Keep the Promise of Medicare Act of 2006

Mr. President, I rise today to introduce, along with Senators Brownback, Clinton, Santorum, and Durbin, the Children and Media Research Advancement Act, or CAMRA Act. This bill is essentially identical to S. 579, which we introduced earlier this year, except that it houses our program within the Centers for Disease Control (CDC) rather than in the National Institute of Child Health and Human Development. We have reviewed the programs and activities within CDC that address issues relating to media's impact on children, and we believe that CDC is a logical home for our legislation.

There is an urgent need to establish a Federal role for targeting research on the impact of media on children. From the cradle to the grave, our children now live and develop in a world of media--a world that is increasingly digital, and a world where access is at their fingertips. This emerging digital world is well known to our children, but its effects on their development are not well understood. Young people today are spending an average of 6 and a half hours with media each day. For those who are under age 6, two hours of exposure to screen media each day is common, even for those who are under age two. That is about as much time as children under age 6 spend playing outdoors, and it is much more time than they spend reading or being read to by their parents. How does this investment of time affect children's physical development, their cognitive development, or their moral values? Unfortunately, we still have very limited information about how media, particularly the newer interactive media, affect children's development. In fact, we have not charged any Federal agency with ensuring an ongoing funding base to establish a coherent research agenda about the impact of media on children's lives. This lack of a coordinated government-sponsored effort to understand the effects of media on children's development is truly an oversight on our part as the potential payoffs for this kind of knowledge are enormous.

Consider our current national health crisis of childhood obesity. The number of U.S. children and teenagers who are overweight has more than tripled from the 1960's through 2002. We think that media exposure is partly the cause of this epidemic. Is it? Is time spent viewing screens and its accompanying sedentary life styles contributing to childhood and adolescent obesity? Or is the

constant bombardment of advertisements for sugar-coated cereals, snack foods, and candy that pervade children's television advertisements the culprit? How do the newer online forms of ``stealth marketing'', such as advergaming where food products are embedded in computer games, affect children's and adolescents' purchasing patterns? What will happen when pop-up advertisements begin to appear on children's cell phones that specifically target them for the junk food that they like best at a place where that food is easily obtainable? The answer to the obesity and media question is complex. A committee at the National Academy of Sciences is currently charged with studying the link between media advertising and childhood obesity. Will the National Academy of Sciences panel have the data they need to answer this important question? A definitive answer has the potential to save a considerable amount of money in other areas of our budget. For example, child health care costs that are linked to childhood obesity issues could be reduced by understanding and altering media diets.

Or take the Columbine incident. After two adolescent boys shot and killed some of their teachers, classmates, and then turned their guns on themselves at Columbine High School, we asked ourselves if media played some role in this tragedy. Did these boys learn to kill in part from playing first-person shooter video games like Doom where they acted as a killer? Were they rehearsing criminal activities when playing this game? We looked to the research community for an answer. In the violence and media area, Congress had passed legislation in the past so that research was conducted about the relationship between media violence and childhood aggression, and as a result, we knew more. Even though much of this data base was older and involved the link between exposure to violent television programs and childhood aggression, some answers were forthcoming about how the Columbine tragedy could have taken place. Even so, there is still a considerable amount of speculation about the more complex questions. Why did these particular boys, for example, pull the trigger in real life while others who played Doom confine their aggressive acts to the gaming context? We need to be able to answer questions about which children under what circumstances will translate game playing into real-life lethal actions. Investing in media research could potentially reduce our budgets associated with adolescent crime and delinquency as well as reduce real-life human misery and suffering.

Many of us believe that our children are becoming increasingly materialistic. Does exposure to commercial advertising and the ``good life'' experienced by media characters partly explain materialistic attitudes? We're not sure. Recent research using brain-mapping techniques finds that an adult who sees images of desired products demonstrates patterns of brain activation that are typically associated with reaching out with a hand. How does repeatedly seeing attractive products affect our children and their developing brains? What will happen when our children will be able to click on their television screen and go directly to sites that advertise the products that they see in their favorite programs? Or use their cell phones to pay for products that they want in the immediate environment? Exactly what kind of values are we cultivating in our children, and what role does exposure to media content play in the development of those values?

A report linked very early television viewing with later symptoms that are common in children who have attention deficit disorders. However, we don't know the direction of the relationship. Does television viewing cause attention deficits, or do children who have attention deficits find television viewing experiences more engaging than children who don't have attention problems? Or do parents whose children have difficulty sustaining attention let them watch more television to encourage more sitting and less hyperactive behavior? How will Internet experiences, particularly those where children move rapidly across different windows, influence attention patterns and attention problems? Once again, we don't know the answer. If early television exposure does disrupt the development of children's attention patterns, resulting in their placement in special education programs, actions taken to reduce screen exposure during the early years could lead to subsequent reductions in children's need for special education classes, thereby saving money while fostering children's development in positive ways.

We want no child left behind in the 21st century. Many of us believe that time spent with computers s good for our children, teaching them the skills that they will need for success in the 21st century. Are we right? How is time spent with computers different from time spent with television? What are the underlying mechanisms that facilitate or disrupt children's learning from these varying media? Can academic development be fostered by the use interactive online programs designed to teach as they entertain? In the first six years of life, Caucasian more so than African American or Latino children have Internet access from their homes. Can our newer interactive media help ensure that no child is left behind or will disparities in access result in leaving some behind and not others?

The questions bout how media affect the development of our children are clearly important, abundant, and complex. Unfortunately, the answers to these questions are in short supply. Such gaps in our knowledge base limit our ability to make informed decisions about media policy.

We know that media are important. Over the years, we have held numerous hearings in these chambers about how exposure to media violence affects childhood aggression. We passed legislation to maximize the documented benefits of exposure to educational media, such as the Children's Television Act which requires broadcasters to provide educational and informational television programs for children. Can we foster children's moral values when they are exposed to prosocial programs that foster helping, sharing, and cooperating like those that have come into being as a result of the Children's Television Act? We acted to protect our children from unfair commercial practices by passing the Children Online Privacy Protection Act which provides safeguards from exploitation for our youth as they explore the Internet, a popular pastime for them. Yet the Internet has provided new ways to reach children with marketing that we barely know is taking place, making our ability to protect our children all the more difficult. We worry about our children's inadvertent exposure to online pornography--about how that kind of exposure may undermine their moral values and standards of decency. In these halls of Congress, we acted to protect our children by passing the Communications Decency Act, the Child Online Protection Act, and the Children's Internet Protection Act to shield children from exposure to sexually-explicit online content that is deemed harmful to minors. While we all agree that we need to protect our children from online pornography, we know very little about how to address even the most practical of questions such as how to prevent children from falling prey to adult strangers who approach them online. There are so many areas in which our understanding is preliminary at best, particularly in those areas that involve the effects of our newer digital media

In order to ensure that we are doing our very best for our children, the behavioral and health recommendations and public policy decisions we make should be based on objective behavioral, social, and scientific research. Yet no Federal research agency has responsibility for oveseeing and setting a coherent media research agenda that can guide these policy decisions. Instead, federal agencies fund media research in a piecemeal fashion, resulting in a patch work quilt of findings. We can do better than that.

The bill we are introducing today would remedy this problem. The CAMRA Act will provide an overarching view of media effects by establishing a program devoted to Children and Media within the Centers for Disease Control. This program of research, to be vetted by the National Academy of Sciences, will fund and energize a coherent program of research that illuminates the role of media in children's cognitive, social, emotional, physical,

and behavioral development. The research will cover all forms of electronic media, including television, movies, DVDs, interactive video games, cell phones, and the Internet, and will encourage research involving children of all ages--even babies and toddlers. The bill also calls for a report to Congress about the effectiveness of this research program in filling this void in our knowledge base. In order to accomplish these goals, we are authorizing $90 million dollars to be phased in gradually across the next five years. The cost to our budget is minimal and can well result in significant savings in other budget areas.

Our Nation values the positive, healthy development of our children. Our children live in the information age, and our country has one of the most powerful and sophisticated information technology systems in the world. While this system entertains them, it is not harmless entertainment. Media have the potential to facilitate the healthy growth of our children. They also have the potential to harm. We have a stake in finding out exactly what that role is. We have a responsibility to take action. Access to the knowledge that we need for informed decision-making requires us to make an investment: an investment in research, an investment in and for our children, an investment in our collective future. The benefits to our youth and our nation's families are immeasurable.

By passing the Children and Media Research Advancement Act, we can advance knowledge and enhance the constructive effects of media while minimizing the negative ones. We can make future media policies that are grounded in a solid knowledge base. We can be proactive, rather than reactive. In so doing, we build a better nation for our youth, fostering the kinds of values that are the backbone of this great nation of ours, and we create a better foundation to guide future media policies about the digital experiences that pervade our children's daily lives.

I ask unanimous consent that the text of the bill be printed in the Record.

Mr. President, today I am introducing a bill to reauthorize the Indian Child Protection and Family Violence Prevention Act. This bill is intended to reauthorize appropriations for child sexual abuse prevention and treatment grants, to identify the scope of child abuse and family violence in Indian country by requiring annual comprehensive data gathering, to encourage inter-agency coordination between the Indian Health Service and public and private medical or treatment organizations in the treatment and examination of children through the use of telemedicine, and to conform the Act to other Federal child abuse reporting and confidentiality laws. The bill provides a 4-year reauthorization of appropriations for the Act.

The Indian Child Protection and Family Violence Prevention Act was enacted in 1990 to address findings of the Senate Select Committee on Indian Affairs and the Special Committee on Investigations as it examined the Federal trust relationship with Indian tribes. Through public hearings, these Committees found that, at the time, Indian country was a safe haven for child abuse perpetrators. I will not forget the testimony of parents whose children fell prey to the notorious cases of multiple child sexual abuse that occurred on the Hopi, Navajo, and Cherokee reservations over the course of many years. The Federal investigation and prosecution of these crimes revealed that child abuse perpetrators were aware that the conditions of reporting, investigating, and preventing crimes upon children were in such a sorry state that their crimes would rarely be detected. Needless to say, the consequences proved tragic to hundreds of child victims, their families and their communities.

We enacted this law to give the Federal Government an opportunity to meet its responsibility to Indian children and families by establishing policies and programs to prevent child abuse and family violence. To accomplish this, appropriations were authorized to establish prevention and treatment programs within the BIA and IHS. The Act also authorized the BIA and IHS to assist tribes in establishing on-reservation child abuse prevention and treatment programs. The Act also provided criminal sanctions for professionals who failed to report acts of abuse or suspected abuse and prescribed a child abuse reporting process for law enforcement.

I don't believe that the possible benefits of the Act have been fully realized.

Neither the BIA nor the IHS have successfully requested or received appropriations to fully implement the programs envisioned by the Act. Today, tribal governments rely on special appropriations, congressional earmarks and piecemeal grants. And, we still do not have a firm idea of the extent to which child sexual or physical abuse is occurring in Indian communities or the degree of success that we are having in treating victims of child abuse. Surely, we can do better than this.

This bill provides for a comprehensive approach to gathering this information on child abuse in Indian country. Under current law, the FBI is responsible for gathering this data. At the time, the FBI was primarily responsible for investigating acts of felony child abuse in Indian country. Today, we know that many Indian tribal police agencies, operating under Indian Self-Determination and Educational Assistance Act compacts and contracts, jointly investigate these felony crimes and that they are also responsible for responding to and investigating tribal offenses. The bill requires a comprehensive sharing of numerical data by all Federal, tribal and State law enforcement agencies.

In addition, the Act requires all local law enforcement agencies to document incidents of child abuse and to submit this documentation to the Federal Bureau of Investigation. The Act, however, does not provide for use of this valuable information. This bill permits the FBI to continue to gather conviction data and to make this information available, on a limited basis, to specific agencies requiring such information in the course of their professional duties. It permits agencies to access information in the course of conducting background checks on those who seek employment in an area involving children.

Finally, the bill authorizes the Indian Health Service to use advances in telemedicine to bring expert advice and training to the examination and diagnosis of child abuse. This new provision recognizes that children, when victimized, require immediate and expert diagnosis and treatment.

This section will help supplement stretched or unavailable IHS resources in the most isolated Indian communities. This body recently sent a clear message on domestic violence and sexual predators. This bill furthers that message by continuing to protect Indian children and families and ensuring that they continue to receive prevention and treatment resources to address the impact of these crimes in their own communities. I look forward to receiving the comments from the Administration and working with my colleagues toward final passage of this bill.

I ask unanimous consent that the text of the bill be printed in the Record.

Mr. President, today I am introducing the ``Keep the Promise of Medicare Act'' of 2006, and am pleased to be joined by my colleagues Senators Kennedy, Harkin, Lautenberg, Dayton, and Corzine.

Retirees will see an average monthly cost-of-living-adjustment increase of $39 in their Social Security checks next year. Although this increase is welcome news, one-fourth of the COLA will be eaten up by rising Medicare Part B premiums, which will increase yet again by double-digits. And the premium for Medicare's new prescription drug benefit could eat up the remainder of the Social Security increase.

As William D. Novelli, chief executive of AARP, said: ``A record increase would usually be welcome news for America's Social Security beneficiaries. But this cost-of-living adjustment is being eaten up by rising gasoline and heating costs, another double-digit increase in the monthly Medicare Part B premium and escalating health care bills.''

This dramatic increase could have been avoided. CMS Administrator McClellan has acknowledged after last year's record 17.5 percent increase that provisions included in the 2003 Medicare law designed to privatize the program directly contributed to the premium increase.

My legislation will limit the 2006 Part B premium increase to the same level as the Social Security COLA. Without this legislation, the Medicare Part B premium will rise by 13 percent to more than $10, to $88.50 a month, in 2006.

``Social Security's COLA will simply not be enough to cover the increasing costs of living as an older person in America,'' said George J. Kourpias, president of the Alliance for Retired Americans.

Adjusting the current premium is a first step, and one we must take immediately. Older Americans have been struggling for too long under the relentless increases in the cost of their health care and prescription drugs. Additionally, we should use this year to revise an outdated law that has led to record increase in Medicare premiums in the last four years. The promise of Medicare must include protection from dramatic increases in the Part B premium.

I urge my colleagues to join me on this important piece of legislation.

Mr. President, today I am introducing the ``Keep the Promise of Medicare Act'' of 2006, and am pleased to be joined by my colleagues Senators Kennedy, Harkin, Lautenberg, Dayton, and Corzine.

Retirees will see an average monthly cost-of-living-adjustment increase of $39 in their Social Security checks next year. Although this increase is welcome news, one-fourth of the COLA will be eaten up by rising Medicare Part B premiums, which will increase yet again by double-digits. And the premium for Medicare's new prescription drug benefit could eat up the remainder of the Social Security increase.

As William D. Novelli, chief executive of AARP, said: ``A record increase would usually be welcome news for America's Social Security beneficiaries. But this cost-of-living adjustment is being eaten up by rising gasoline and heating costs, another double-digit increase in the monthly Medicare Part B premium and escalating health care bills.''

This dramatic increase could have been avoided. CMS Administrator McClellan has acknowledged after last year's record 17.5 percent increase that provisions included in the 2003 Medicare law designed to privatize the program directly contributed to the premium increase.

My legislation will limit the 2006 Part B premium increase to the same level as the Social Security COLA. Without this legislation, the Medicare Part B premium will rise by 13 percent to more than $10, to $88.50 a month, in 2006.

``Social Security's COLA will simply not be enough to cover the increasing costs of living as an older person in America,'' said George J. Kourpias, president of the Alliance for Retired Americans.

Adjusting the current premium is a first step, and one we must take immediately. Older Americans have been struggling for too long under the relentless increases in the cost of their health care and prescription drugs. Additionally, we should use this year to revise an outdated law that has led to record increase in Medicare premiums in the last four years. The promise of Medicare must include protection from dramatic increases in the Part B premium.

I urge my colleagues to join me on this important piece of legislation.

Mr. President, I am pleased to join the chairman of the Senate Indian Affairs Committee as original sponsor of the Indian Child Protection and Family Violence Prevention Act Amendments of 2005. The primary goals of the Indian Child Protection and Family Violence Prevention Act of 1990, which the legislation we introduce today would reauthorize, were to reduce the incidence of child abuse, and mandate the reporting and tracking of child abuse in Indian Country.

The Indian Child Protection and Family Violence Prevention Act Amendments would provide additional safeguards for the privacy of information about a child; provide more involvement by the FBI and the Attorney General in documenting incidents of child abuse; direct a study to identify impediments to the reduction of child abuse in Indian Country, as well as require data collection and annual reporting to Congress on child abuse in Indian Country; and authorize the Indian Health Service to use telemedicine in connection with examinations of abused Indian children.

I particularly appreciate that this reauthorization legislation addresses a related issue about which I have deep concern--the epidemic of youth suicide in many reservation communities. Indian Country has higher rates of youth suicide, as well as of child abuse, than other American population groups. Often, children who attempt suicide have been abused by a family or community member. This bill would authorize professionals trained in behavioral health, including suicide prevention and treatment, to be included on the staff of regional Indian Child Resource and Family Services Centers.

Chairman McCain and I are committed to providing these additional protections for Native American children. I urge my colleagues to support passage of this reauthorization bill, along with adoption of provisions for child abuse prevention and child protective services that are contained in legislation also under consideration to reauthorize the Indian Health Care Improvement Act.