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[Page: S7696] GPO's PDF---
The PRESIDING OFFICER. The Senate will resume consideration of S. 1233.
The legislative clerk read as follows:
A bill (S. 1233) making appropriations for Agriculture, Rural Development, Food and Drug Administration, and Related Agencies programs for the fiscal year ending September 30, 2000, and for other purposes.
Pending:
Feinstein Amendment No. 737, to prohibit arbitrary limitation or conditions for the provision of services and to ensure that medical decisions are not made without the best available evidence or information.
The PRESIDING OFFICER. The Feinstein amendment is the pending business.
AMENDMENT NO. 1103 TO AMENDMENT NO. 737
Mr. LOTT. Madam President, I send a second-degree amendment to the desk to the pending Feinstein amendment.
The PRESIDING OFFICER. The clerk will report the amendment.
The legislative clerk read as follows:
The Senator from Mississippi [Mr. LOTT] proposes an amendment numbered 1103 to amendment No. 737.
Mr. LOTT. Madam President, I ask unanimous consent that reading of the amendment be dispensed with.
The PRESIDING OFFICER. Is there objection?
Mr. FEINGOLD. I object.
The PRESIDING OFFICER. Objection is heard. The clerk will read the amendment.
Mr. LOTT. Madam President, I ask unanimous consent that reading of the amendment be dispensed with so that I may explain briefly what is in this amendment, and if the Senator from Wisconsin wishes, he can continue the objection. I will clarify it for those who are curious about exactly what that amendment is.
The PRESIDING OFFICER. Is there objection?
Without objection, it is so ordered.
Mr. LOTT. Madam President, I just offered the Kennedy health care bill, the identical text of amendment No. 703, which was offered by Senator DORGAN to the agriculture appropriations bill. I hope that our colleagues on the other side of the aisle will let this go forward so that we can take appropriate action.
I wanted to explain that. If the Senator insists, the reading can continue.
Mr. FEINGOLD. I thank the majority leader. I have no objection at this point.
(The text of the amendment is printed in today's RECORD under ``Amendments Submitted.'')
Mr. LOTT. Madam President, again, I did offer the Kennedy health care bill to the agriculture appropriations bill. My thinking is that rather than doing this piecemeal, let's go ahead and deal with the overall Democrat bill dealing with the Patients' Bill of Rights. In order to make sure it is properly considered, I will advocate cloture and I will, in fact, vote for cloture. I think that way we can deal with this issue straight up, not playing around with it.
I emphasize again that this is a farce. I am treating it accordingly. When both sides really want to get serious about sitting down and working out a way to consider this bill separately as a legislative vehicle, I will be glad to do that. But it should not continue to tangle up the appropriations bills. I believe Senator DASCHLE and I really want to get some work done this week for the benefit of the country. I am convinced that he has that intent. By taking this action, I think we can still pass some appropriations bills this week and clear our calendar of a lot of nominations.
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CLOTURE MOTION
Mr. LOTT. Madam President, I send a cloture motion to the Kennedy amendment to the desk.
The PRESIDING OFFICER. The cloture motion having been presented under rule XXII, the Chair directs the clerk to read the motion.
The legislative clerk read as follows:
Cloture Motion
We, the undersigned Senators, in accordance with the
provisions of rule XXII of the Standing Rules of the Senate, do hereby move to
bring to a close debate on the pending amendment No. 1103 to the Agriculture
Appropriations bill:
Senators Trent Lott, Thad Cochran, Ben Nighthorse
Campbell, Susan M. Collins, Craig Thomas, Michael D. Crapo, Kay Bailey
Hutchison, Bob Bennett, Larry Craig, Connie Mack, Chuck Grassley, Christopher H.
Bond, Richard Shelby, Tim Hutchinson, Ted Stevens, and Michael B. Enzi.
Mr. LOTT. Madam President, I know this is an important issue to the minority leader. He will be here shortly. If he wishes, I would be willing to go ahead and have this cloture vote occur as the last vote in the voting sequence that we have stacked this afternoon at 5:30, notwithstanding rule XXII. I am not asking for that right now, but I make that offer to our colleagues. We can vote on that cloture motion this afternoon if they wish, or we can do it tomorrow. But at some point, it will ripen, and we will then have a chance to vote on cloture. I suggest that we actually vote on it.
At this time, I yield the floor.
Mr. DURBIN addressed the Chair.
The PRESIDING OFFICER. The Senator from Illinois is recognized.
Mr. DURBIN. Madam President, I have just arrived from Illinois, and I have come at the right moment because we are considering something called cloture in the Senate. The reason you file a motion for cloture--as Senator BYRD knows because he knows the Senate rules better than anyone, and probably wrote most of them--is to bring to an end to debate and to force the Senate to go forward on a vote.
The Republican strategy, as enunciated by Senators LOTT and NICKLES, is to bring an end to this debate. Which debate would they like to see end? The debate about reforming health insurance in America. They do not want us to move forward with amendments pending by Senators FEINSTEIN of California, KENNEDY of Massachusetts, and others, which address the issue of health insurance reform. They do not want to face votes on these amendments. They do not want us to bring the Democratic Patients' Bill of Rights to the floor and ask Members on both sides of the aisle to vote their conscience, up or down, yes or no, on how we can change health insurance in America.
For several days last week, the argument was made that ``we don't have time to debate health insurance reform.'' But as one day flowed into a second day, and now into another week, we are spending a lot of time on the issue without voting on it. We are spending time finding ways to avoid voting on health insurance reform--a Democratic Patients' Bill of Rights.
Now my Republican colleagues have their own version of the bill and, of course, they are very proud of their version, as we are of ours. We have suggested: Bring your bill to the floor
and bring your amendments to the floor. We will bring ours, and then we will assume the role of Senators. We will debate and we will vote. Ultimately, we hope to put together a good bill. But whatever the outcome, we will then go home and explain to the people we represent why we voted one way or another. This is not a radical strategy or policy.
Mr. NICKLES. Will the Senator yield?
Mr. DURBIN. I will yield for a question in a moment, if the Senator will allow me to complete my thought.
What we are suggesting here is reminiscent of what most people expect to occur on the floor of the Senate--that Senators of differing viewpoints come forward and present their points of view and vote on them. We have gone on day after weary day with the Republican leadership trying to find ways to stop us from debating and stop us from voting.
Over this weekend, I made a tour of my State of Illinois, which is a big State. I ran into some people who told me an interesting story about their experience with health care. One group was in a machine shed on a farm near Farmington, IL. About 30 farmers gathered. I asked them about the farm crisis and I asked them about health insurance. They were equally animated on both subjects, concerned about their loss of income and also concerned about the jeopardy they and their families face because of health insurance.
Last weekend, I was in Peoria and I met with Henry Rahn. He raises soybeans and corn. If you go to most Illinois farms, you will find that is the case. He was quoted a price of $17,000 a year for health insurance for himself and his wife. What really wrangled Mr. Rahn was that in spite of his paying top dollar, the insurance companies were always trying to get out of paying for his health care needs. Recently he suffered a heart attack, and his coverage was threatened when he went to an emergency room because he had not called 24 hours in advance to notify the insurance company.
Another farmer, Bob Zinser--he is a farmer in Peoria and is also a chiropractor--told me in no uncertain terms that the HMO and PPO plans were total garbage. Mr. Zinser says, ``It seems like insurance companies have infinite wisdom on what's right and what's wrong.''
These farmers I met were angry about how they were treated by insurance companies. They wanted action.
Under the GOP version--the Republican version--of managed care reform, these farmers I have just spoken about are not protected. They have written a bill which literally leaves behind 115 million Americans and provides no insurance reform. They do some things for small groups. But unlike the Democratic bill, which covers the vast majority of people with health insurance, the Republican bill leaves many behind, including the farmers and other self-employed people I just mentioned.
When I described this to the farmers at the gathering, they couldn't believe it: You are talking about health insurance reform on the floor of the Senate, and yet it won't help us and our families? I said: The Republican version of the bill will not; the Democratic version will.
Last night I flew to the Chicago area and went to Highland Park and met with a cardiologist. His story was chilling. Let me tell you exactly what he told me last night.
He said a patient came to his office--a woman--on Thursday complaining of chest pains. He didn't think she was in an emergency situation but he wanted her to go to the hospital the next day--the next morning--for a catheterization, a
very common diagnostic procedure used in cardiology, to determine just what her heart problem might be.
So they called her insurance company, and the insurance company said: No, we will not let her have a catheterization on Friday, because that hospital that you want to send her to is not covered by her health insurance. So the doctor said: What would you have her do? They said: Let us make an appointment for her. We will call on Saturday to see what we can find.
She passed away on Sunday. A decision about a hospital ended up jeopardizing this woman's health and her life.
This doctor said to me: What am I supposed to tell her family?
Think of how vulnerable each and every one of us is, going into a doctor's office hoping to get the very, very best diagnosis or treatment but always wondering if we will be second guessed by some bureaucrat at an insurance company. That is what this debate is all about.
I understand the frustration of the Republican leadership. Those of us on the Democratic side for 2 weeks now have been pressing to bring this issue to the floor. We have said we will take the outcome of the vote, whatever it might be, but let us have this debate. America is looking for us to initiate that debate. But, sadly, there are those on the Republican side who do not want to face these votes. They don't want to have to vote yes or no. They don't want to have to decide between the insurance companies' agenda and the agenda of families across the Nation.
That is a sad commentary on the state of affairs in the Senate, because the men and women I spoke to in that machine shed at the farm in Farmington, IL, and the doctor I spoke with in Highland Park understand full well
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There are certainly important bills for us to consider. We have a myriad of important appropriations bills to consider. I hope we can come to them soon. But we have taken the position on the Democratic side that we are only prepared to move to the appropriations bills once we have an agreement from the Republican side that we will debate health insurance reform, we will debate the Patients' Bill of Rights. Unfortunately, as of this moment we do not have that agreement.
There is also a question of accountability. I think this is a bottom line thought: The doctor who told me the story about the woman he wanted to refer for a heart catheterization but was told she couldn't go to the hospital that he wanted and the insurance company would come up with another one, I hope that doctor is never sued by anyone because of that decision. But those things do happen to doctors and hospitals. Despite the fact that the insurance company made the decision--the insurance company took her out of that doctor's care and said she had to go to another hospital--under current law in the United States of America, that health insurance company is protected from liability in court except for the cost of the procedure. If there is suffering, if there is pain, if there is loss of income, or if there is death, the insurance company, having made the decision which it did, will not be held liable.
You say, well, certainly there must be other companies in America which enjoy this kind of special privilege. And the answer is no--not any; none. No other company in America enjoys this protection from liability or enjoys this exemption from accountability like health care insurance companies.
Some on the Republican side have argued, oh, you Democrats just want to bring the health insurance companies in court to make lawyers wealthy. Of course, lawyers would be involved. It would be naive to say they wouldn't be involved. But the bottom line is, if you do not believe that your corporate decision--your insurance company decision--is something you can be held accountable for, how careful will you be? You will make a decision based on the bottom line profit: What is good for my company? How much money will be there at the end of the year? If you make the wrong decision in the interest of the patient, will you be held accountable? Not under the law as written today.
The Democratic Patients' Bill of Rights says no; health insurance companies, as every other company in America, will be held accountable for their conduct. Currently only foreign diplomats and health insurance companies cannot be brought into court in America. We think that should change. When it changes, we think health insurance companies, as in the example I used of the cardiologist, will think twice: Well, Doctor , perhaps you send that letter for a catheterization at the nearest hospital on Friday morning. No. We will not play with the insurance policy. We will work it out later. Let's take care of her health condition.
But they didn't. They decided, let's stick to the letter of the insurance policy.
How frustrating it is for doctors who face this. The doctors I talk to feel helpless.
You read in the paper last week that the American Medical Association is talking about forming a union--the ``International Brotherhood of Physicians'' or something. What would bring what is typically viewed as a conservative political group such as the AMA to a moment in time where they have decided they have had enough, that they have no voice when it comes to medical decisions, and they have to come together and bargain collectively with insurance companies?
I will tell you what has brought them to this point--the example that I used, and some others, where they realize that they have been overruled time and time again. They are frustrated. They are angry. That is why they have decided to start exploring the possibility of forming a union.
The message is here, America. This is an issue which cannot wait. When the Republican leadership comes to the floor and accuses us of stalling tactics, we are not trying to stall this process; we on the Democratic side are trying to accelerate this process.
Let's bring this bill to the floor. This is our last week before the Fourth of July recess. Let's dedicate this week to the Patients' Bill of Rights. Let's make sure that when we go home on Independence Day and walk down the parade route, the people we are looking at, who are waving sometimes at us, realize we have done our best, we have done our best to address an issue that is critical to every American.
The Rand study said that 115 million Americans have had a bad experience with a health insurance company or know someone in their family, or close friend, who has. The cases I have cited to you are not isolated examples. The letters stack up in our office from people all across my State of Illinois and all across this Nation. I have been speaking on the floor the last couple of weeks on this issue, and I have started receiving these letters. I have asked people to send letters to me in my office and to tell me about their experience with health insurance.
Every single letter tells the same story--letters where women who have chosen an OB/GYN as their primary care physician, a person they are confident of, a person they want to work with, have been overruled by insurance companies that said: We have a new doctor for you; situations where people, as I described earlier, will go into an emergency room only to learn that they are denied coverage because they picked the wrong hospital or they didn't call in advance for an emergency room.
Can you imagine, racing to the hospital with a son who has just fallen out of a tree in the backyard, trying to remember the number of the insurance company? Is that the last thing on your mind? It certainly would be on mine. I can remember taking my son to an emergency room when he decided to catch a baseball with his teeth instead of the glove. Those things happen. And you race off to the emergency room. You don't want to fumble in the glove compartment to find the insurance policy. You are worried about that little boy whom you love like everything in this world, and you want to get him to a good doctor as quickly as possible. You don't want to get tangled up in an insurance company bureaucracy.
Many times we find that the people, for example, who need specialists for medical care learn that they are being overruled by insurance companies that say: No; even though a doctor told you you needed a certain specialist, we don't approve of it.
One doctor who kept calling insurance companies and receiving frustrating answers finally asked the clerk on the phone: Are you a doctor ? The voice at the insurance company said no.
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