January 30, 1980
Page 1203
Mr. LONG. Mr. President, will the Senator yield for a question?
Mr. BAYH. I yield.
Mr. LONG. When was the Senator advised of that?
Mr. BAYH. When was that?
Mr. LONG. Yes.
Mr. BAYH. I cannot tell the Senator the exact date.
Mr. LONG. Was that before we entered into the unanimous consent agreement or after?
Mr. BAYH. I am advised that it was after.
Mr. LONG. If it was after, it would not mate any difference, because both sides have a right to explain why they think an amendment is germane or not. When both sides have been heard, the Parliamentarian should advise the Chair, and the Chair should rule.
This unanimous consent agreement was made on November 20, 1979.
Mr. MAGNUSON. On this bill?
Mr. BAYH. The only reason the Senator from Indiana brings this up is to show that; at least at one time in the discussion of this matter, it was a close question and that the Parliamentarian came down on the other side of it. It is a question of great significance, as to whether we are going to help people who have cancer and other terminal illnesses to provide for themselves and their families in their last hours.
The Senator from Indiana comes down very strongly on the position enunciated first by the Senator from Washington, that a study about terminal illness certainly gives sufficient germaneness. But if we have different opinions on that, certainly a matter of such significant consequences, of life and death, should not be decided by the Senate on a point of order.
Mr. LONG. Mr. President, the Senator can raise this issue on any other bill.
I have a memorandum which was prepared with the help of our staff, and I ask unanimous consent to have it printed in the RECORD.
There being no objection, the memorandum was ordered to be printed in the RECORD, as follows:
BAYH AMENDMENTON TERMINALLY ILL
Under the time limitation agreement, no amendment not specified in the agreement may be considered unless it is germane to the bill. The Bayh amendment introduces new matter not dealt with in the House bill or the Committee amendment. It is therefore not germane and should be considered not in order.
It might be argued that the provision is germane because the bill contains a section dealing with the terminally ill. This argument is invalid for these reasons:
(1) Section 605 of the bill authorizes appropriations from general revenues for the Social Security Administration to participate in a demonstration project to study the impact of the present program on the terminally ill and how best to provide services to help them. The Bayh amendment provides an entitlement to benefits payable from the Social Security Trust Funds to terminally ill persons.
(2) Section 505 of the bill is free standing legislation. The Bayh amendment permanently amends the Social Security Act.
(3) Section 505 of the bill would permit appropriations totaling ten million dollars or less over the next five years. The Bayh amendment would directly result in expenditures totaling more than one billion dollars over the same period.
Neither the House bill nor the Committee amendment substantively modify the provision of present law (section 223(a) of the Social Security Act) which would be changed by the Bayh amendment. Present law provides that disabled individuals may not receive disability benefits during the first five full months of disability unless they were previously entitled to disability under the program and the prior disability ended within the previous 5 years. This rule would be unchanged by the bill as reported. (Other aspects of the bill change the rules as to when a disability terminates and the Committee bill does make a conforming amendment to section 223(a) to reflect the new provisions relating to benefit termination. However, that change, unlike the Bayh amendment, does not eliminate the waiting period for a category of individuals who are now subject to it.)
Mr. LONG. Mr. President, the Senator from Indiana is not prejudiced in any way; because, according to his own representation, he did not raise the question prior to the time the unanimous consent agreement was entered into. Subsequent to that time, when the point came up, the Parliamentarian, of course, should consider the authorities that can be suggested by both sides.
The Senator could offer his amendment on any other bill, and he would be within the rules, and he would not be asking Senators to go contrary to the agreement they made in November of last year.
Mr. BAYH. Mr. President, I do not want to quibble on that point—
The PRESIDING OFFICER. The time of the Senator has expired.
The Senator from Louisiana has 1 minute.
Mr. LONG. I yield back the remainder of my time.
The PRESIDING OFFICER. The question is, "Shall the ruling of the Chair stand as the judgment of the Senate?"
On this question the yeas and nays have been ordered, and the clerk will call the roll.
The legislative clerk called the roll.
So the ruling of the Chair was not sustained as the judgment of the Senate.
The PRESIDING OFFICER. The question recurs on agreeing to the amendment of the Senator from Indiana.
Mr. LONG. Mr. President, I yield time on the bill to the Senator from Maine. How much time does the Senator from Maine require?
Mr. MUSKIE. Not more than 5 minutes.
Mr. LONG. I yield the Senator 5 minutes.
Mr. MUSKIE. Mr. President, I am sorry I was not on the floor when this amendment was brought up in the course of the debate. I was tied up in Budget Committee hearings. We are having hearings on the administration's budget proposal.
Mr. ROBERT C. BYRD. Mr. President, may we have order? Senators should hear what the Senator from Maine is about to say.
The PRESIDING OFFICER. The Senate will be in order.
The Senator from Maine.
Mr. MUSKIE. This amendment arose as we were bringing those hearings to a close. Since I do have some responsibility for bringing to the attention of the Senate matters that impact seriously on the budget. I think I have an obligation to do so in this case even though it is clear from the vote that has already been taken what the will of the majority of the Senate is.
I am not sure whether or not the relevant points, which I think ought to be a part of the record, were raised in the earlier debate.
I know the distinguished floor manager of the bill undoubtedly is expressing his point of view with his customary thoroughness and eloquence, but I do want to make it clear to the Senate that this amendment has serious budget implications not just for a single year but for the long run. In addition, the implications for further change are inherent in the amendment.
I just cannot believe that the Bayh formulation — and I say this with all respect to my good friend from Indiana — will stand as the ultimate policy because it would generate inequities that some future Senate will be motivated to react to in the way that the Senate has reacted to this case. So, without unduly delaying the Senate, I would like to make my points.
First, as I understand the amendment, it provides that persons medically determined to be terminally ill — that is, expected to live 12 months or less — would not be required to wait 7 months from the onset of their disability before receiving social security benefits.
Because the amendment is effective in 1981, and the 1981 budget resolution has not yet been agreed to — we just began consideration of it today — under section 303 of the Budget Act the legislation is subject to a point of order until the Congress has acted on the first budget resolution. But I do not want to emphasize that. I want to emphasize the policy problem.
With respect to this amendment, outlays would be increased as follows: Fiscal year 1980 by $120 million; fiscal year 1981 by $132 million; fiscal year 1982 by $143 million; fiscal year 1983 by $153 million; fiscal year 1984 by $163 million; and the 5-year impact totals $711 million.
The argument for this amendment is put most succinctly, and I find the amendment as appealing as any Senator in this Chamber. The argument for the amendment is that some totally disabled people never receive social security disability insurance benefits because they die before the 5-month waiting period has expired. That simple statement will prompt every Senator to vote yea and do so as visibly and as clearly and as loudly as he can. Certainly, that is my instinct.
But what is the other side of the story? First, there is no evidence that the terminally ill have a greater need for benefits during the first 5 months of disability than do other disabled beneficiaries.
The amendment, in effect, says that those who are medically determined to be terminally ill and expected to live 12 months or less should not be subject to the 5-month waiting period, but those who are going to die in 2 years will get no benefit during that 5-month waiting Period. They will still have to wait.
If you were to buy the logic behind this, then you would eliminate the 5-month waiting period altogether, so as not to create any inequity.
The second point is it would be difficult to administer and would create anomalies because it is frequently difficult to determine medically if a person is terminally ill and can be expected to die within 12 months. One of our colleagues told me — and I will not name him — that his grandmother was declared terminally ill and lived for 14 years after the determination.
The third point is that in some cases people could be found to be terminally ill, as I just described, and yet could live more than 12 months or even recover. It would be unfair to other disabled beneficiaries that such people would get 5 additional months of benefits.
The fourth point is that in still other cases, people not found to be terminally ill could die within 12 months of becoming disabled. Their survivors could claim that they were treated unfairly because they did not get 5 additional months of benefits.
The fifth point is that physicians would be placed in the difficult position of determining whether to state a person is terminally ill so that he can receive 5 months' extra benefits or to withhold the information on the grounds that it would be harmful to the patient and his family.
With cancer victims, for example, doctors often make the judgment that a given cancer patient — because of his mental condition or emotional state — ought not to be advised that he is terminally ill or that the doctor should not predict a date of death within 12 months. What do you do in that case?
The next point, Mr. President, is the problems and anomalies caused by the amendment could lead to pressures to shorten or eliminate the waiting period altogether which would substantially increase the cost of the disability program.
With respect to the budget itself, given action to date in the Senate — including the reported version of the pending legislation — the Finance Committee is over its fiscal year 1980 outlay crosswalk by $1 billion, over its fiscal year 1981 outlay crosswalk by $1.3 billion, and over its fiscal year 1982 outlay crosswalk by $1.2 billion. These significant overages reduce the spending available to other committees in each year under the ceilings in the second budget resolution.
Mr. President, I have stated the perspective of the chairman of the Budget Committee on this amendment as succinctly as I can. I do not take pleasure in it and I did not take pleasure in voting to support the motion to table.
May I ask the Parliamentarian whether he has had an opportunity to study the question of the point of order under the Budget Act?
The PRESIDING OFFICER. It is out of order.
Mr. MUSKIE. It is out of order? So it is subject to the point of order.
The PRESIDING OFFICER. The Chair has the question under advisement at this time.
Mr. MUSKIE. I see. I will withhold that.
Mr. MAGNUSON. Mr. President, will the Senator yield?
The PRESIDING OFFICER. Who yields time?
Mr. MUSKIE. Mr. President, I am happy to yield to the distinguished Senator from Washington.
Mr. MAGNUSON. Mr. President, the Senator has not made up the first budget resolution, has he?
Mr. MUSKIE. Of course not.
Mr. MAGNUSON. And if Congress votes something before you make it up, you just have to accommodate what Congress voted, do you not?
Mr. MUSKIE. The Senator is exactly right.
Mr. MAGNUSON. All right. We voted this thing, or we are going to vote it.
Mr. MUSKIE. Mr. President, that is the Senator's prerogative. But it is also my prerogative to tell the Senate
Mr. MAGNUSON. Wait a minute. If it is an extra cost, I ask the question, then, does it have to be accommodated by the budget?
Mr. MUSKIE. Of course. But what the Senator seems to be implying is that if I think the proposal is out of order, I should not raise the question because it is the Senate's will to do what it wants to. Of course, it is the Senate's will. But, the whole thesis of. the Budget Act is that the Senate ought to have all of the information that is possible to bring to bear on the issue before it votes, so that it can make an intelligent vote. I understand that the Senator can disagree with what I said.
Mr. MAGNUSON. Mr. President, I will say to the Senator from Maine that this is an amendment that has been around for months.
Mr. MUSKIE. I do not challenge that.
Mr. BAYH. Years.
Mr. MAGNUSON. Years.
Mr. MUSKIE. There may be a reason why it has been around for years and not adopted. There may be a good reason, and I may have touched upon some of those reasons.
The Senator from Washington knows better than to suggest that I have the power to deter the Senate from doing what the Senate wants. The Senate could increase the deficit for fiscal year 1980 to $60 billion, if it wishes. I cannot stop it.
But when I see a proposition like this — one which has problems that the Senate ought to take into account, it is my job to lay it out for the record. I am sorry if that is inconvenient and embarrassing. But that is the fact.
Mr. BAYH addressed the Chair.
The PRESIDING OFFICER. The Chair recognizes the Senator from Indiana.
Mr. BAYH. Mr. President, I appreciate the fact that the Senator from Maine has brought to the attention of the Senate these matters.
I will say that most of those have been raised very eloquently by the Senator from Louisiana, which certainly does not preclude the Senator's right as chairman of the Budget Committee to bring them up again.
The PRESIDING OFFICER. Who yields time to the Senator from Indiana?
Mr. BAYH. Mr. President, the question I wanted to raise goes directly to the Senator from Maine and he and the Parliamentarian are now involved in a discussion to determine whether the subject is under a point of order.
The PRESIDING OFFICER. The time is under control. Does anyone yield time?
Mr. DOLE. Mr. President, I yield to the Senator from Indiana 5 minutes off the bill.
Mr. BAYH. Mr. President, I point out to both the Parliamentarian and the Senator from Maine that, at least from the standpoint of the point of order, the Senator from Indiana — both Senators from Washington, and the Senator from Tennessee — thought we would escape any immediate point of order by pointing out that none of these funds are applicable in this fiscal year. It does not take effect until the next fiscal year.
Mr. MUSKIE. Mr. President, section 303 applies to the legislation that would impact upon a fiscal year before the first concurrent budget resolution for the year has been adopted.
In other words, this amendment changes the law applicable for 1981, and the fiscal year budget which we have just begun to consider. The Parliamentarian has not yet determined whether section 303 applies to the amendment. I do not have any parliamentary bias against the amendment of the Senator, but section 303 does impact upon legislation that first increases outlays in 1981. Whether it does so in a way that does violence to section 303 the Parliamentarian is now considering.
Mr. BAYH. Would the Senator feel more comfortable if we made it applicable to this fiscal year? I am not quibbling.
Mr. MUSKIE. May I say I am not comfortable about the whole amendment. I thought I went out of my way to indicate that. Does the Senator think it is easy for me to stand here and make a case against an amendment of this kind? Of course I am not comfortable. Does the Senator think I can be more comfortable because he changes the effective date? No, I cannot be more comfortable.
The basic point is that I have to stand here in opposition to an amendment which clearly the majority of the Senate wants to pass, is emotionally inclined to pass. No, I am not comfortable. That change will not make me any more or less comfortable.
I would say to the Senator that, by making that change, it might avoid a point of order. I would not object to his doing that.
Mr. BAYH. The Senator from Indiana is not unaware of the difficulty of dealing with the cost of this. That is why in the early debate on this, the Senator from Indiana and others tried to point out the unique characteristics of the kinds of citizens we are dealing with here. To suggest that someone who has been declared by two doctors as terminally ill present the same question as someone who has lost a leg, I think is to ignore the reality of the situation.
The reason we are confining it to those who are terminally ill, and the reason I think we have a compelling case for this, is that if a person loses a leg and is disabled, upon living beyond 5 months he can then start drawing out of his social security disability fund.
The tragic but real fact of life is if someone has been declared terminally ill as a cancer patient and he is the average patient, he does not live beyond 5 months. In fact, he probably does not live beyond 21/2 to 3 months.
What we are suggesting is that this fact presents a compelling reason to let someone draw from that security fund into which he has contributed without a 5-month waiting period.
I must say that the statement made by the Senator from Maine, in which he suggests that it does not make any difference whether one is dying from cancer or is disabled in some other way, seems to me to show a lack of familiarity with the problems suffered by those who have cancer.
Mr. MUSKIE. I do not think I made any such suggestion.
Mr. BAYH. If this Senator may continue with his comments, I think the Senator from Maine did say there was no reason to treat the terminally ill any differently than other disabled and thus he was concerned — I understand his concern — that this would be setting a precedent for other kinds of disability.
Mr. MUSKIE. I did not suggest that. I have friends with cancer, some of whom have been ill for less than 5 months, some whom have been ill for more than 5 months, some for more than 12 months, and I find it difficult to understand why, when one of these friends dies 13 months after becoming ill, he or she should not get this exemption, but one who dies within 6 months does.
The PRESIDING OFFICER. The time of the Senator has expired.
Mr. BAYH. This Senator yields himself 2 minutes.
The PRESIDING OFFICER. There is no time remaining.
Mr. DOLE. Mr. President, how much time remains on the bill?
The PRESIDING OFFICER. Twenty-four minutes remain on the bill.
Mr. DOLE. I yield 2 minutes to the Senator from Indiana.
The PRESIDING OFFICER. The Senator from Indiana.
Mr. BAYH. I hope we are having this debate without suggesting that any of our colleagues who may be concerned about the costs are not compassionate and concerned about people who have cancer. That is not what the Senator from Indiana is suggesting. What he is suggesting is that the fact is that those who are covered must be declared terminally ill by two doctors.
There is a definition, a certain standard, a certain criterion, that has to be met under social security regulations to show that this is a very serious determination. Having given that determination, the majority of those who are thus classified live less than 5 months. Some of them may live 13 months and thus would be covered and be able to draw. There is no question about that. But the vast majority of them would not.
I suggest to the Members there is a uniqueness about the circumstances surrounding a family where there is someone who is unable to work, who is dying from cancer, that does not exist in the families of others who are disabled because of other reasons.
Mr. MUSKIE addressed the Chair.
The PRESIDING OFFICER. The Senator from Maine.
Mr. MUSKIE. Mr. President, I guess it is unavoidable
The PRESIDING OFFICER. Who yields time?
Mr. RIBICOFF. I yield 5 minutes to the Senator from Maine.
Mr. MAGNUSON. Will the Senator yield for me to ask for the yeas and nays?
Mr. MUSKIE. Yes.
Mr. MAGNUSON. Mr. President, I ask for the yeas and nays on this amendment.
The PRESIDING OFFICER. Is there a sufficient second? There is a sufficient second.
The yeas and nays were ordered.
Mr. MUSKIE. I might say I am not concerned primarily with cost, Mr. President—
Mr. BAYH. If the Senator will permit me to interject, as he tried to correct my inferences, I thought I had made it very clear that the Senator is not objecting on the basis of cost.
Mr. MUSKIE. I understood the Senator to say that, but he also said something else. I just want to make it clear in my own words. It is not cost, principally. I understand that budgets are more than costs and deficits. Budgets are people as well. I know that. I fight for them all the time in that Budget Committee. If Senators have any question about that, I invite them to attend the markup sessions.
I cannot fight for unlimited funds for every human cause and still discharge my responsibilities as chairman of the Budget Committee. If the only way I can be compassionate is to raise all limits on people programs, then we might as well drop the budget process.
Secondly, I am not making a distinction on the basis of a disease. I made the distinction very succinctly; it was in writing and will go into the RECORD exactly as written.
Mr. President, this amendment is subject to a point of order under the Budget Act. I am not going to raise the point of order. There has already been one point of order and the Senate has voted on it. So I think the Senate ought to vote up or down on the amendment. I have made my case. It is subject to a point of order and I hope Senators will bear that in mind. My not raising it today does not mean that I unilaterally repeal section 303 of the Budget Act.
I think there is no reason why Senators should not vote on the merits as they see them and, whatever the Senate votes, the Senate is my boss, as Senator Mansfield used to say.
I say just one word in closing: I am asked constantly why we cannot balance the budget. It is these kinds of things, with a deep emotional appeal, that have as much to do with the growth of Federal spending as anything else in the budget. Just look at the charts in the new budget on where the budget growth has been in the last 10 or 15 years. It has been in this area of payments to individuals, and it is so easy for us to act on them. Then, having written them into law as entitlements, the Appropriations Committee will say to us, "Well, we cannot control them, because they are entitlements; it has already been written into the law," and they are right.
Mr. MAGNUSON. I agree this is an entitlement.
Mr. MUSKIE. It is an entitlement, of course.
Mr. MAGNUSON. Not subject to appropriations.
Mr. MUSKIE. That is exactly what I am saying. The only place to apply a budgetary judgment on it is now; we cannot do it any other time.
UP AMENDMENT NO. 933
Mr. DOLE. Mr. President, I send an amendment to the desk and ask for its immediate consideration.
The PRESIDING OFFICER. The amendment will be stated.
The assistant legislative clerk read as follows:
The Senator from Kansas (Mr. DOLE) proposes an unprinted amendment numbered 933 to amendment numbered 749:
On page 2, line 7, change the "12" to "6."
Mr. DOLE. Mr. President, I hope the Senator from Kansas is being constructive, as I suggested to the Senator from Indiana earlier, when we tried to satisfy some of the concerns by requiring a second opinion. I think, in line with what the Senator from Indiana stated several times on the floor, that since most of the people affected die within the 5-month waiting period, it would be more in line with the purpose of the Senator from Indiana and the Senator from Washington and others if we change it so it would read to certify that the individual is terminally ill and is expected to die within 6 months instead of 12 months.
The people who will live beyond 5 months will get benefits after that waiting period. It seems to me that with this minor change we can still meet the needs of those who are expected to die during the waiting period while keeping the cost down somewhat.
I share some of the agony expressed by the distinguished chairman of the Committee on the Budget that anyone who suggests any tampering with the amendment might be suspect in the eyes of some. But it seems to this Senator that there is a cost problem.
I hope that if, in fact, this amendment is passed, my modification will help to assure that it survives the conference. I hope the Senator from Indiana might be willing to accept that modification.
Mr. BAYH. A parliamentary inquiry, Mr. President.
The PRESIDING OFFICER. The Senator will state it.
Mr. BAYH. Does the Senator from Indiana have time?
The PRESIDING OFFICER. The Senator does not have time. The time is unler the control of the Senator from Connecticut and the Senator from Kansas.
Mr. RIBICOFF. May I ask how much me the Senator from Indiana desires?
Mr. BAYH. Five minutes.
Mr. RIBICOFF. Mr. President, I yield minutes to the Senator.
Mr. BAYH. I thank the Senator from Connecticut.
Mr. President, my reluctance to accept the amendment of the Senator from Kansas, which I know is offered in good faith, is based on the fact that the 12-month period was arrived at after consulting with a number of physicians who deal on a daily basis with terminal illness, and terminal illness, as a term of art, is used in the frame of reference of someone who is not expected to live more than 12 months.
I point out that being categorized as terminally ill and thus being assessed by two doctors as having a longevity of less than 12 months does not automatically qualify someone to start drawing disability payments. One has to have that assessment, plus one also has to meet the other criteria which are established under title XX for disability as not being able to maintain any substantial means of gainful employment.
In other words, those cancer patients who live on for 14 years are not qualified — and everybody who has cancer would not meet the criterion of being terminally ill in that 12-month period.
Many of them — in fact, most cancer patients — work right down to the last physical capability of doing that. That is a unique quality, I think, of cancer patients. Those people really want to hang in there, and want to be active as long as possible.
There is a specific description, a legal description, as to what criteria and what definition would be applied under medical terms if one were declared terminally ill after discovery of breast cancer. It includes the turning over of actual medical records and hospital records which indicate that the perimeters of the carcinoma go beyond the area of radical excision of the tumor and surrounding lymph nodes. The records must include biopsies, information on the location of the tumor, information on the extent of metastasis and voluminous additional objective medical information.
One would have to conform to that general description as established by the social security rules and guidelines, would have to not be able to maintain any substantial employment — as well as meet the terminal illness definition which is extremely strict. So I do not see the necessites of the amendment of the Senator from Kansas.
What it potentially does is get a number of people who might die just before they got to the 5-month period and still not qualify. It increases the number who would not qualify but who died before they could reach the point. If, indeed, the people who are judged terminally ill are not expected to live more than 6 months we may be creating unsolvable problems for physicians and we are going to have people who are going to be suffering. I do not think the Senator from Kansas wants that.
Mr. DOLE. That is not the intent of my amendment. I wanted to tighten it up, obviously, so we might satisfy some of those budgetary concerns. There is no way of knowing how much it is tightened up, but it seems to me it is a position where, if you live beyond the 6-month period, you are receiving benefits; if you are certified that you cannot live beyond 6 months, there is no waiting period. It seems to me it is a compromise that ought to be acceptable and that many of us would support.
Mr. MAGNUSON. Will the Senator yield in the meantime?
Mr. DOLE. Yes, I yield.
Mr. MAGNUSON. I hope the Senator will withdraw his amendment, because, if and when this amendment passes, we. are going to go to conference anyway. It is not in the House bill. I am hoping we can work something out on this amendment by which the Senator can withdraw it, because the matter will be up in conference. Then we can work out whether it is a 5-month period or a year and get more information on the facts involved and it will be somewhere within that period.
Of course, 5 months is a little deceiving, anyway, because you cannot shut it off when somebody is going to die.
Second, it takes, sometimes, 8 or 9 months to get through the paperwork. The regulations and paperwork with HEW and social security are horrendous.
Some of these people actually get the doctors to certify. It takes months sometimes, weeks at least, so the time element, to set a time date, is a little unusual.
Mr. DOLE. I thank my distinguished colleague.
Mr. President, it would seem to me that most physicians could look at someone and after the examination probably determine very easily if that person might survive 3, 4, or 5 months. It might be difficult to make a judgment on 12, 15, or 18 months.
But, in any event, it seems to me there is a consensus being reached.
We understand the problem. We hope we can deal responsibly with the problem so we do not do violence to the social security system, or any part thereof.
Mr. MAGNUSON. The Senator's amendment has 6 months?
Mr. DOLE. Six months.
It seems to me a physician, or two physicians, can determine after examination if someone is very critically ill and will not survive 6 months more easily than that he will not survive 9 months, 12 months, or 15 months.
So it would seem to me the one way to properly address that and make certain we are looking at those extreme cases and reduce it from 12 to 6 months.
Mr. BAYH. Will the Senator yield?
Mr. DOLE. Yes.
Mr. BAYH. I apologize for interrupting.
Mr. President, I know exactly what the Senator is trying to accomplish. I know of his compassion and concern for this problem. We do not want to allow someone, who either intentionally or unintentionally, is taking advantage of this special provision designed to meet a certain unique health problem.
The Senator from Indiana is concerned because in discussing with doctors the description of terminal, the 1-year frame of reference is usually used.
As I pointed out, in the case of cancer, most of those folks do not live 5 months.But I am concerned that by cutting it back to 6 months, we may be giving those in the profession who are asked to attest or to swear to this particular criteria a burden they do not feel they can meet. They could say that they think someone would live for 1 year, but they would not want to swear to only 6 months.
I know of the Senator's concern. I ask the Senator if he would consider withdrawing this amendment with the understanding we would go together and talk to professionals in the field to see if this would cause a problem. If not, I would support any efforts he and others might make in conference to do what we all want to accomplish.
Mr. DOLE. Mr. President, I commend the Senator from Indiana. He, more than anyone on this floor, understands the problem.
I also want to commend the distinguished senior Senator from Washington (Mr. MAGNUSON) , who brought this witness to our committee, along with Senator JACKSON.
The Senator from Kansas will be a conferee. I think this debate has been helpful in the right sense. There are some problems with the amendment, but there is no question about anyone's motives in this Chamber.
Mr. President, I ask that the amendment be withdrawn and that we do work on this between now and the time of the conference.
There is nothing in the House bill on this issue, so it is going to depend on persuasion on the Senate side.
As to those of us who are conferees, it is my hope we can come up with something we can sell the conference and still be responsible in light of the very sound arguments made by the distinguished Senator from Maine (Mr. MUSKIE).
The PRESIDING OFFICER. The amendment is withdrawn.