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Statement on Introduced Bill (Senate - September 18, 1995)

By Mr. HATFIELD (for himself, Mr. Harkin, and Mrs. Boxer):

S. 1251. A bill to establish a national fund for health research to expand medical research programs through increased funding provided to the National Institutes of Health, and for other purposes; to the Committee on Finance.

The National Fund For Health Research Act

Mr. HATFIELD: Mr. President, this week finds us at the height of the appropriations process, as the end of the fiscal year rapidly approaches. It has been a season of difficult fiscal decisions which must be made to conform to the constraints of our balanced budget agreement. Never are the tradeoffs as vivid as when we consider spending levels for health and education programs, as we did this morning when the Senate Appropriations Committee completed action on the fiscal year 1996 Labor, HHS, and Education appropriations bill.

I am pleased to report that the committee provided nearly $1.5 billion more than the House for education programs. In addition, we provided a 2.7 percent increase for health research at the National Institutes of Health. While this level is less than that provided by the House, I believe it represents a fair balance between the vitally important issues of health and education. But clearly, my preference would have been to provide a much larger increase for medical research so that the engine which drives the quality of medical care and reduced health costs could run at full tilt.

The current reality is, however, that available funds for discretionary spending are decreasing. We cannot continue to look solely to the appropriations process for the necessary resources to keep our biomedical research enterprise growing at a rate which takes advantage of the myriad medical breakthroughs on the horizon. We must look for a funding source to supplement annual appropriations to the National Institutes of Health.

Today I am pleased to unite with my friend and colleague, Senator Harkin, in introducing legislation to establish the national fund for medical research. We joined forces in this effort last year and worked hard to see that medical research was a part of the health care reform debates. At the end of the process, although the issue was ultimately unresolved, we had received the attention and support of many Members in this Chamber. We introduce this bill today, with the support of Senator Boxer of California, with the intention of building on the momentum of last year to gain the support of our many colleagues in this body who are committed to the biomedical research infrastructure.

Our legislation proposes to create a new fund in the U.S. Treasury, financed by an increase in Federal tobacco taxes and income generated through a voluntary Federal income tax checkoff. By raising the Federal tax on cigarettes by 25 cents per package, as well as raising the tax to an equivalent level on smokeless tobacco products, the Joint Committee on Taxation has estimated annual income for the fund of approximately $4.2 billion. These funds will be distributed on a phased-in basis to the National Institutes of Health to supplement, not replace, the funds the organization receives each year in the appropriations process. Funds will be distributed in accordance with the proportion of funds each of the member institutes and centers receive in the appropriations process, after 5 percent has been divided between the Office of the Director, the National Center for Research Resources, and the National Library of Medicine.

Funds raised through this proposal will increase the budget of the NIH by 35 percent over the fiscal year 1995 appropriated level. This will allow many more research grant applications to be funded so that scientific opportunities of merit can be pursued and ultimately translated into cost-effective treatments and cures which will improve our national quality of life. I know of no better investment for the Federal Government than one which strengthens our human capital--be it in education or health research, our greatest strength is a healthy, and thus wealthy, populous.

Mr. President, my good friend, the great philanthropist, Mary Lasker once said, "If you think research is expensive, try disease." Diseases cost this country hundreds of billions of dollars annually. Last year, federally supported research on Alzheimer's disease totalled $300 million, yet it is estimated that $90 billion is expended annually on care. Federally supported research on diabetes totals $290 million, yet it is estimated that $25 billion is expended annually on care. Federally supported research on mental health totals $613 million, yet it is estimated that $130 billion is expended annually on care.

As we struggle in the coming months to achieve a balanced budget, we must embrace policies that enable us to make the most out of our scarce Federal dollars. Federal funding for medical research should be a top priority because without new knowledge to develop new strategies to prevent disease, new treatments to delay the progression of disease and new interventions to cure disease; health care costs will continue to spiral out of control. Disease drives the cost of health care. A concerted Federal assault on disease will not only save precious funds, but it will provide hope to the afflicted.

Watching a medical catastrophe affect a family or individual is one of the greatest tragedies we face in this country. The impacts are accentuated when this misfortune comes in the form of an incurable disease. Loved ones are left with no hope, and feeling powerless as they watch the debilitating effects of disease overcome the individual. I know many of my colleagues in the Senate have experienced this sense of powerlessness. They have watched helplessly while family members deteriorate from the effects of a deadly disease. The vibrant individual that they knew and loved is reduced to a withering shell of a human being. The one thing, and the only thing that provides comfort to the afflicted and to their loved ones, is hope. Hope for an end to the suffering. Hope for a return to a normal life. Hope for a cure. This hope does not have to be great, even the faintest glimmer brings happiness to someone faced with a fatal future.

Medical research is the sole hope we can provide to millions of Americans who will experience disease and disability either in their own lives or in their families. We can care for them in our hospitals and clinics but we cannot alleviate their pain or end their suffering without cures and preventative treatments. Cures are the direct result of our investment in medical research.

This legislation is important because it will help provide a more sustainable funding base for medical research. During the debate on the budget resolution, I offered an amendment to restore $7 billion of the nearly $8 billion cut for the NIH proposed by the Senate budget resolution over the next 7 years. This amendment passed by a vote of 85-14. While this was a short-term victory for the NIH, it demonstrates the need for a stable endowment for medical research. The war against disease can not be fully waged if medical researchers have to engage in yearly squabbles with Congress over funding levels.

As most of my colleagues know, I am a practical man. I do not underestimate the difficulty any tax increase has in the current political climate, but I submit we must listen to the people who put the new Republican majority in power.

A recent Harris Poll has shown that Americans strongly support health research and are willing to put their money behind their words. The poll asked Americans which type of scientific research they favored--66 percent favored medical research and a pitiful 4 percent preferred defense research. This same poll determined that if assured that the funds would be spent for medical research, 74 percent of Americans are willing to spend $1 more in taxes. Other polling data consistently shows that more than two-thirds of Republican and Democratic voters, including voters in tobacco-growing States, favor raising tobacco taxes.

These results make it clear that our constituents desire a strong Federal commitment to medical research, even if it means an increase in taxes. An increase in tobacco taxes is easily the most appropriate source of funding for this bill. The Centers for Disease Control and Prevention reports that the Federal Government spends more than $20 billion per year to pay for the direct health care costs caused by tobacco. Tobacco taxes will help offset and reduce the economic costs of smoking. Taxes on tobacco products are a proven source of revenue around the world. Most major industrialized nations tax tobacco at $2 to $3.60 per package.

The increase in the tobacco tax will provide extensive health benefits. Tobacco use is the greatest cause of preventable death in America. About 1.3 million children and adults will be discouraged from smoking by a 25-cent tobacco tax. Because about half of all long-term smokers die of diseases caused by smoking, a 25-cent tobacco tax will save the lives of more than 300,000 Americans alive today. I hope these heart-wrenching statistics will put an end to the congressional coddling of the almighty tobacco lobby. Tobacco use imposes a great price on our society, and those who profit from tobacco use should contribute their fair share to this devastation.

This legislation has everything to do with providing our Nation with a brighter future. While sustainable resources for medical research are essential for our Nation's prosperity, our young people will ultimately determine the future of our Nation. Zenia Kim, a finalist in the Miss Oregon Pageant, and an aspiring medical researcher, provides me with a personal impetus to progress on this legislation. Like many Zenia had not given disease or medical research much thought until a close relative was stricken with cancer. After seeing her family member experience the terrors of chemotherapy, she dedicated her life to finding a cure to cancer.

Zenia has vigorously pursued this pledge by working during her college summers at Oregon Health Sciences University. It was here, at one of our Nation's top academic medical centers, that she encountered the problems of insufficient funds for medical research. This inspired her to develop a comprehensive proposal to cure cancer. The main component of this proposal is research. Kim writes, "as a future medical scientist, I would like to know that there will be enough funding available to pursue my research endeavors."

I would like Zenia to someday realize her goal and find a cure for cancer. I would like to assure Zenia, that when she graduates from medical school, we will have adequate funding for medical research. I urge my colleagues to support the National Fund for Medical Research to help Zenia and others like her to provide hope for those tormented by disease and disabilities.

I ask unanimous consent to include in the Record, a copy of the bill, a question and answer summary, a sample of letters of support, and a list of nearly 200 organizations supporting this effort.

There being no objection, the material was ordered to be printed in the Record, as follows:

104th CONGRESS
  1st Session
                                S. 1251

  To establish a National Fund for Health Research to expand medical 
 research programs through increased funding provided to the National 
             Institutes of Health, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

           September 18 (legislative day, September 5), 1995

 Mr. Hatfield (for himself, Mr. Harkin, and Mrs. Boxer) introduced the 
 following bill; which was read twice and referred to the Committee on 
                                Finance

_______________________________________________________________________

                                 A BILL


 
  To establish a National Fund for Health Research to expand medical 
 research programs through increased funding provided to the National 
             Institutes of Health, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the "National Fund for Health Research 
Act".

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) Nearly 4 of 5 peer reviewed research projects deemed 
        worthy of funding by the National Institutes of Health are not 
        funded.
            (2) Less than 3 percent of the nearly one trillion dollars 
        our Nation spends on health care is devoted to health research, 
        while the defense industry spends 15 percent of its budget on 
        research.
            (3) Public opinion surveys have shown that Americans want 
        more Federal resources put into health research and are willing 
        to pay for it. Polling data consistently shows that more than 
        two-thirds of all voters support a major tobacco tax increase 
        if revenues generated are dedicated to health-related programs.
            (4) Ample evidence exists to demonstrate that health 
        research has improved the quality of health care in the United 
        States. Advances such as the development of vaccines, the cure 
        of many childhood cancers, drugs that effectively treat a host 
        of diseases and disorders, a process to protect our Nation's 
        blood supply from the HIV virus, progress against 
        cardiovascular disease including heart attack and stroke, and 
        new strategies for the early detection and treatment of 
        diseases such as colon, breast, and prostate cancer clearly 
        demonstrates the benefits of health research.
            (5) Health research which holds the promise of prevention 
        of intentional and unintentional injury and cure and prevention 
        of disease and disability, is critical to holding down costs in 
        the long term.
            (6) The state of our Nation's research facilities at the 
        National Institutes of Health and at universities is 
        deteriorating significantly. Renovation and repair of these 
        facilities are badly needed to maintain and improve the quality 
        of research.
            (7) Because the Concurrent Resolution on the Budget for 
        fiscal year 1996 (H. Con. Res. 67) freezes discretionary 
        spending for the next 5 years, the Nation's investment in 
        health research through the National Institutes of Health is 
        likely to decline in real terms unless corrective legislative 
        action is taken.
            (8) A health research fund is needed to maintain our 
        Nation's commitment to health research and to increase the 
        percentage of approved projects which receive funding at the 
        National Institutes of Health.
            (9) Each year 419,000 Americans die directly from tobacco 
        use and thousands more die from diseases caused by exposure to 
        environmental tobacco smoke. This year one out of every five 
        Americans who die will die from tobacco use.
            (10) A recent study by the Centers for Disease Control and 
        Prevention estimates that the Federal Government expended more 
        than $20,000,000,000 in 1993 alone to treat illnesses 
        associated with tobacco use.
            (11) A 25 cent increase in the tobacco tax would discourage 
        1,300,000 Americans from smoking and prevent more than 300,000 
        premature deaths.
            (12) An estimated 90 percent of all smokers start when they 
        are teenagers or younger.
            (13) Voluntary income tax checkoffs for medical research 
        for specific diseases exist in some States and have proven 
        successful in generating funds for such research.

               TITLE I--NATIONAL FUND FOR HEALTH RESEARCH

SEC. 101. ESTABLISHMENT.

    (a) Establishment.--There is established in the Treasury of the 
United States a fund, to be known as the "National Fund for Health 
Research" (hereafter in this section referred to as the "Fund"), 
consisting of such amounts as are transferred to the Fund under 
subsection (b) and any interest earned on investment of amounts in the 
Fund.
    (b) Transfers to Fund.--
            (1) In general.--The Secretary of the Treasury shall 
        transfer to the Fund amounts equivalent to--
                    (A) taxes received in the Treasury under section 
                5701 of the Internal Revenue Code of 1986 (relating to 
                taxes on tobacco products) to the extent attributable 
                to the increase in such taxes resulting from the 
                amendments made by title II of the National Fund for 
                Health Research Act; and
                    (B) the amounts designated under section 6097 
                (relating to designation of overpayments and 
                contributions to the Fund).
            (2) Transfers based on estimates.--The amounts transferred 
        by paragraph (1) shall annually be transferred to the Fund 
        within 30 days after the President signs an appropriations Act 
        for the Departments of Labor, Health and Human Services, and 
        Education, and related agencies, or by the end of the first 
        quarter of the fiscal year. Proper adjustment shall be made in 
        amounts subsequently transferred to the extent prior estimates 
        were in excess of or less than the amounts required to be 
        transferred.
    (c) Obligations From Fund.--
            (1) In general.--Subject to the provisions of paragraph 
        (4), with respect to the amounts made available in the Fund in 
        a fiscal year, the Secretary of Health and Human Services shall 
        distribute--
                    (A) 2 percent of such amounts during any fiscal 
                year to the Office of the Director of the National 
                Institutes of Health to be allocated at the Director's 
                discretion for the following activities:
                            (i) for carrying out the responsibilities 
                        of the Office of the Director, including the 
                        Office of Research on Women's Health and the 
                        Office of Research on Minority Health, the 
                        Office of Alternative Medicine, the Office of 
                        Rare Disease Research, the Office of Behavioral 
                        and Social Sciences Research (for use for 
                        efforts to reduce tobacco use), the Office of 
                        Dietary Supplements, and the Office for Disease 
                        Prevention; and
                            (ii) for construction and acquisition of 
                        equipment for or facilities of or used by the 
                        National Institutes of Health;
                    (B) 2 percent of such amounts for transfer to the 
                National Center for Research Resources to carry out 
                section 1502 of the National Institutes of Health 
                Revitalization Act of 1993 concerning Biomedical and 
                Behavioral Research Facilities;
                    (C) 1 percent of such amounts during any fiscal 
                year for carrying out section 301 and part D of title 
                IV of the Public Health Service Act with respect to 
                health information communications; and
                    (D) the remainder of such amounts during any fiscal 
                year to member institutes and centers, including the 
                Office of AIDS Research, of the National Institutes of 
                Health in the same proportion to the total amount 
                received under this section, as the amount of annual 
                appropriations under appropriations Acts for each 
                member institute and Centers for the fiscal year bears 
                to the total amount of appropriations under 
                appropriations Acts for all member institutes and 
                Centers of the National Institutes of Health for the 
                fiscal year.
            (2) Plans of allocation.--The amounts transferred under 
        paragraph (1)(D) shall be allocated by the Director of the 
        National Institutes of Health or the various directors of the 
        institutes and centers, as the case may be, pursuant to 
        allocation plans developed by the various advisory councils to 
        such directors, after consultation with such directors.
            (3) Grants and contracts fully funded in first year.--With 
        respect to any grant or contract funded by amounts distributed 
        under paragraph (1), the full amount of the total obligation of 
        such grant or contract shall be funded in the first year of 
        such grant or contract, and shall remain available until 
        expended.
            (4) Trigger and release of monies and phase-in.--
                    (A) Trigger and release.--No expenditure shall be 
                made under paragraph (1) during any fiscal year in 
                which the annual amount appropriated for the National 
                Institutes of Health is less than the amount so 
                appropriated for the prior fiscal year.
                    (B) Phase-in.--The Secretary of Health and Human 
                Services shall phase-in the distributions required 
                under paragraph (1) so that--
                            (i) 25 percent of the amount in the Fund is 
                        distributed in fiscal year 1997;
                            (ii) 50 percent of the amount in the Fund 
                        is distributed in fiscal year 1998;
                            (iii) 75 percent of the amount in the Fund 
                        is distributed in fiscal year 1999; and
                            (iv) 100 percent of the amount in the Fund 
                        is distributed in fiscal year 2000 and each 
                        succeeding fiscal year.
            (5) Administrative expenses.--Amounts in the Fund shall be 
        available to pay the administrative expenses of the Department 
        of the Treasury directly allocable to--
                    (A) modifying the individual income tax return 
                forms to carry out section 6097 of the Internal Revenue 
                Code of 1986; and
                    (B) processing amounts received under such section 
                6097 and transferring such amounts to such Fund.
    (d) Budget Treatment of Amounts in Fund.--The amounts in the Fund 
shall be excluded from, and shall not be taken into account, for 
purposes of any budget enforcement procedure under the Congressional 
Budget Act of 1974 or the Balanced Budget and Emergency Deficit Control 
Act of 1985.

                     TITLE II--FINANCING PROVISIONS

SEC. 201. AMENDMENT OF 1986 CODE.

    Except as otherwise expressly provided, whenever in this title an 
amendment or repeal is expressed in terms of an amendment to, or repeal 
of, a section or other provision, the reference shall be considered to 
be made to a section or other provision of the Internal Revenue Code of 
1986.

SEC. 202. INCREASE IN EXCISE TAXES ON TOBACCO PRODUCTS.

    (a) Cigarettes.--Subsection (b) of section 5701 is amended--
            (1) by striking "$12 per thousand ($10 per thousand on 
        cigarettes removed during 1991 or 1992)" in paragraph (1) and 
        inserting "$24.5 per thousand", and
            (2) by striking "$25.20 per thousand ($21 per thousand on 
        cigarettes removed during 1991 or 1992)" in paragraph (2) and 
        inserting "$51.45 per thousand".
    (b) Cigars.--Subsection (a) of section 5701 is amended--
            (1) by striking "$1.125 cents per thousand (93.75 cents 
        per thousand on cigars removed during 1991 or 1992)" in 
        paragraph (1) and inserting "$13.64 per thousand", and
            (2) by striking "equal to" and all that follows in 
        paragraph (2) and inserting "equal to 26.03 percent of the 
        price for which sold but not more than $61.25 per thousand."
    (c) Cigarette Papers.--Subsection (c) of section 5701 is amended by 
striking "0.75 cent (0.625 cent on cigarette papers removed during 
1991 or 1992)" and inserting "1.53 cents".
    (d) Cigarette Tubes.--Subsection (d) of section 5701 is amended by 
striking "1.5 cents (1.25 cents on cigarette tubes removed during 1991 
or 1992)" and inserting "3.06 cents".
    (e) Smokeless Tobacco.--Subsection (e) of section 5701 is amended--
            (1) by striking "36 cents (30 cents on snuff removed 
        during 1991 or 1992)" in paragraph (1) and inserting 
        "$3.69", and
            (2) by striking "12 cents (10 cents on chewing tobacco 
        removed during 1991 or 1992)" in paragraph (2) and inserting 
        "$1.45".
    (f) Pipe Tobacco.--Subsection (f) of section 5701 is amended by 
striking "67.5 cents (56.25 cents on pipe tobacco removed during 1991 
or 1992)" and inserting "$4.85".
    (g) Application of Tax Increase to Puerto Rico.--Section 5701 is 
amended by adding at the end the following new subsection:
    "(h) Application to Taxes to Puerto Rico.--Notwithstanding 
subsections (b) and (c) of section 7653 and any other provision of 
law--
            "(1) In general.--On tobacco products and cigarette papers 
        and tubes, manufactured or imported into the Commonwealth of 
        Puerto Rico, there is hereby imposed a tax at the rate equal to 
        the excess of--
                    "(A) the rate of tax applicable under this section 
                to like articles manufactured in the United States, 
                over
                    "(B) the rate referred to in subparagraph (A) as 
                in effect on the day before the date of the enactment 
                of the National Fund for Health Research Act.
            "(2) Shipments to puerto rico from the united states.--
        Only the rates of tax in effect on the day before the date of 
        the enactment of this subsection shall be taken into account in 
        determining the amount of any exemption from, or credit or 
        drawback of, any tax imposed by this section on any article 
        shipped to the Commonwealth of Puerto Rico from the United 
        States.
            "(3) Shipments from puerto rico to the united states.--The 
        rates of tax taken into account under section 7652(a) with 
        respect to tobacco products and cigarette papers and tubes 
        coming into the United States from the Commonwealth of Puerto 
        Rico shall be the rates of tax in effect on the day before the 
        date of the enactment of the National Fund for Health Research 
        Act.
            "(4) Disposition of revenues.--The provisions of section 
        7652(a)(3) shall not apply to any tax imposed by reason of this 
        subsection."
    (h) Effective Date.--The amendments made by this section shall 
apply to articles removed (as defined in section 5702(k) of the 
Internal Revenue Code of 1986, as amended by this Act) after December 
31, 1995.
    (i) Floor Stocks Taxes.--
            (1) Imposition of tax.--On tobacco products and cigarette 
        papers and tubes manufactured in or imported into the United 
        States or the Commonwealth of Puerto Rico which are removed 
        before January 1, 1996, and held on such date for sale by any 
        person, there is hereby imposed a tax in an amount equal to the 
        excess of--
                    (A) the tax which would be imposed under section 
                5701 of the Internal Revenue Code of 1986 on the 
                article if the article had been removed on such date, 
                over
                    (B) the prior tax (if any) imposed under section 
                5701 or 7652 of such Code on such article.
            (2) Authority to exempt cigarettes held in vending 
        machines.--To the extent provided in regulations prescribed by 
        the Secretary, no tax shall be imposed by paragraph (1) on 
        cigarettes held for retail sale on January 1, 1996, by any 
        person in any vending machine. If the Secretary provides such a 
        benefit with respect to any person, the Secretary may reduce 
        the $500 amount in paragraph (3) with respect to such person.
            (3) Credit against tax.--Each person shall be allowed as a 
        credit against the taxes imposed by paragraph (1) an amount 
equal to $500. Such credit shall not exceed the amount of taxes imposed 
by paragraph (1) on January 1, 1996, for which such person is liable.
            (4) Liability for tax and method of payment.--
                    (A) Liability for tax.--A person holding cigarettes 
                on January 1, 1996, to which any tax imposed by 
                paragraph (1) applies shall be liable for such tax.
                    (B) Method of payment.--The tax imposed by 
                paragraph (1) shall be paid in such manner as the 
                Secretary shall prescribe by regulations.
                    (C) Time for payment.--The tax imposed by paragraph 
                (1) shall be paid on or before April 1, 1996.
            (5) Articles in foreign trade zones.--Notwithstanding the 
        Act of June 18, 1934 (48 Stat. 998, 19 U.S.C. 81a) and any 
        other provision of law, any article which is located in a 
        foreign trade zone on January 1, 1996, shall be subject to the 
        tax imposed by paragraph (1) if--
                    (A) internal revenue taxes have been determined, or 
                customs duties liquidated, with respect to such article 
                before such date pursuant to a request made under the 
                1st proviso of section 3(a) of such Act, or
                    (B) such article is held on such date under the 
                supervision of a customs officer pursuant to the 2d 
                proviso of such section 3(a).
            (6) Definitions.--For purposes of this subsection--
                    (A) In general.--Terms used in this subsection 
                which are also used in section 5702 of the Internal 
                Revenue Code of 1986 shall have the respective meanings 
                such terms have in such section, as amended by this 
                Act.
                    (B) Secretary.--The term "Secretary" means the 
                Secretary of the Treasury or his delegate.
            (7) Controlled groups.--Rules similar to the rules of 
        section 5061(e)(3) of such Code shall apply for purposes of 
        this subsection.
            (8) Other laws applicable.--All provisions of law, 
        including penalties, applicable with respect to the taxes 
        imposed by section 5701 of such Code shall, insofar as 
        applicable and not inconsistent with the provisions of this 
        subsection, apply to the floor stocks taxes imposed by 
        paragraph (1), to the same extent as if such taxes were imposed 
        by such section 5701. The Secretary may treat any person who 
        bore the ultimate burden of the tax imposed by paragraph (1) as 
        the person to whom a credit or refund under such provisions may 
        be allowed or made.

SEC. 203. MODIFICATIONS OF CERTAIN TOBACCO TAX PROVISIONS.

    (a) Exemption for Exported Tobacco Products and Cigarette Papers 
and Tubes To Apply Only to Articles Marked for Export.--
            (1) Subsection (b) of section 5704 is amended by adding at 
        the end the following new sentence: "Tobacco products and 
        cigarette papers and tubes may not be transferred or removed 
        under this subsection unless such products or papers and tubes 
        bear such marks, labels, or notices as the Secretary shall by 
        regulations prescribe."
            (2) Section 5761 is amended by redesignating subsections 
        (c) and (d) as subsections (d) and (e), respectively, and by 
        inserting after subsection (b) the following new subsection:
    "(c) Sale of Tobacco Products and Cigarette Papers and Tubes for 
Export.--Except as provided in subsections (b) and (d) of section 
5704--
            "(1) every person who sells, relands, or receives within 
        the jurisdiction of the United States any tobacco products or 
        cigarette papers or tubes which have been labeled or shipped 
        for exportation under this chapter,
            "(2) every person who sells or receives such relanded 
        tobacco products or cigarette papers or tubes, and
            "(3) every person who aids or abets in such selling, 
        relanding, or receiving,
shall, in addition to the tax and any other penalty provided in this 
title, be liable for a penalty equal to the greater of $1,000 or 5 
times the amount of the tax imposed by this chapter. All tobacco 
products and cigarette papers and tubes relanded within the 
jurisdiction of the United States, and all vessels, vehicles, and 
aircraft used in such relanding or in removing such products, papers, 
and tubes from the place where relanded, shall be forfeited to the 
United States."
            (3) Subsection (a) of section 5761 is amended by striking 
        "subsection (b)" and inserting "subsection (b) or (c)".
            (4) Subsection (d) of section 5761, as redesignated by 
        paragraph (2), is amended by striking "The penalty imposed by 
        subsection (b)" and inserting "The penalties imposed by 
        subsections (b) and (c)".
            (5)(A) Subpart F of chapter 52 is amended by adding at the 
        end the following new section:

"SEC. 5754. RESTRICTION ON IMPORTATION OF PREVIOUSLY EXPORTED TOBACCO 
              PRODUCTS.

    "(a) In General.--Tobacco products and cigarette papers and tubes 
previously exported from the United States may be imported or brought 
into the United States only as provided in section 5704(d). For 
purposes of this section, section 5704(d), section 5761, and such other 
provisions as the Secretary may specify by regulations, references to 
exportation shall be treated as including a reference to shipment to 
the Commonwealth of Puerto Rico.
    "(b) Cross Reference.--

                                "For penalty for the sale of tobacco 
products and cigarette papers and tubes in the United States which are 
labeled for export, see section 5761(c)."
            (B) The table of sections for subpart F of chapter 52 is 
        amended by adding at the end the following new item:

                              "Sec. 5754. Restriction on importation 
                                        of previously exported tobacco 
                                        products."
    (b) Importers Required To Be Qualified.--
            (1) Sections 5712, 5713(a), 5721, 5722, 5762(a)(1), and 
        5763 (b) and (c) are each amended by inserting "or importer" 
        after "manufacturer".
            (2) The heading of subsection (b) of section 5763 is 
        amended by inserting "Qualified Importers," after 
        "Manufacturers,".
            (3) The heading for subchapter B of chapter 52 is amended 
        by inserting "and Importers" after "Manufacturers".
            (4) The item relating to subchapter B in the table of 
        subchapters for chapter 52 is amended by inserting "and 
        importers" after "manufacturers".
    (c) Repeal of Tax-Exempt Sales to Employees of Cigarette 
Manufacturers.--
            (1) Subsection (a) of section 5704 is amended--
                    (A) by striking "Employee Use or" in the heading, 
                and
                    (B) by striking "for use or consumption by 
                employees or" in the text.
            (2) Subsection (e) of section 5723 is amended by striking 
        "for use or consumption by their employees, or for 
        experimental purposes" and inserting "for experimental 
        purposes".
    (d) Repeal of Tax-Exempt Sales to United States.--Subsection (b) of 
section 5704 is amended by striking "and manufacturers may similarly 
remove such articles for use of the United States;".
    (e) Books of 25 or Fewer Cigarette Papers Subject to Tax.--
Subsection (c) of section 5701 is amended by striking "On each book or 
set of cigarette papers containing more than 25 papers," and inserting 
"On cigarette papers,".
    (f) Storage of Tobacco Products.--Subsection (k) of section 5702 is 
amended by inserting "under section 5704" after "internal revenue 
bond".
    (g) Authority To Prescribe Minimum Manufacturing Activity 
Requirements.--Section 5712 is amended by striking "or" at the end of 
paragraph (1), by redesignating paragraph (2) as paragraph (3), and by 
inserting after paragraph (1) the following new paragraph:
            "(2) the activity proposed to be carried out at such 
        premises does not meet such minimum capacity or activity 
        requirements as the Secretary may prescribe, or".
    (h) Special Rules Relating to Puerto Rico and the Virgin Islands.--
Section 7652 is amended by adding at the end the following new 
subsection:
    "(h) Limitation on Cover Over of Tax on Tobacco Products.--For 
purposes of this section, with respect to taxes imposed under section 
5701 or this section on any tobacco product or cigarette paper or tube, 
the amount covered into the treasuries of Puerto Rico and the Virgin 
Islands shall not exceed the rate of tax under section 5701 in effect 
on the article on the day before the date of the enactment of the 
Health Partnership Act of 1995."
    (i) Effective Date.--The amendments made by this section shall 
apply to articles removed (as defined in section 5702(k) of the 
Internal Revenue Code of 1986, as amended by this Act) after December 
31, 1995.

SEC. 204. IMPOSITION OF EXCISE TAX ON MANUFACTURE OR IMPORTATION OF 
              ROLL-YOUR-OWN TOBACCO.

    (a) In General.--Section 5701 (relating to rate of tax), as amended 
by section 701, is amended by redesignating subsections (g) and (h) as 
subsections (h) and (i) and by inserting after subsection (f) the 
following new subsection:
    "(g) Roll-Your-Own Tobacco.--On roll-your-own tobacco, 
manufactured in or imported into the United States, there shall be 
imposed a tax of $4.85 per pound (and a proportionate tax at the like 
rate on all fractional parts of a pound)."
    (b) Roll-Your-Own Tobacco.--Section 5702 (relating to definitions) 
is amended by adding at the end the following new subsection:
    "(p) Roll-Your-Own Tobacco.--The term 'roll-your-own tobacco' 
means any tobacco which, because of its appearance, type, packaging, or 
labeling, is suitable for use and likely to be offered to, or purchased 
by, consumers as tobacco for making cigarettes."
    (c) Technical Amendments.--
            (1) Subsection (c) of section 5702 is amended by striking 
        "and pipe tobacco" and inserting "pipe tobacco, and roll-
        your-own tobacco".
            (2) Subsection (d) of section 5702 is amended--
                    (A) in the material preceding paragraph (1), by 
                striking "or pipe tobacco" and inserting "pipe 
                tobacco, or roll-your-own tobacco", and
                    (B) by striking paragraph (1) and inserting the 
                following new paragraph:
            "(1) a person who produces cigars, cigarettes, smokeless 
        tobacco, pipe tobacco, or roll-your-own tobacco solely for the 
        person's own personal consumption or use, and".
            (3) The chapter heading for chapter 52 is amended to read 
        as follows:

    "CHAPTER 52--TOBACCO PRODUCTS AND CIGARETTE PAPERS AND TUBES".

            (4) The table of chapters for subtitle E is amended by 
        striking the item relating to chapter 52 and inserting the 
        following new item:

                              "Chapter 52. Tobacco products and 
                                        cigarette papers and tubes."
    (d) Effective Date.--
            (1) In general.--The amendments made by this section shall 
        apply to roll-your-own tobacco removed (as defined in section 
        5702(k) of the Internal Revenue Code of 1986, as amended by 
        this Act) after December 31, 1995.
            (2) Transitional rule.--Any person who--
                    (A) on the date of the enactment of this Act is 
                engaged in business as a manufacturer of roll-your-own 
                tobacco or as an importer of tobacco products or 
                cigarette papers and tubes, and
                    (B) before January 1, 1996, submits an application 
                under subchapter B of chapter 52 of such Code to engage 
                in such business,
        may, notwithstanding such subchapter B, continue to engage in 
        such business pending final action on such application. Pending 
        such final action, all provisions of such chapter 52 shall 
        apply to such applicant in the same manner and to the same 
        extent as if such applicant were a holder of a permit under 
        such chapter 52 to engage in such business.

SEC. 205. DESIGNATION OF OVERPAYMENTS AND CONTRIBUTIONS FOR THE 
              NATIONAL FUND FOR HEALTH RESEARCH.

    (a) In General.--Subchapter A of chapter 61 (relating to returns 
and records) is amended by adding at the end the following new part:

   "PART IX--DESIGNATION OF OVERPAYMENTS AND CONTRIBUTIONS FOR THE 
                   NATIONAL FUND FOR HEALTH RESEARCH

"Sec. 6097. Amounts for the National Fund for Health Research.

"SEC. 6097. AMOUNTS FOR THE NATIONAL FUND FOR HEALTH RESEARCH.

    "(a) In General.--Every individual (other than a nonresident 
alien) may designate that--
            "(1) a portion (not less than $1) of any overpayment of 
        the tax imposed by chapter 1 for the taxable year, and
            "(2) a cash contribution (not less than $1),
be paid over to the National Fund for Health Research. In the case of a 
joint return of a husband and wife, each spouse may designate one-half 
of any such overpayment of tax (not less than $2).
    "(b) Manner and Time of Designation.--Any designation under 
subsection (a) may be made with respect to any taxable year only at the 
time of filing the original return of the tax imposed by chapter 1 for 
such taxable year. Such designation shall be made either on the 1st 
page of the return or on the page bearing the taxpayer's signature.
    "(c) Overpayments Treated as Refunded.--For purposes of this 
section, any overpayment of tax designated under subsection (a) shall 
be treated as being refunded to the taxpayer as of the last day 
prescribed for filing the return of tax imposed by chapter 1 
(determined with regard to extensions) or, if later, the date the 
return is filed.
    "(d) Designated Amounts Not Deductible.--No amount designated 
pursuant to subsection (a) shall be allowed as a deduction under 
section 170 or any other section for any taxable year.
    "(e) Termination.--This section shall not apply to taxable years 
beginning in a calendar year after a determination by the Secretary 
that the sum of all designations under subsection (a) for taxable years 
beginning in the second and third calendar years preceding the calendar 
year is less than $5,000,000."
    (b) Clerical Amendment.--The table of parts for subchapter A of 
chapter 61 is amended by adding at the end the following new item:

                              "Part IX. Designation of overpayments 
                                        and contributions for the 
                                        National Fund for Health 
                                        Research."
    (c) Effective Date.--The amendments made by this section shall 
apply to taxable years beginning after December 31, 1995.
                                 <all>
S 1251 IS----2



National Fund for Health Research Act--Questions and Answers

What does the proposal call for?
A National Fund For Health Research would be established to provide additional resources for health research over and above those provided to the National Institutes of Health (NIH) in the annual appropriations process. The Fund would greatly enhance the quality of health care by investing more resources in finding preventive measures, cures and cost effective treatments for the major illnesses and conditions that strike Americans.
Financing for the Fund comes from an increase in federal tobacco taxes--25 cents per pack of cigarettes and an equivalent tax on other tobacco products. This tax would raise an estimated $4.2 billion annually. In addition to providing revenue for the Fund, raising tobacco taxes will protect children and save lives. Every day more than 3,000 children become smokers and more than 1,000 of them will eventually die as a result of smoking. Raising tobacco taxes is a highly effective way to reduce tobacco use by children. A 25-cent tax will discourage an estimated 1.3 million children and adults from smoking and will save the lives of more than 300,000 Americans alive today.
Each year amounts within the Fund would automatically be allotted to each of the NIH Institutes and Centers. Five percent of the monies would be directed to extramural construction and renovation of research facilities, the National Library of Medicine, and the Office of the Director. So that an appropriate range of basic and applied research is supported, each Institute and Center would receive the same percentage of the remaining Fund monies as they received of the total NIH appropriation for that fiscal year. In order to insure that the additional funds generated do not simply replace regularly appropriated NIH funds, monies from the Fund would be released only if the total appropriated for the NIH in that year equal or exceed the prior year appropriations.
Additional monies for the Fund would be generated by a voluntary federal income tax check-off. Every year, when filing their Federal income tax returns, Americans would have the opportunity to designate tax overpayments and contributions for health research. Monies from the check-off would be deposited in the Fund.

Why is this proposal necessary?
Health research has brought us the advances in treatment and prevention of disease and disability that define our current high standards of medical practice. Perhaps more than any other component of our health care system, health research holds the promise of both reducing medical costs and improving the quality of life of Americans. Yet, because the federal budget agreement freezes discretionary spending for the next four years, Federal funding for health research will likely not even keep up with inflation unless a separate funding stream is established.

Will the Fund simply replace existing monies appropriated to NIH?
No. Monies generated by the Fund would be in addition to, not in replacement of those provided to each of the NIH Institutes in the normal appropriations process. Monies from the Fund could not be allotted unless total NIH appropriations in that year were equal to or greater than the prior year appropriations. Therefore, the Fund could not be used as a mechanism to replace or reduce regularly appropriated funds.

How would money from the Fund be allocated among research priorities?
The proposal does not pick winners and losers among areas of health research. It does not interfere with the funding decisions made through the normal appropriations process. Funds would be allocated to each of the NIH Institutes and Centers based on the percentage that each of these entities received of the total NIH appropriation for that year. Monies allotted to each NIH entity would be spent according to a plan developed by the entities' advisory council in consultation with the NIH Director. Each Institute would decide the appropriate distribution of Fund monies among various research priorities within the Institute.
In recognition of the poor state of many medical research facilities, 2 percent of the total Fund would be taken off the top for extramural construction and renovation of research building and facilities. In accordance with traditional funding patterns, 1 percent of the total Fund would go to the National Library of Medicine. An additional 2 percent would go to the NIH Director for intramural construction and renovation and other activities supported by the Office of the Director.

Isn't research a major reason why the cost of health care is so high in this country? Won't an increase in research funding lead to an increase in health care costs?
Absolutely not. Funding for research can be an effective means of controlling health costs in the long run. Investment in research pays off in terms of lower medical expenses, reduced worker absenteeism, and improved productivity. For example, according to NIH statistics, an investment of $1.2 million in the development of a mass screening device for neonatal hypothyroidism in newborns has the potential 1-year saving of over $206 million. An investment of slightly over $679,000 for a treatment for preventing the recurrence of kidney stones saves close to $300 million in annual treatment costs and lost days work.
Today, many families are anxiously looking for a treatment and cure of Alzheimer's disease. Federally supported funding for research on Alzheimer's disease totals $300 million annually on caring for people with Alzheimer's. A cure or treatment for Alzheimer's, in addition to relieving suffering, would result in enormous savings.
Won't more research lead to the development and over utilization of new tests and expensive equipment?
There are legitimate concerns about the over utilization and duplication of expensive technologies. These concerns should be addressed by an increased emphasis on outcomes and effectiveness research. We should solve the problem of over utilization of services but not at the expense of improving quality and coming up with more effective treatments and cures.

Do the American people support increases in tobacco taxes to pay for increases in health research?
Polling data consistently show that more than two-thirds of Republican and Democratic voters, including voters in tobacco-growing states, favor raising tobacco taxes if revenues are dedicated to health-related activities.

Does the proposal include prevention research?
Absolutely. Research is our first line of defense. It is the ultimate investment in prevention. Research provides the building blocks for prevention--research has produced immunizations, critical information about the importance of diet and exercise in preventing disease, and a screening test to prevent the transmission of HIV through blood products. Research is the key to prevention.

Cancer Understanding and Research Efforts

(Statement of Zenia Kim)

The CURE program is designed to focus on two areas of cancer treatment: prevention and research.

Introduction

I remember when I was attending Junior High and High School, I never really learned about cancer or the risk factors involved. When I was a senior in high school, a very close relative of mine became very ill and was diagnosed with cancer. She started chemotherapy treatment but things got worse. I promised myself at that moment that I was going to perform my own research on cancer. What caused this disease and why wasn't my loved one getting better? I began volunteering at our local hospital in the Pathology lab, where I observed doctors examining various forms of cancers. I learned how to spot cancers of all sorts. As I continued my education at Brigham Young University, I continued with my cancer research. I worked with a Chemistry professor by the name of Dr. James Thorne, and he assisted me in understanding the chemical aspect of cancer research. We worked on a treatment called Photodynamic Therapy. This form of cancer treatment became very appealing because it did not have as many negative side effects that chemotherapy had. I became so involved with the research that I wrote my own paper on Photodynamic Therapy. I am still continuing my research with Dr. Thorne for the third year, and hope that this is our real breakthrough in curing cancer. While I was performing research on Photodynamic Therapy, I really wanted to continue my volunteer work in a hospital setting. I volunteered at Utah Valley Regional Medical Center in the Oncology Department. Here, I got to experience the other side, the patient's side. I remember talking with many cancer patients and listening to their distress, their hopeless feelings. I became so determined . . . that I was going to find a cure for cancer. As my research continued at BYU, I discovered that research funds were very limited. The national funding organizations can hardly support any of the proposals coming in. As a future medical research specialist, I became disheartened. Over the summer, I worked at Oregon Health Sciences University Medical School performing medical cancer research, and there too discovered the limited funding available for research. This is why I became so inspired to develop my own program called the CURE.

Cancer understanding and research efforts

The CURE focuses on two areas of cancer treatment. The first is prevention. I believe that if many students learned about the risks involved with cancer as a junior high or high school student, there would be a significant decrease in the incidents of cancer. I would like to see a unit integrated within the health curriculum that emphasizes the risks of cancer. Furthermore, I would like to invite guest speakers, perhaps one who has fought and recovered from cancer or the loved ones of a cancer victim, to tell about their side of their story. I think that by personalizing a real situation, students feel more sensitive and more in tune with the problem. That is exactly what we need. We need students to feel realistic, sad, or even scared so that they won't associate with any of the risks involved with cancer. The decisions that students in their junior high and high school years make can indefinitely affect the course of their lives. Furthermore, this is the time that they opt to engage in such acts as smoking, using tobacco, sun tanning, etc. So, by integrating a cancer unit within secondary education, the hope is that the future generations will choose to stay risk free and beat the battle against cancer.
The second area of cancer treatment that the CURE focuses on is research. Prevention is great to eliminate cancer but for those already afflicted with cancer, there must be another alternative. I would like to personally declare, to those of all ages, that research is the first and most important step towards cancer cure. By understanding the mechanism of how cancer cells undergo their uncontrolled rate of division, we can come closer to finding the right reagents to stop it. I know that cancer research has been going on for many years, and I believe that we are coming so much closer to the cure. We really need to support the research funding. I have sadly discovered that less than 10 percent of all the proposals that are sent to large funding organizations, such as the National Institute of Health, actually get funded. This to me is a horrifying reality. But the question always seems to be, "Where are we going to get the money?" I believe that we can first start with larger corporations. They have elicited a certain percentage of their profits into donations. I would like to encourage those corporations to donate more of their profits into research. Also, I support Senator Hatfield's and Senator Harkin's Trust Fund Proposal in allocating more money towards research from a tobacco tax. By raising the tobacco tax by a small fraction, we will not destroy the tobacco industry and we will be able to fund more scientific discoveries. As a future medical scientist, I would like to know that there will be enough funding available to pursue my research endeavors. I love research and I thrive off making new scientific discoveries. I just hope that I can continue my love for research when I work in my own laboratory someday soon.

As Miss Tri-Valley, I have actually had the opportunity to speak to students in junior high and high schools throughout the Beaverton/Portland area. I always emphasize these two important points that I have established in the CURE Program: Prevention and Research--these are our two means of defeating cancer.

American Lung Association,

September 14, 1995.
Hon. Mark Hatfield,
U.S. Senate, Hart Senate Office Building, Washington, DC.

Dear Senator Hatfield: The American Lung Association strongly endorses the legislation you are introducing today, Research Trust Fund Act. Enactment of the Research Trust Fund Act will be a win-win proposition for the health and well-being of the American people.

The Research Trust Fund Act will save lives through prevention. Each year 419,000 Americans die from causes directly related to tobacco use and thousands more die from diseases caused by exposure to environmental tobacco smoke. These preventable deaths represents a huge human loss to our society. The proposed $0.25 increase in the federal excise tax on tobacco products will help reduce the number of people who smoke. It is estimated that for every $0.25 increased in the federal tobacco tax, about one million people living today will be discouraged from smoking and 200,000 to 300,000 premature deaths will be prevented.

The Research Trust Fund Act will save health care dollars. The cost of treating people who suffer from tobacco related illnesses places a staggering financial burden on the American health care system. Although smokers tend to die younger, over the course of their life, current and former smokers generate an estimated $501 billion in excess health care costs. Treating tobacco related illnesses cost the $21 billion per year, with an additional estimated cost of $47 billion in lost productivity. Reducing the number of people who use tobacco products by increasing the federal tobacco tax will help reduce the economic burden tobacco consumption places on the U.S. health care system.

The Research Trust Fund Act will save lives through improved treatments and cures. The estimated $4 billion to $5 billion generated by the Research Trust Fund will provided needed additional funding for biomedical research sponsored by the National Institutes of Health. Through increased support of basic and clinical biomedical research at the National Institutes of Health, researchers will continue to broaden our understanding of life sciences and develop new approaches to preventing, treating, and curing disease.

The American Lung Association and its volunteers stand ready to work with you and Congress to enact this important legislation. I would also like to take this opportunity to commend you for your leadership and foresight in introducing the Research Trust Fund Act. The Research Trust Fund will go a long way to improving the health of all Americans.

Sincerely,
Jacqueline D. McLeod, MPH, M.Ed,
President.

Federation of American

Societies for Experimental Biology,

Bethesda, MD, September 11, 1995.
Hon. Mark Hatfield,
Chair, Senate Appropriations Committee, U.S. Senate, Washington, DC.

Dear Mr. Chairman: The Federation of American Societies for Experimental Biology (FASEB) supports with enthusiasm your efforts to provide supplemental resources for NIH and biomedical research.

The Federation concurs that the federal commitment to health research is grossly underfunded. Less than 3 percent of the nearly one trillion dollars our Nation spends on health care is devoted to health research, while the defense industry spends 15 percent of its budget on research. Ample evidence exists to demonstrate that health research has improved the quality of health care in the United States, and is one of the best methods of health care cost containment.

Therefore, FASEB supports the proposal to create an additional source of biomedical funding, such as through the National Fund for Health Research Act. We are confident that these additional funds would not be used to offset regular appropriations.

Sincerely,
Ralph A. Bradshaw, Ph.D.,
President.

National Committee To Preserve Social Security and Medicare,
Washington, DC, September 14, 1995.
Hon. Mark O. Hatfield,
U.S. Senate, Hart Senate Office Building, Washington, DC.

Dear Senator Hatfield: On behalf of the nearly six million members and supporters of the National Committee to Preserve Social Security and Medicare, I am writing in strong support of your legislation to increase medical research funding to the National Institutes of Health (NIH).

Increased research into the causes and potential cures of many diseases related to aging could have a profound impact on the lives of older Americans and their families. Alzheimer's disease, a degenerative brain disorder, afflicts about 4 million people in the United States, and costs the nation an estimated $80 billion to $100 billion a year. Osteoporosis, which causes fragile bones and painfully crippling fractures, costs an estimated $10 billion a year. When families can no longer meet the care needs of relatives with these illnesses, disabled people often end up in nursing homes, where bills totaled $69.6 billion in 1993.

The Hatfield/Harkin Research Fund legislation to be introduced today is a significant step forward to find cures or better treatments, save lives and dollars. We commend you on your long-time commitment to medical research.

Sincerely,
Martha A. McSteen,
President.

Association of

American Medical Colleges,

Washington, DC, September 15, 1995.
Hon. Mark O. Hatfield,
U.S. Senate, Hart Senate Office Building, Washington, DC.

Hon. Tom Harkin,
U.S. Senate, Hart Senate Office Building, Washington, DC.

Dear Senators Hatfield and Harkin: The Association of American Medical Colleges (AAMC) strongly endorses your proposal to create a National Fund for Health Research. The debate on this year's budget makes it clear that we must identify additional, sustainable sources of funding to supplement the regular appropriation for the National Institutes of Health [NIH] if we are to continue to rely upon scientific discovery to improve the health and quality of life for all Americans. In addition, sustained support for the NIH is needed if the United States is to maintain its position as the world's leader in biomedical and behavioral research. The fund you propose is an innovative and necessary complement to NIH funding.

The Federal Government plays a necessary role in the support of this nation's biomedical and behavioral research efforts. The investment that the Federal Government has made in the NIH has produced a comprehensive network of scientists, physicians, and technicians at more than 1,700 institutions across the United States dedicated to the continued pursuit of fundamental knowledge and the application of this information to the prevention, diagnosis, and treatment of disease. NIH-supported scientists have made enormous contributions to the nation's health. In addition, NIH-sponsored research has made significant economic contributions, both locally and nationally. The role that the U.S. biotechnology industry plays globally is just one example of the economic benefits to be derived from NIH research.

Moreover, your proposal addresses a major cause of disease and death in this country: tobacco. As health professionals, we must do everything in our power to reduce the use of tobacco in this country, particularly among children and teenagers. Your bill is an important part of that strategy. We will work with you to urge all health-related organizations and institutions to support this proposal and to encourage other Senators to cosponsor it.

Finally, on behalf of the Association's members, I wish to thank you for your leadership and unfailing commitment to a strong, vital medical research effort in this country. We appreciate the continued support and trust that you have placed in the NIH, and by implication in our institutions and faculty. We look forward to continuing to work with you to sustain this national treasure that is so critically important to the nation's health.

Very sincerely yours,
Jordan J. Cohen, M.D.
President.

American Cancer Society,

National Public Issues Office,

Washington, DC, September 15, 1995.
Hon. Mark Hatfield,
U.S. Senate,
Washington, DC.

Dear Senator Hatfield: On behalf of more than two million American Cancer Society volunteers, I am writing to commend you and Senator Harkin for your leadership in introducing the National Fund for Health Research Act. Your proposal combines two critical initiatives: increasing biomedical research funding and protecting children from tobacco addiction by raising tobacco taxes. The American Cancer Society strongly supports this bill.

Increasing funding for biomedical research is a top priority for all health organizations that understand the role such research plays in treating diseases, reducing suffering, improving the efficiency of our health care system and improving the health status of the entire nation. The American Cancer Society is particularly concerned about the rise in cancer rates. Cancer will become the leading cause of death in the United States by the year 2000. Biomedical research performed by the National Institutes of Health is of vital importance in the fight against cancer. The United States currently devotes less than 3 percent of health care spending to research. This amount is unacceptably low as a matter of health and economics.

There is no more appropriate way to finance this bill than through a tobacco tax increase. By itself, this tax will discourage about 1.3 million children and adults from smoking and will ultimately save the lives of more than 300,000 Americans alive today. Raising tobacco taxes is one of the most important measures we can take to reduce the current epidemic of tobacco use by teenagers.

More than two-thirds of Republican and Democratic voters, including voters from tobacco-growing states, supports raising tobacco taxes for health-related purposes such as this.

You have our full support. We look forward to working with you and your staff.

Sincerely,
Kerrie B. Wilson,
National Vice President for Government Relations, American Cancer Society.

Medical Research and Health Care Concerns: A Survey of the American Public

(Conducted by Louis Harris & Associates, June 1995)

A nationwide Harris telephone poll was conducted of 1004 adults in the United States from June 8-11, 1995. Figures for age, sex, race, education, and region were weighted where necessary to bring them into line with their actual proportions in the population. The margin of error for the survey is approximately 3.1 percent.
Research! America, a national not-for-profit organization dedicated to raising public awareness of and support for medical research, commissioned Louis Harris & Associates to ask questions about medical research as a part of a larger survey focusing on a broad range of current issues.

HIGHLIGHTS

1. Americans oppose cuts in medical research dollars.
Respondents were told that one impact of proposed changes in the Federal budget would be less money going to universities and their hospitals which teach medical students and do medical research. When asked whether they favored or opposed these changes in the Federal budget, 65% opposed proposed cuts in Federal support for universities and hospitals.
The younger those surveyed, the higher their response: Among 18-24 year-olds, the opposition to the proposed cuts rises to 75%; among 15-29 year-olds, the opposition to the proposed cuts is 72%.

2. Americans would pay higher taxes to support medical research.
73% would be willing to pay a dollar more perweek in taxes if they knew the money would be spent on medical research to better diagnose, prevent and treat disease.
Results from a November, 1993 Harris Poll were very similar--74% were willing to pay a dollar more per week in taxes if spent on medical research.

3. Americans urge Congress to provide tax incentives for private industry to conduct medical research.
61% of those surveyed want their Senators and Representatives to support legislation that would give tax credits to private industries to conduct more medical research.

4. Americans are willing to designate tax refund dollars for medical research.
45% would probably, and 15% would definitely check off a box on their federal income tax return to designate tax refund money specifically for medical research.
When asked how much money they would be willing to designate to medical research, the median amount reported was $23.

5. Americans overwhelmingly value maintaining the United States' position as a leader in medical research.
94% of those surveyed believe that it is important that the United States maintains its role as a world leader in medical research!

6. Americans heartily endorse having the Federal Government support basic science research.
Those surveyed were asked if they agree or disagree with the following: "Even if it brings no immediate benefits, basic science research which advances the frontiers of knowledge is necessary and should be supported by the Federal Government."
69% of respondent agree; 79% of young people ages 18-24 agree with the need to support basic research.

7. Medical research takes second place only to national, defense for tax dollar value.
While 45% gave federal defense spending the highest rating for tax dollar value, second place went to medical research with 37% of the respondents giving it a favorable tax dollar value.
Public education and federal anti-crime efforts ranked the lowest.

8. Americans want more information about medical research in the print and broadcast media.
61% of the Americans surveyed would like to see more medical research information in newspaper, magazines and on television.
77% of young people 18-24 want more medical research information from these sources.
For further information on the survey or other Research! America activities, contact Tracy Turner at (703) 739-2577; Fax (703) 739-2372.

Organizations Endorsing the Hatfield-Harkin Research Fund Proposal as of September 14, 1995

Academy of Radiology Research.
Alliance for Aging Research.
Alliance for Eye and Vision Research.
Alzheimer's Association.
American Academy of Allergy, Asthma & Immunology.
American Academy of Child and Adolescent Psychiatry.
American Academy of Dermatology.
American Academy of Medical Acupuncture.
American Academy of Neurology.
American Academy of Ophthalmology.
American Academy of Orthopaedic Surgeons.
American Academy of Otolaryngology--Head and Neck Surgery.
American Academy of Pediatrics.
American Association for Cancer Education.
American Association for Cancer Research.
American Association for Dental Research.
American Association of Anatomists.
American Association of Blood Banks.
American Association of Colleges of Nursing.
American Association of Colleges of Pharmacy.
American Association of Critical-Care Nurses.
American Association of Dental Schools.
American Association of Immunologists.
American Association of Pharmaceutical Scientists.
American Cancer Society.
American College of Cardiology.
American College of Chest Physicians.
American College of Clinical Pharmacology.
American College of Medical Genetics.
American College of Preventive Medicine.
American College of Rheumatology.
American Diabetes Association.
American Federation for Clinical Research.
American Gastroenterological Association.
American Geriatrics Society.
American Heart Association.
American Institute of Nutrition.
American Lung Association.
American Nurses Association.
American Orthopaedic Association.
American Pediatric Society.
American Physiological Society.
American Podiatric Medical Association.
American Porphyria Foundation.
American Psychiatric Association.
American Psychological Society.
American Skin Association, Inc.
American Sleep Disorders Association.
American Society for Bone and Mineral Research.
American Society for Cell Biology.
American Society for Clinical Nutrition.
American Society for Dermatologic Surgery.
American Society for Investigative Pathology.
American Society for Microbiology.
American Society for Pharmacology and Experimental Therapeutics.
American Society for Reproductive Medicine.
American Society for Therapeutic Radiology and Oncology.
American Society for Virology.
American Society of Addiction Medicine.
American Society of Animal Sciences.
American Society of Clinical Oncology.
American Society of Hematology.
American Society of Nephrology.
American Society of Pediatric Hematology/Oncology.
American Society of Tropical Medicine & Hygiene.
American Speech-Language-Hearing Association.
American Thoracic Society.
American Urological Association.
Amputee Coalition of America.
Arizona Disease Prevention Center at the University of Arizona.
Arthritis Foundation.
Association for Behavioral Sciences & Medical Education.
Association for Professionals in Infection Control & Epidemiology, Inc.
Association for Research in Vision and Ophthalmology.
Association of Academic Health Centers.
Association of American Cancer Institutes.
Association of American Medical Colleges.
Association of American Veterinary Medical Colleges.
Association of Medical Graduate Departments of Biochemistry.
Association of Medical School Microbiology and Immunology Chairs.
Association of Medical School Pediatric Department Chairman.
Association of Minority Health Profession Schools.
Association of Pediatric Oncology Nurses.
Association of Population Centers.
Association of Professors of Dermatology.
Association of Professors of Medicine.
Association of Subspecialty Professors.
Association of Teachers of Preventive Medicine.
Association of University Environmental Health Sciences Centers.
Association of University professors of Ophthalmology.
Association of University Programs in Occupational Health and Safety.
Autism Society of America.
Cancer Research Foundation of America.
Citizens for Public Action on Blood Pressure and Cholesterol, Inc.
Coalition for American Trauma Care.
Coalition of Patient Advocates for Skin Disease Research.
College on Problems of Drug Dependence.
Columbia University.
Columbia University, Health Sciences.
Consortium for Skin Research.
Peter C. & Pat Cook Health Sciences Research & Education Institute at Butterworth Hospital.
Cooley's Anemia Foundation.
Cooper Hospital/University Medical Center.
Corporation for the Advancement of Psychiatry.
Council of Community Blood Centers.
Cystic Fibrosis Foundation.
Drew/Meharry/Morehouse Consortium Cancer Center.
Digestive Disease National Coalition.
Dystonia Medical Research Foundation.
Dystrophic Epidermolysis Bullosa Research Association of America.
Ehlers Danlos National Foundation.
The Endocine Society.
Environmental Science Associates, Inc.
Epilepsy Foundation of America.
Families Against Cancer.
Federation of American Societies for Experimental Biology.
Federation of Behavioral, Psychological & Cognitive Sciences.
Foundation for Ichthyosis & Related Skin Types.
Fox Chase Cancer Center.
General Clinical Research Center Programs Directors' Association.
Genome Action Coalition.
Fred Hutchinson Cancer Research Center.
Arthur G. James Cancer Hospital & Research Institute.
Johns Hopkins University.
Johns Hopkins University, School of Medicine.
Joint Council on Allergy, Asthma and Immunology.
Joint Steering Committee for Public Policy.
Louisiana State University Medical Center.
Lupus Foundation of America, Inc.
Lucille P. Markey Cancer Center.
Medical College of Pennsylvania & Hahnemann University.
Medical Center of Wisconsin Cancer Center.
Medical Library Association.
Myasthenia Gravis Foundation of America, Inc.
National Alopecia Areata Foundation.
National Association for Biomedical Research.
National Association for the Advancement of Orthotics and Prosthetics.
National Association of Children's Hospitals.
National Association of Pediatric Nurse Associates and Practitioners.
National Association of State Universities and Land Grant Colleges.
National Breast Cancer Coalition.
National Caucus of Basic Biomedical Science Chairs.
National Coalition for Cancer Research.
National Committee to Preserve Social Security and Medicare.
National Diabetes Research Coalition.
National Easter Seal Society.
National Eczema Association.
National Foundation for Ectodermal Dysplasias.
National Health Council.
National Marfan Foundation.
National Multiple Sclerosis Society.
National Organization for Rare Disorders.
National Osteoporosis Foundation.
National Perinatal Association.
National Psoriasis Foundation.
National Tuberous Sclerosis Association.
National Vitiligo Foundation, Inc.
National Vulvodynia Association.
New England Society of Physical Medicine and Rehabilitation.
New York University Medical Center.
Northwestern Memorial Hospital.
Oncology Nursing Society.
Orton Dyslexia Society, Inc.
Paralyzed Veterans of America.
Penn State Hershey Medical Center.
Population Association of America.
Radiation Research Society.
The Family of Christopher Reeve.
Research! America.
St. Jude Children's Research Hospital.
Scleroderma Federation, Inc.
Scleroderma Research Foundation.
Society for the Advancement of Women's Health Research.
Society for Investigative Dermatology.
Society for Neuroscience.
Society for Pediatric Research.
Society of Critical Care Medicine.
Society of Medical College Directors of Continuing Medical Education.
Society of Toxicology.
Society of University Otolaryngologists--Head and Neck Surgeons.
Society of University Urologists.
Stanford University School of Medicine.
Sturge Weber Foundation.
Sudden Infant Death Syndrome Alliance.
Sylvester Comprehensive Cancer Center.
Teratology Society.
Tourette Syndrome Association, Inc.
Tufts University Dept. of Physical Medicine and Rehabilitation.
United Scleroderma Foundation Inc.
University of Cincinnati Barrett Cancer Center.
University of Miami School of Medicine, Division of Genetics.
University of Minnesota, Duluth, School of Medicine.
University of Nevada, School of Medicine.
University of Rochester Cancer Center.
University of Virginia, School of Medicine.
University of Washington, School of Medicine.
Wake Forest University, Bowman Gray School of Medicine.
Wisconsin Comprehensive Cancer Center.
Yale University, School of Medicine.

Mr. HARKIN: Mr. President, I rise today with Senator Hatfield to introduce the Fund for Health Research Act. This legislation is similar to legislation that the two of us introduced during the last Congress which gained broad bipartisan support in both the House and Senate.

Our proposal would establish a national fund for health research to provide additional resources for health research over and above those provided to the National Institutes of Health [NIH] in the annual appropriations process. The fund would greatly enhance the quality of health care by investing more in finding preventive measures, cures and more cost effective treatments for the major illnesses and conditions that strike Americans.

The fund would be financed by a 25-cent tax on each pack of cigarettes and an equivalent tax on other tobacco products such as snuff and chewing tobacco. This tax would raise an estimated $4.2 billion annually.

Mr. President, in addition to providing revenue for health research, raising tobacco taxes will protect children and save lives. Every day more than 3,000 children become smokers and more than 1,000 of them will eventually die as a result of smoking. Raising tobacco taxes is a highly effective way to reduce tobacco use by children. A 25-cent tax will discourage an estimated 1.3 million children and adults from smoking and will save the lives of more than 300,000 Americans alive today.

Additional moneys for the fund would be generated by a voluntary Federal income tax check-off. Every year, when filing their Federal income tax returns, Americans would be given the opportunity to designate tax overpayments and contributions for health research. Moneys from the check-off would be deposited in the fund.

Each year under our proposal amounts within the national fund for health research would automatically be allocated to each of the NIH institutes and centers. Each institute and center would receive the same percentage as they received of the total NIH appropriation for that fiscal year.

Last year Senator Hatfield and I argued that any health care reform plan should include additional funding for health research. Health care reform has been taken off the front burner but the need to increase our Nation's commitment to health research has not diminished.

While health care spending devours nearly $1 trillion annually our medical research budget is dying of starvation. The United States devotes less than 2 percent of its total health care budget to health research. The Defense Department spends 15 percent of its budget on research. Does this make sense? The cold war is over but the war against disease and disability continues.

Increased investment in health research is key to reducing health costs in the long run. If we can find the cure for a disease like Alzheimer's the savings would be enormous. Today, federally supported funding for research on Alzheimer's disease totals $300 million yet it is estimated that nearly $100 billion is expended annually on caring for people with Alzheimer's.

Gene therapy and treatments for cystic fibrosis and Parkinson's could eliminate years of chronic care costs, while saving lives and improving patients' quality of life.

Mr. President, Senator Hatfield and I do everything we can to increase funding for NIH through the appropriations process. But, given the current budget situation and freeze in discretionary spending what we can do is limited. Without action, our investment in medical research through the NIH is likely to continue to decline in real terms.

The NIH is not able to fund even 25 percent of competing research projects or grant applications deemed worthy of funding. This is compared to rates of 30 percent or more just a decade ago. Science and cutting edge medical research is being put on hold. We may be giving up possible cures for diabetes, Alzheimer's, Parkinson's, and countless other diseases.

Our lack of investment in research may also be discouraging our young people from pursuing careers in medical research. The number of people under the age of 36 even apply for NIH grants dropped by 54 percent between 1985 and 1993. This is due to a host of factors but I'm afraid that the lower success rates among all applicants is making biomedical research less and less attractive to young people. If the perception is that funding for research is impossible to obtain, young people that may have chosen medical research 10 years ago will choose other career paths.

Mr. President, I am pleased that over 130 groups representing patients, hospitals, medical schools, researchers, and millions of Americans have already endorsed our proposal. And, polling data consistently show that more than two-thirds of Republican and Democratic voters, including votes in tobacco-growing States, favor raising tobacco taxes if funds will be devoted to health related programs.

Mr. President, health research is an investment in our future--it is an investment in our children and grandchildren. It holds the promise of cure or treatment for millions of Americans.



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