting inappropriately. They are targeting, once again, to reward those already most rewarded. They are targeting to reward those who already have health care. They are targeting in a way that ignores the concern of the President and most of us here, which is: How do you provide coverage to those people who are without coverage or having the greatest difficulty in providing for their health care with HMOs that are cutting them out.

   Mr. KERREY. Will the Senator yield for a further question?

   Mr. KERRY. I would be glad to yield.

   Mr. KERREY. Essentially, the argument is over. Our colleagues on the other side of the aisle are agreeing with us; their Presidential candidate is wrong; we should target tax cuts.

   Then you move on to the next question, which is, Who is going to get the tax cut? What standards do we apply to make that decision? Would the Senator from Massachusetts agree that it seems one of the missing questions that was not asked was--it doesn't seem to me it was asked. None of our colleagues from the other side of the aisle are here. I look forward to asking them. I don't know who was in the room when this was written. But whoever was in the room from the other side of the aisle, there were no Democrats there. Does it appear to the Senator that anybody in that room asked the question: Is this fair, given the needs of this country? Is this package fair? Did they seem to apply a standard or a test of fairness as they made their decision?

   Mr. KERRY. Let me answer the Senator from Nebraska by saying, in the 16 years I have been in the Senate--in the debates we had in 1986 on tax simplification--in almost every single tax proposal we have worked on in those years, I have never heard the word ``fairness'' come from that side of the aisle. I have never heard them suggest that the plan they are offering America is based on a fundamental notion of what is fair for all Americans.

   Mr. KERREY. I wonder if the Senator----

   Mr. KERRY. I will say this to my colleague. If you look at the distribution here to the HMOs, and if you look at what happens to community hospitals, to home health care delivery, to the nursing homes, to those people who are part of a community and stay in a community, and who are not there for profit, versus what they have done to provide the lion's share of funding to those who work for profit but at the same time have cut off 400,000 senior citizens from getting health care, it is an extraordinary imbalance on its face.

   Mr. KERREY. Will the Senator yield for one additional question?

   Mr. KERRY. I will yield.

   Mr. KERREY. And then I will wait to speak further after the Senator finishes his opening remarks.

   In this morning's New York Times, there is an article describing the Texas Governor's speech in Pennsylvania yesterday. He does know how to turn a phrase. It is very good language. But I wonder if the Senator from Massachusetts sees a conflict in what the Governor of Texas is saying that he wants to do and what is in this bill.

   Let me read what he said:

   In my administration, we will ask not only what is legal but also what is right, not just what the lawyers allow but what the public deserves.

   He went on and said:

   In my administration, we will make it clear there is the controlling legal authority of conscience.

   Does my friend from Massachusetts think this process and this proposal meets the test that the Governor of Texas set yesterday in Pennsylvania?

   Mr. KERRY. Mr. President, let me say to my colleague, the question he raises should not be treated by my colleagues as simply political posturing or somehow a statement that suggests that there is simply a point to be scored here.

   In the years I have been here, I have never seen the distinguished Senator from West Virginia, Mr. BYRD--who I think most people in the Senate would agree is really the custodian of the institution--he is the Senator who has written the most, thought the most, and perhaps stood the strongest for the rights and prerogatives of Senators, and the rights and prerogatives of

   this institution.

   What the Senator from Nebraska is raising in his question really goes to the core of the conscience, if you will, of the Senate, of what is right, of what is the controlling legal authority for the Senate.

   Is it appropriate to have a process that excludes and distorts and diminishes the institution in the way this process has?

   The distinguished minority leader is on the floor of the Senate. I saw him as angry yesterday and as visibly upset as I think any of us in our caucus have ever seen him because of his sense of this violation of process, of the ways in which the rights of individual Senators are being denied.

   Now, people may not like a particular vote around here, and people may not want to vote because they don't like the fact they have to stand by that vote, but the fact is, this legislation that comes to the floor of the Senate today is a violation of our rights, of the sort of conscience, if you will, that the Senator is talking about, about doing what is right.

   I will go on, if I may, to underscore----

   Mrs. BOXER. Before the Senator moves on any further, I ask him if he will yield for a question?

   Mr. KERRY. I am delighted to yield to the Senator.

[Page: S11197]  GPO's PDF

   (Mr. BROWNBACK assumed the chair.)

   Mrs. BOXER. I thank my friend from Massachusetts for coming down here and putting into words what so many of us are feeling--just this sense of unfairness, not only about the process, which he described so well, taking what is supposed to be a Small Business bill, hollowing it out and stuffing it full of other issues, leaving out the people who are supposed to be involved, but also the substance of what is actually in this bill.

   I want to probe him on one question. Is the Senator aware that tens of billions of dollars in this bill are going to the HMOs, and there is not one string attached that the HMOs have to serve the senior citizens who they kicked out of Medicare?

   We are giving bags of money to one of the most unpopular businesses in America today because they do not treat people fairly, without one requirement that they take these seniors home again and give them health care again.

   I say to the Senator, you have seen it in your State and I have seen it in my State, where seniors were told: Join this HMO through Medicare. You won't have any copayments. You will be fine, only to wake up in the morning and be kicked out.

   Could my colleague talk about the fairness or unfairness of that?

   Mr. KERRY. May I say to my friend from California, she is one of the champions in the Senate for that kind of fairness and for her sensitivity to the notion of what happens to our seniors. Obviously in California it is vital to have that kind of sensitivity.

   Let me underscore what she just said, because not only do the tens of billions of dollars go to the HMOs in a disproportionate share--one-third in the first 5 years, 50 percent in the second 5 years--the Senator from South Dakota, the distinguished minority leader, led an effort in the Senate to try to secure $80 billion as the appropriate balanced budget fix here, with a recognition that we would do away with the 15-percent cut which has been mandated inappropriately by almost everybody's agreement.

   What we are winding up with is $30 billion, which has now been divided by the majority party completely inappropriately to one of the greatest sources of the problem in the delivery of health care in the country.

   What is absolutely extraordinary in this situation is that, as the Senator from California mentions, there is only one sort of minor requirement here about what kind of behavior the HMOs might be held to.

   All of us in the Senate have been fighting for months to try to get a Patients' Bill of Rights and establish a real set of principles and standards by which people in the United States will know what they are going to get from HMOs, what they can expect from HMOs, and how they will be treated by HMOs. But here we are with a great big grab bag giveaway to the HMOs, without any of those standards being embraced here.

   If you want to talk about the conscience, and doing what is right, which is what the Senator from Nebraska talked about, here is an incredible example of the way in which they have sort of flagrantly chosen how to satisfy their constituencies, their sense of who ought to get something, and have left out completely the rights we have been fighting for that would have accrued--

   the basic rights, a woman's right to know she can keep her own OB/GYN she has had for a number of years, a person's right to go to an emergency room of their choice, a right to a second opinion. Think about that, to get a second opinion and not to have some HMO bureaucrat in a State that isn't even associated with your particular health care problem not make the decision but have your doctor make a decision. We can't even come to the floor of the Senate and do that here. We have to give away money to the folks who already have health care rather than taking care of the people who are uninsured which could be done cheaper.

   In fact, what the President says in his letter is really interesting. I will share this completely with my colleagues as we put it into the RECORD.

   The President said, before this came to the floor, before we were put in the predicament of having to vote against something that has a lot of good in it, many of us like components of what is in this bill. Many of us worked hard to get components of this bill. We are going to be forced to vote against it because of the fundamental unfairness. The President of the United States makes that very clear in his letter. I will continue to read what the President says to both leaders:

   Instead you put forward a series of tax cuts that, particularly when standing alone, would be inequitable, inefficient, and even potentially counterproductive to health care policy. For example, while our FamilyCare proposal would expand coverage to 4 million uninsured parents at a cost of slightly over $3,000 per person, your proposal would provide additional coverage to one-seventh the people at six times the cost per person. Moreover, your proposal would give the least assistance to moderate income families that need the help the most, while even raising concerns that those with employer-based coverage today could lose their insurance.

   Similarly, on long-term care, I offered to embrace your proposed deduction for long-term care insurance in exchange for inclusion of my proposal to give families, who are burdened today by long-term care needs, a $3,000 tax credit .

   That sounds pretty bipartisan to me. The President said: I offered to embrace your proposed deduction if you would embrace my effort to give families who have long-term care problems a $3,000 tax credit .

   What happens? Rebuffed.

   The President says:

   Unfortunately, your legislation ignores the bipartisan package I suggested and instead would provide half the benefits of my proposal for financially pressed families trying to provide long-term care for elderly and sick family members. Surely we can agree on this bipartisan compromise that has already been endorsed by a broad array of members of Congress, advocates for seniors and people with disabilities and insurers. Similarly, I am perplexed that we cannot agree to include the bipartisan credit for vaccine research and purchases that is essential to save lives and advance public health.

   Let me say a word about that, if I may, because I wrote that legislation. We have been struggling in the Congress to get this considered. I wrote it with Senator BILL FRIST. This is an effort to try to guarantee that the great AIDS crisis will be properly addressed. Millions of people are dying in Africa, countless hundreds of thousands are affected here in our own country by this ravaging disease. Unfortunately, the pharmaceutical companies have no incentive because people in those countries cannot afford to buy the drugs. It is much more profitable to produce Viagra or any number of other drugs that are advertised now--Claritin, whatever. There are a whole set of drugs that have quick return and that make money. But poor countries cannot afford to buy these

   drugs.

   We have already passed into legislation funding of some $500 million for AIDS vaccine distribution across the world. The problem is that there is no vaccine today, and there won't be a vaccine unless the companies have an incentive and a capacity to be able to develop it. It is not only AIDS, incidentally, it is also for tuberculosis, for malaria. There are infectious diseases for which we could have further research in terms of vaccine development.

   What we want to do is provide the companies with a tax credit and the capacity to do that. It has broad bipartisan support. It is only $1.5 billion over 10 years. But that is not even in here. That is ignored in here. The President of the United States is suggesting it ought to be in here. They are perfectly prepared to take a huge percentage of the $30 billion and give it to the HMOs, but they are not prepared to provide the $1.5 billion in an effort to provide incentives foe AIDS vaccine research.

   The President also says:

   I also am disappointed that you have made virtually no attempt to address the concerns my Administration has expressed to you about the pension provisions of your bill. By dropping the progressive savings incentives from the Senate Finance Committee bill, you have failed to address the lack of pension coverage for over 70 million people. Moreover, employers may have new incentives to drop pension coverage for some of the low- and moderate-income workers lucky enough to have pension plans today.

   Finally, I remain deeply concerned that your Medicare and Medicaid refinement proposal continues to fail to attach accountability provisions to excessive payment increases to health maintenance organizations (HMOs) while rejecting critical investments in beneficiaries and vulnerable health care providers. Specifically, you insist on an unjustified spending increase for HMOs at the same time as you exclude bipartisan policies

[Page: S11198]  GPO's PDF

   I read the newspapers today, and I saw a fairly typical sort of Washington response from someone on the other side of the aisle suggesting that the President's veto of this bill was somehow going to provide them with an upper hand in the last weeks of this election cycle. This is not about the last week of the election. This is about fundamental policy, which the President has described in this letter, which goes directly to the question of how this country is going to provide for health care for our citizens. There are 44 million or so Americans who have no health care whatsoever. What about them?

   Mr. DASCHLE. Will the Senator from Massachusetts yield for a moment?

   Mr. KERRY. I am happy to yield to the distinguished leader.

   Mr. DASCHLE. I thank him and commend him for his powerful statement and the eloquence with which he has described our current circumstance.

   I appreciate especially his interest in reading into the RECORD many of the concerns the President expressed in his letter to all of us yesterday. I also appreciate his contribution to the caucus as we have attempted to work through how we ought to respond to this very unusual set of circumstances. He is our ranking member on the Committee on Small Business. He indicated to me yesterday that there was no consultation prior to the time this conference report was brought to the Senate. I ask the Senator from Massachusetts if he could elaborate first on what consultation, what degree of communication there was in coming to the floor and in talking about this bill. To what extent was his signature sought prior to the time we came to the floor?

   Mr. KERRY. Mr. President, I will gladly respond to the distinguished leader's question. I went into this a little bit before he came. Let me repeat: The distinguished Senator from Missouri and I worked hard on the small business components of this. But there was no consultation whatsoever, no phone call, no request for signature, no meeting, no discussion even about this bill being used, at least with this Senator, as the vehicle for these components being put in it. We were not in the room. We didn't know where the room was. We weren't even asked whether or not this was something we might or might not object to or what the impact might be on the bipartisan efforts that had taken place to have a complete small business reauthorization bill.

   Moreover, the bill that comes to the floor today is not even the same small business reauthorization that we worked on. It has been changed, again, we had no consultation and no part.

   Mr. DASCHLE. I ask the Senator from Massachusetts this: Obviously, there are many times when we are called upon to vote. But I have never heard of a time when the ranking member of a conference was denied even access to the text of whatever it was he was conferencing on.

   Let me ask the Senator from Massachusetts, has he now seen a copy of the conference report?

   Mr. KERRY. I have it right here, Mr. President. I tell the leader I do now have a copy of it.

   Mr. DASCHLE. Is it the Senator's understanding that the entire conference report is what we have in our hands--two pages?

   Mr. KERRY. It is two pages with two signature pages, and the joint explanatory statement of the committee--about five pages. I will show it to my colleague. I had no input on this explanatory statement and it is hard to explain, but it is just a small paragraph to describe the hundreds of pages mention on by reference in this report.

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