Border Death Reduction Act of 2006

Mr. President, today, I am pleased to join Chairman Grassley in introducing the Medicare Data Access and Research Act. This bill will take an important step to advance the safety, efficacy, and quality of health care services delivered to people under the Medicare Program and it will help improve the care delivered to all Americans.

This bill requires the Secretary of Health and Human Services, HHS, to make Medicare data accessible to Federal health agencies and the health services research community for the purpose of conducting studies that will serve the public health. As the largest single payer of health care services in the United States--covering over 40 million lives, 70 million hospital days, and processing nearly a billion physician claims per year--Medicare collects and maintains a wealth of information on the health services delivered to a significant portion of the population. This information has been a national resource for research and analysis of health care. And with the addition of the Medicare prescription drug benefit, it will be the most comprehensive resource our Nation has to study the effects of diseases and the treatments we have for them.

The Centers for Medicare and Medicaid Service, CMS, currently releases certain Medicare data to the public and more comprehensive data to the research community. This bill would build on current activities by requiring CMS to link hospital claims, physician claims, and other relevant information to data collected under the new Medicare drug benefit.

In addition, the Secretary will provide yearly access to the linked Medicare dataset to all Federal health agencies within the department, such as the Food and Drug Administration, the Centers for Disease Control, the National Institutes of Health, and the Agency for Healthcare Quality and Research. These agencies will enter into data use agreements with CMS to ensure that the type and level of Medicare data shared is appropriate, that the agencies conduct research in accordance with their missions and the purpose of furthering the public health, and that the privacy of the data is protected. The goal is to give Federal health agencies another tool to evaluate the safety, efficacy, and quality of care delivered to Medicare beneficiaries--a large segment of the health system.

This bill also provides public health researchers access to the linked Medicare dataset. Expanding access to Medicare data will open up a new era in our health system. It will enable scientists to more quickly identify both short- and long-term safety concerns with drug regimens and health treatments. It will enable more treatments to be compared. And it will promote more development of guidelines, so providers and patients know more about what works best.

Some may argue that access to linked Medicare data should not be limited to researchers and should be available for commercial purposes. But the full Medicare database should be used exclusively for the public good and not for private or commercial gain. This is the crux of this bill. Hence, the bill limits the use of data to the purpose of providing ``generalizable knowledge to inform the public health through scientific publication and other forms of public dissemination.'' Strict penalties will be imposed on any unauthorized use of the data including civil money penalties and disqualification from receiving Medicare data for at least 2 years.

CMS will publish criteria used to approve research applications to ensure that those selected are qualified and experienced to conduct analyses and maintain the confidentiality of Medicare information. Researchers will also make public their detailed results and methods within 1 year from completing their studies. They will make available to the public at no charge any tool developed through this program. They must agree not to sell data or create commercial data products using such data and abide by safeguards protecting the confidentiality of the data established by the Secretary.

The final section of the bill ensures that congressional support agencies, including the Congressional Budget Office, the Congressional Research Service, the Government Accountability Office, and the Medicare Payment Advisory Commission, also have access to the full range of data they need to carry out their functions and responsibilities. Congress depends on the research and analyses conducted by these agencies to inform our deliberations and decisions on the Medicare Program.

Last year, I worked with Senator Grassley to introduce the Medicare Value-Based Purchasing Act, which establishes a pay for performance system under Medicare. An important element of that system is the collection and reporting of quality measures to CMS and to the public. The bill we are introducing today complements those activities. We can improve health care by allowing Medicare to become a value-based purchaser of services and by reporting quality measures through the Medicare Program. And we can improve health care for all by allowing rigorous health services research to be conducted using the resource of Medicare data.

Mr. President, the Medicare Data Access and Research Act will allow us to expand our knowledge of health care and improve the quality of care for all Americans.

Mr. President, in August of 1802, from his desk in Monticello, President Thomas Jefferson glimpsed the future of the young American economy. He was shaken by what he saw.

Jefferson had just finished reading a book published a year earlier in London. The slim volume was the travel account of Alexander MacKenzie, a young Scotsman working in Great Britain's Canadian colonies.

In June of 1793, MacKenzie had crossed the Continental Divide at a place where it was just 3,000 feet high and easily portaged. Two weeks later, he reached the Pacific Ocean. Using a makeshift paint of vermilion and grease, Mackenzie inscribed his name on a rock to memorialize his discovery, and to claim it for Great Britain.

The economic implications of MacKenzie's discovery were enormous. In his book, MacKenzie urged the British to build on his discovery and develop a passage to the Pacific. Such a passage would give Great Britain control over much of North America's lucrative fur trade and access to the world's markets. Worse, MacKenzie's discovery threatened to stunt America's economic growth in its infancy.

MacKenzie's book lit a fire under Jefferson. That summer, he talked of little else. He enlisted the most qualified man he knew. And with him, Jefferson devised a plan for action. It was a plan to counter the economic threat from the north. It was a plan to safeguard America's economic future.

That December, President Jefferson presented his plan to Congress. It was America's first economic competitiveness plan. It called for one officer, a dozen soldiers, and $2,500.

Thomas Jefferson's economic competitiveness plan of 1802 has become better known as the Lewis and Clark Expedition. Today, we see that expedition as one of our Nation's great displays of ambition and courage. And today, we see that it laid the foundation of the United States as we know it.

Today, America faces a new competitive challenge. Our challenge is not over control of the fur trade. It comes not from an imperial power or its colony. It is not a race for territory in unexplored lands. Our challenge is far more complex. And the need to act is even more urgent.

America today faces a world more integrated, more interdependent, and more intensely competitive than ever in our history. In this world, it is our challenge to succeed. It is our challenge to leave our children and grandchildren an economy that is better than the one that we inherited.

We seek an economy that is not laden with debt, but bursting with opportunity. We seek an economy that plants the seeds of innovation and education today, knowing that generations far in the future will harvest their bounty. We seek an economy whose workers are increasingly productive, and whose skills are continuously sharpened.

Our challenge is to create an economy in which investment in our workers is our greatest asset, not our heaviest burden. Our challenge is to create an economy known for what it will be, rather than for what it was.

To realize this competitive economy, we must--like Jefferson--rise to the challenge. We must--like Jefferson--look to unknown horizons and march out to meet them. We must call upon our greatest minds and set them to creating a plan. And we must dedicate the resources necessary to implement that plan.

I have spent much of the past year planning a comprehensive competitiveness agenda. In February, I introduced the Trade Competitiveness Act, a bill to open markets and keep a level playing field for America's ranchers, farmers, and businesses.

In March, I introduced the Energy Competitiveness Act, to fund cutting edge research in energy while making alternative energies more affordable.

In April, I introduced the Savings Competitiveness Act, to create savings today, so that we may invest and innovate tomorrow.

In May, I introduced the Research Competitiveness Act, to give start- ups and universities better access to capital for research and development, and to improve and make permanent the R&D tax credit.

Today, I am introducing the fifth in this series of bills: the Education Competitiveness Act of 2006. Just as education is the foundation of a competitive economy, this legislation is the foundation of my competitiveness agenda.

Thomas Jefferson knew that it was not enough to send Lewis and Clark to the Pacific Ocean without the means to return. Lewis and Clark knew that the discoveries and contacts that they made had to be lasting to make a difference for our economy.

The Education Competitiveness Act is also designed to have a lasting effect. This legislation embraces education in its earliest stages, following through to continuing education and worker training. Each provision is designed with maximum flexibility to meet our States' unique needs. It is a bill that recognizes excellence, welcomes innovation, and rewards ambition.

The Education Competitiveness Act has seven important components.

First, it recognizes that our Nation needs to continue to bring quality teachers into the classroom. The bill funds 100,000 scholarships for future teachers of languages, early education, and science. It creates incentives for teachers to serve in rural and underserved areas. And it rapidly expands funding to advanced placement and international baccalaureate programs.

Second, the bill recognizes that early education is widely considered to be one of the best education investments that money can buy. The bill creates a flexible program of matching grants to build a national system of universal, voluntary prekindergarten. The bill sets out benchmarks for quality and provides help for States to make sure that their teachers are the best that they can be.

Third, the bill helps students to go the extra mile in their studies, by offering States the means to expand afterschool programs in everything from college test preparation to drug prevention. Summer programs get students out of the classroom for hands-on experience in science, technology, mathematics, and engineering.

Fourth, the bill looks to the needs of tomorrow's workforce. That workforce will increasingly demand technical skills based in math, science, and engineering. The bill provides a free college education to any student wishing to study science, technology, math, or engineering. In return, the student must work 4 years in that field of study. The bill offers States matching grants to establish and expand specialty math, science, and technology schools. And the bill makes young promising scientists eligible for cash grants to continue their research.

Fifth, the bill addresses the chronic neglect of our Nation's Indian education. The bill fully funds Indian colleges and makes a real commitment to the Johnson O'Malley program. The bill also increases the Pell grant to $6,000. Eighty percent of Montana's students rely on financial aid, including Pell grants.

Sixth, the Education Competitiveness Act allows American workers to continue learning. The bill funds programs to link businesses and schools, to give workers the skills that they need. Where universities and community colleges are too far away, distance learning grants will help bridge that gap.

Finally, the bill's tax provisions grant greater access to education. The bill starts by simplifying confusing tax credits and combining them into a single refundable higher education credit of up to $2,000 per student. The bill eases the burden of loan repayment by permitting graduates to deduct more of the interest paid on their student loans. And the bill increases the deductions for charitable contributions to schools as well as teachers' expenses in classrooms.

Taken together, these seven components form a bill that is both comprehensive and responsible. It is a bill that would help to secure a more competitive American economy.

I look forward to returning to the floor to describe each title in greater detail. I also look forward to discussing these proposals with my colleagues.

The Education Competitiveness Act sets out a bold agenda, to be sure. Some of its rewards may only be reaped decades from now. Some of its benefits may only be realized by our grandchildren. But I firmly believe that this is an agenda that we must begin to implement today.

Like the journey of Lewis and Clark 200 years ago, this is an agenda that portends discovery and rewards for America. It is an agenda that promises a passage to a new nation. I urge my colleagues to join me as we advance to this future, and join me in sponsoring the Education Competitiveness Act.

Mr. President, one cold May morning earlier this year, a Border Patrol agent found the body of a 3-year-old boy in a blue windbreaker, his arms crossed. He had died trying to cross our southern border, the youngest victim our borders have claimed this year.

The boy's mother's name is Edith Rodriguez. She is 25 years old. She attempted to cross the border illegally, in hopes that she might escape the desperate poverty of her home state of Veracruz, Mexico. Edith hired a human smuggler--a coyote.

The coyote gave his charges an illegal drug, ephedrine, to help them keep awake and moving. But Edith and her son still could not keep up with the group. So the coyote, in a cruel and heartless act, abandoned them in the desert. Alone. With no food and little water, with a dangerous drug coursing through his system, exposed to the elements-- Edith Rodriguez's little boy died.

Edith Rodriguez violated the laws of the United States when she crossed the border illegally. She was wrong to violate our border. But all should agree that her son did not deserve to die.

Here are the facts: Every 18\1/2\ hours, someone dies trying to cross the border between the United States and Mexico. About a year ago, I asked the Government Accountability Office to study the deaths that take place along America's borders.

Today, my office released that study. The results are sobering, shocking, and, I strongly believe, a cause for action. Since 1995, deaths along our borders have doubled. Despite the heroic rescue efforts of the men and women of Customs and Border Protection, things have gotten worse. In 1995, 266 people

died trying to cross our borders. Last year, 427 perished.

The increases, it appears, stem largely from an increase in deaths from exposure to the elements in the Sonoran Desert in Arizona. Illegal entries, however, have not increased. Quite frankly, it is getting more dangerous to cross our border.

Until recently, CBP did not even keep a systematic count of those who died crossing our borders. We still do not have a unified national strategy for reducing the deaths. We still do not know how well our safety efforts work--if they are saving lives or not. We need to do more.

The founding document of our Nation, the Declaration of Independence, lists ``life'' first on the list of Government's responsibilities. The overwhelming majority of the people who cross our border do so in search of a better life. They take enormous risks and make enormous investments in hopes of helping their families.

Illegal immigration needs to stop. We must defend our borders. We must construct physical barriers, add detention beds, hire personnel, and equip them with better technology. But we have a higher moral obligation to protect the life of every person--every man, woman, and child--who sets foot on American soil. We must do everything in our power to preserve life.

That is why I propose the Border Death Reduction Act. I urge my colleagues to support it.

The law will implement the GAO's recommendations. It will require CBP to create a strategy for reducing border deaths. It will mandate a full count of deaths along the border. It will impose tough, new penalties on coyotes who abandon their charges, and it will expand the network of rescue beacons that people in trouble can use to call for help.

These beacons, I believe, are an absolutely vital link in our border security system. Let me explain. Rescue beacons are devices at prominent locations that individuals can activate when they need help. They are tall polls with lights at the top and radio transmitters inside. People in trouble can activate a beacon to let CBP know that they need help. We know that beacons work: CBP has already saved dozens of people based entirely on beacon alerts.

But individuals who activate beacons do not get a free pass. They will, of course, receive necessary medical treatment. But rescued individuals will still be detained and deported like anyone else who violates our borders.

Deploying more beacons in the desert will save lives in the desert and simultaneously improve the security of our frontiers.

We cannot delay. We should not rest. We must protect the lives of all those who set foot upon our soil. I urge my colleagues to support the Border Death Reduction Act.

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

Mr. President, for decades, healthcare analysts and industry experts have wondered whether healthcare should consume 16 percent of our Nation's economic output, as it currently does.

By virtually any measure, we spend more on healthcare than any other country in the world.

Consider the facts. According to the World Health Organization; we spend twice as much per person on healthcare as Britain and Japan; and we spend nearly 30 percent more than second-ranking Monaco.

In the past 5 years alone, the cost of health insurance to companies has nearly doubled--from $4,200 to $8,100 per family.

But experts also concur that rising healthcare costs does not mean the quality of healthcare is improving. Just this summer, the Institute of Medicine released the most extensive report ever on medication errors.

The results? At least 1.5 million Americans are sickened, injured, or killed each year by errors in prescribing, dispensing, and taking medications.

Errors are widespread--on average, a hospital patient is subjected to 1 error each day he or she occupies a hospital bed--and they are costly, at an estimated expense of $3.5 billion per year.

We have good reason to question the cost and quality of our healthcare services. That is why, in August, President Bush issued an executive order requiring all Federal agencies with a health insurance program to increase price transparency and provide options promoting quality and efficiency of care.

The Executive Order builds on the Federal Govermment's efforts to release Medicare payment information for individual healthcare providers.

While this is an important step toward transparency, more can be done. We need a way to analyze that data and make the results of the analysis consumer friendly, so that patients have real information they can use to make better informed healthcare decisions.

The bill before us today--of which I am a proud cosponsor--picks up where current Federal efforts leave off. The Medicare Quality Enhancement Act establishes quality transparency in the Medicare Program.

It doesn't require anything extra of providers. In fact, CMS is already collecting the data we need--because any provider that accepts Medicare patients must report quality data to CMS.

Instead, the bill requires CMS to establish public-private partnerships with Medicare quality reporting organizations, or MQROs. CMS will provide MQROs with data CMS already collects--Medicare enrollment, claims, and survey and assessment data. The MQROs will then perform the analysis.

Any entity or provider will be able to make report requests of MQROs, the results of which will be made public. The methodology an MQRO uses to analyze the data will also be made public. And providers can additionally instruct MQROs to use a certain methodology when making a report request.

I know many providers are concerned about CMS's capacity and capability to analyze healthcare quality data.

In part, that is why this bill requires CMS to contract with MQROs. The Secretary must determine that each MQRO has the research capability to conduct and complete reports as a condition for entering into the contract. MQROs must also demonstrate that they have the experience and expertise to analyze quality data.

As an additional contract requirement, each MQRO must comply with Federal privacy regulations to ensure beneficiary confidentiality. Additionally, MQROs must disclose financial interests as a condition to contract.

As a transplant surgeon, I understand the concerns and fears providers have. Many providers are worried that we aren't far enough along in terms of quality data collection to be able to analyze it.

But we must push the envelope in this area. It is my hope that provider groups will take the lead and request reports using a methodology and standards of quality that represent the best care in each of their fields.

Quality transparency is absolutely essential to improving healthcare. Without it, beneficiaries cannot make informed decisions about their healthcare.

Consumers already enjoy transparency in other industries. When we buy a new car, we can open an Internet browser and in a matter of moments can make objective side-by-side comparisons of different models--and then we can take them for a test drive.

When we need groceries, we pull out the Sunday supermarket ads to see what is on sale and where.

And when we furnish our homes, we shop around--comparing style, price, color, quality, warranty, and service.

But right now, we can't do that in healthcare. Whether it is a routine checkup or a heart transplant, we have no way of assessing how much bang we are getting for a buck.

Only when we institute quality transparency do we empower beneficiaries to make informed decisions about their healthcare.

This bill is a great step toward the goal of complete quality transparency. It is a formidable goal; that is why we are starting with something we know--Medicare.

Senator Gregg has worked long hours to bring this bill to fruition, and I thank him for his efforts. I hope our colleagues will join us in supporting this important measure.

Mr. President, I rise today to introduce the Medicare Quality Enhancement Act of 2006 to improve quality and reduce the cost of health care.

The Medicare Quality Enhancement Act addresses three important problems in our Nation's health care delivery system: rising costs, broad variations in the quality of care, and a lack of information on health care quality and cost.

Among the most pressing issues that need to be addressed in the area of health care is the issue of rapidly rising health care costs. The United States spends more on health care as a percentage of GDP than any other industrialized country. According to the Centers for Medicare and Medicaid Services (CMS), total health expenditures are estimated to be $2.16 trillion

in 2006 and are projected to rise to over $4 trillion in 2015.

The pressures of rising health care costs are being felt by consumers, providers, employers, State and local governments, and the Federal budget alike--with no end in sight. Premiums for employer-based health insurance rose by 9.2 percent in 2005--the fifth consecutive year of increases over 9 percent. Health insurance expenses are the fastest growing expense to employers, consuming more and more of each company's bottom line.

From a Federal budget perspective, over the next 10 years, Medicare will grow on average 8.5 percent to $885 billion and Medicaid will grow similarly at 8 percent to $413 billion. These programs along with Social Security will take up 56 percent of the total budget in 2016. Such rate of growth is unsustainable.

Despite this enormous level of spending, there is wide variation in the quality of the care Americans receive. In addition to the existing crisis of ever increasing costs, we are now learning that there are vast variations in the ratio of spending to outcomes, meaning that more care is not necessarily better care. A recent report by the Dartmouth Atlas Project demonstrated this point and showed no correlation between high utilization of services and high quality of care. This information provides an opportunity to improve care and reduce costs. We simply cannot afford business as usual in health care, especially when we have no way of determining the value of what we are purchasing.

The Agency on Healthcare Research and Quality (AHRQ) also reports wide variation in health care practice. AHRQ claims that millions of Americans fail to receive necessary care resulting in complications and increased costs. Others, they say, receive health care services that are completely unnecessary, which also increases costs.

These problems are compounded by a third issue the lack of information available to consumers and purchasers on quality and cost. Currently, health care consumers do not have the tools necessary to make sound quality and cost decisions about their care. The few tools that are available to them are based on limited amounts of privately held data and their analysis is often not broad enough to provide the most accurate results.

The Medicare Quality Enhancement Act gives consumers, employers, providers and others the tools they need to begin controlling unnecessary spending; improves quality of care in our nation's health care delivery system; and provides the public with reports to make informed health care decisions.

The bill works by sharing taxpayer funded Medicare data with private sector Medicare Quality Reporting Organizations (MQROs), allowing them to develop reports to measure health care quality for the public. Consumer groups, employers, insurance companies, labor unions and others have repeatedly requested access to Medicare claims data to improve the quality of the health care provided to their members, employees, and beneficiaries and to help control the ever-rising costs of health care. The Medicare Quality Enhancement Act ensures that the data collected by Medicare and paid for by the taxpayer can be utilized by qualified organizations to measure quality and control costs while protecting beneficiary privacy.

The measure also empowers consumer groups, providers, employers, insurance plans, labor unions and others by allowing them to request health care quality and efficiency reports from the newly-formed MQROs--information that will assist in better-informed purchasing decisions. Further, the bill provides for the public release of all reports, including detailed information on the methodology, standards and measures of quality used in developing the reports ensuring the information is available for the general public. In addition, MQROs that contract with the Department of Health and Human Services will be authorized to aggregate both private and public data, providing a significantly more robust assessment of both quality and efficiency.

In the development of this bill, my first goal was to protect beneficiary privacy. Specifically, the bill limits the number of MQRO participants and explicitly holds them to the strict standards of both the Health Insurance Portability and Accountability Act (HIPAA) and the Privacy Act. It also requires MQROs to have operational standards and procedures in place to provide for the security of the database. Lastly, the bill requires a privacy review by the Department of Health and Human Services of each analytical report prior to release.

The Medicare Quality Enhancement Act promotes the development of model quality standards through a newly established Quality Advisory Board within the Department of Health and Human Services and encourages the Administration to continue its extraordinary work with providers, consumers, insurers and others in the health care community toward sound quality measurement for all patients. Collaborative groups such as the Ambulatory Care Quality Alliance (AQA) and the Hospital Quality Alliance (HQA) are working hard to establish standards and the Medicare Quality Enhancement Act encourages their work to continue.

Under the bill, researchers are granted additional access to Medicare data and are allowed to report in a provider- and supplier-identifiable format as long as they meet existing strict criteria for the use of Medicare data within CMS. Some of our best information on quality and efficiency has been borne of fine academic institutions and private study and they, too, should have the opportunities to use this data to improve our health care system.

In closing, the Medicare Quality Enhancement Act is needed in order for America's health care system to improve. The public needs to understand the quality of the care they are purchasing and the time has come for the health care community to compete on quality, value, and cost payment should not simply be for the volume of care provided, but instead for the quality of the care provided.

The Medicare Quality Enhancement Act takes important steps to provide health care consumers with the information they need to make educated decisions about health care; information they already have to make decisions on nearly every other product they purchase in the marketplace. It requires that information paid for by the taxpayer and held by Medicare is fully available to improve our health care system. The public will then finally have the tools necessary to make informed health care decisions for themselves and their families.

This bill has the support of groups that represent consumers, providers, employers and insurers. I hope my colleagues will see the merit of this legislation and that it will be considered before we adjourn this year.

Mr. President, I am pleased to join my colleague from Montana, Senator Baucus, in introducing the Medicare Data Access and Research Act. Senator Baucus and I have long enjoyed a good working relationship in our roles as chairman and ranking member of the Finance Committee. Our work on this bill once again demonstrates our commitment to working in a bipartisan manner.

The Medicare Data Access and Research Act establishes a process through which Federal agencies and other researchers can access Medicare data for the purpose of health services research. This might seem like a pretty mundane issue to some people, but I can assure you that it is far from it. Medicare processes 500 million claims for benefits each year; millions of prescriptions have been filled under the new Medicare prescription drug benefit.

Linking data on hospital and physician services provided to Medicare beneficiaries to prescription drug data will offer a tremendous resource for researchers in our Federal agencies, as well as those based at universities and other research centers. What of research can these data support? They can support studies and analyses related to postmarketing surveillance of prescription drugs and research on drug safety. More concretely, analyzing the Medicare claims data can help agencies, such as the Food and Drug Administration FDA, identify situations like the one involving Vioxx more quickly, and provide a new valuable tool to enable the FDA to take swifter action to protect the public's health and well-being.

The Centers for Disease Control and Prevention, the Agency for Healthcare Research and Quality, and the National Institutes of Health all have missions that require the conduct of meticulous health services research. The Medicare database and access to it established under the bill we are introducing today will help these agencies fulfill their missions to study immunization rates; to develop and monitor the use of preventive screenings; conduct research on the clinical comparative effectiveness of prescription drugs; and to help prevent, diagnose, and treat disease.

To ensure access to the data, the bill requires the Secretary of Health and Human Services to enter data release agreements on an annual basis with these agencies. In entering the data release agreements, the Secretary must take appropriate steps to protect the confidentiality of the information, while maintaining the ability of researchers at Federal agencies to conduct meaningful analyses.

The bill also permits the Secretary to enter into data use agreements to permit researchers at universities and other organizations to have access to the data. As will be the case for the Federal agencies, these researchers may only use the data for purposes of advancing the public's health. They can conduct studies on the safety, effectiveness, and quality of health services.

Some people might be concerned that these data will be given to just anyone. That is not the case. In applying for data access, researchers at universities and other organizations will have to meet strict criteria. They must have well-documented experience in analyzing the type and volume of data to be provided under the agreement. They must agree to publish and publicly disseminate their research methodology and results. They must obtain approval for their study from a review board. They must comply with all safeguards established by the Secretary to ensure the confidentiality of information. These safeguards cannot permit the disclosure of information to an extent greater than permitted by the Health Insurance Portability and Accountability Act of 1996 and the Privacy Act of 1974.

The final section of the bill ensures that congressional support agencies, including the Congressional Budget Office, the Congressional Research Service, the Government Accountability Office, and the Medicare Payment Advisory Commission, also have access to data they need to carry out their functions and responsibilities. This body depends on the research and analyses conducted by those agencies to inform our deliberations and decisions on the Medicare Program.

Last year, Senator Baucus and I introduced the Medicare Value-Based Purchasing Act to establish a pay for performance system under Medicare. That bill was aimed at promoting quality and ensuring value under the Medicare Program. The bill that we are introducing today complements that objective. How can we promote quality and ensure value in Medicare? By having a better understanding of what services are effective, by knowing how we can help beneficiaries avoid illness and disease, by having insight about potential over-use and under-use of health care services, and by identifying troubling trends and patterns. How can we learn about those topics? By supporting rigorous health services research.

Mr. President, the Medicare Data Access and Research Act creates a sound framework for accomplishing that objective.

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

Mr. President, one cold May morning earlier this year, a Border Patrol agent found the body of a 3-year-old boy in a blue windbreaker, his arms crossed. He had died trying to cross our southern border, the youngest victim our borders have claimed this year.

The boy's mother's name is Edith Rodriguez. She is 25 years old. She attempted to cross the border illegally, in hopes that she might escape the desperate poverty of her home state of Veracruz, Mexico. Edith hired a human smuggler--a coyote.

The coyote gave his charges an illegal drug, ephedrine, to help them keep awake and moving. But Edith and her son still could not keep up with the group. So the coyote, in a cruel and heartless act, abandoned them in the desert. Alone. With no food and little water, with a dangerous drug coursing through his system, exposed to the elements-- Edith Rodriguez's little boy died.

Edith Rodriguez violated the laws of the United States when she crossed the border illegally. She was wrong to violate our border. But all should agree that her son did not deserve to die.

Here are the facts: Every 18\1/2\ hours, someone dies trying to cross the border between the United States and Mexico. About a year ago, I asked the Government Accountability Office to study the deaths that take place along America's borders.

Today, my office released that study. The results are sobering, shocking, and, I strongly believe, a cause for action. Since 1995, deaths along our borders have doubled. Despite the heroic rescue efforts of the men and women of Customs and Border Protection, things have gotten worse. In 1995, 266 people

died trying to cross our borders. Last year, 427 perished.

The increases, it appears, stem largely from an increase in deaths from exposure to the elements in the Sonoran Desert in Arizona. Illegal entries, however, have not increased. Quite frankly, it is getting more dangerous to cross our border.

Until recently, CBP did not even keep a systematic count of those who died crossing our borders. We still do not have a unified national strategy for reducing the deaths. We still do not know how well our safety efforts work--if they are saving lives or not. We need to do more.

The founding document of our Nation, the Declaration of Independence, lists ``life'' first on the list of Government's responsibilities. The overwhelming majority of the people who cross our border do so in search of a better life. They take enormous risks and make enormous investments in hopes of helping their families.

Illegal immigration needs to stop. We must defend our borders. We must construct physical barriers, add detention beds, hire personnel, and equip them with better technology. But we have a higher moral obligation to protect the life of every person--every man, woman, and child--who sets foot on American soil. We must do everything in our power to preserve life.

That is why I propose the Border Death Reduction Act. I urge my colleagues to support it.

The law will implement the GAO's recommendations. It will require CBP to create a strategy for reducing border deaths. It will mandate a full count of deaths along the border. It will impose tough, new penalties on coyotes who abandon their charges, and it will expand the network of rescue beacons that people in trouble can use to call for help.

These beacons, I believe, are an absolutely vital link in our border security system. Let me explain. Rescue beacons are devices at prominent locations that individuals can activate when they need help. They are tall polls with lights at the top and radio transmitters inside. People in trouble can activate a beacon to let CBP know that they need help. We know that beacons work: CBP has already saved dozens of people based entirely on beacon alerts.

But individuals who activate beacons do not get a free pass. They will, of course, receive necessary medical treatment. But rescued individuals will still be detained and deported like anyone else who violates our borders.

Deploying more beacons in the desert will save lives in the desert and simultaneously improve the security of our frontiers.

We cannot delay. We should not rest. We must protect the lives of all those who set foot upon our soil. I urge my colleagues to support the Border Death Reduction Act.

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