Health Professionals Substance Abuse Education Act

Mr. President, when I began my first campaign for the U.S. Senate in 1995, I published a booklet entitled ``Where I Stand.'' I wrote it because the first obligation of a candidate is to tell voters what you believe. In that booklet, I wrote:

The Social Security system must be preserved, protected,

and improved. We have made this covenant with our senior

citizens. However, the long-term future of the Social

Security system is in peril. If we do not get this issue

resolved soon, this Nation faces an entitlement disaster,

eroding the trust between grandchildren and grandparents. We

must explore every option in order to fix and strengthen our

Social Security system. This will require bold leadership.

A decade later, those words still define my position on Social Security. Social Security has been one of the most important and successful Government programs in the history of America. Almost every American family over the last 70 years has been touched by Social Security. In signing the Social Security Act of 1935, Franklin Roosevelt said:

None of the sums of money paid out to individuals in

assistance or insurance will spell anything approaching

abundance. But they will furnish that minimum necessity to

keep a foothold, and that is the kind of protection Americans

want.

A fundamental point that President Roosevelt made was that Social Security was not intended to replace the personal responsibility of individuals saving for and preparing for their own retirements. Social Security was never intended to be a substitute for a retirement or savings plan. It is a safety net for people. Social Security is an insurance contract that protects the most vulnerable in our society from falling into poverty. But Social Security is actuarially unsustainable with its present commitments to future generations.

Today, I am introducing comprehensive Social Security reform legislation. I began my day in Nebraska this morning with some of the people who would be most affected by my bill--America's next generation. It is their generation that will be asked to sustain the future of Social Security.

My generation, the baby boom generation, has been the largest and most productive workforce in the history of man. The impending retirement of the 77 million-strong baby boom generation will impact every aspect of our economy, Government, and society--Medicare and Medicaid, health care, our workforce, and our competitive position in a world filled with countries much younger than ours. The next generation of Americans will respond to these challenges as every generation of Americans has responded to challenges--with innovation and hard work.

However, my generation has a moral obligation to ensure that future generations do not have to bear an increasingly heavy burden of providing retirement resources for future generations. That is why we must reform Social Security. It is a 1935 model trying to operate in a 21st century world. It will soon be incapable of delivering the promises and resources that it was built to provide 70 years ago.

Last week, in testimony before the House Budget Committee, Federal Reserve Chairman Alan Greenspan urged Congress to act on modernizing entitlement programs sooner rather than later. He warned that, unless we act now to meet the huge unfunded liabilities facing our entitlement programs, there will be severe economic consequences for our Nation. Chairman Greenspan is right.

America's largest entitlement programs--Social Security, Medicare, and Medicaid--are on a trajectory that cannot be sustained. For fiscal year 2006, the Congressional Budget Office tells us that 64 percent of the $2.5 trillion Federal budget will be obligated to mandatory spending, of which 42 percent is for Medicare, Medicaid, and Social Security. Those are tax dollars that are committed--money that cannot be used for anything else.

Each year, the percentage of the Federal budget obligated to funding entitlement programs grows larger and larger. The current unfunded liability for Social Security over the next 75 years--this is the horizon that the Social Security Administration uses to calculate benefits and expenditures--is $3.7 trillion. That means over the next 75 years, we are obligated to make the commitments of the retiree benefits a reality. Yet we have $3.7 trillion of debt. We don't know where and how we are going to get that $3.7 trillion. We are now $3.7 trillion in debt in the current obligations over the next 75 years for Social Security. Medicare's unfunded liability is nearly $28 trillion. These liabilities are in addition to America's current national debt of $7.5 trillion.

Medicare costs are growing faster than any other Government or entitlement program. As we see health care costs continue to rise, coupled with the growing number of retirees, it will only continue to put more and more pressure on our Federal budget and squeeze out money for important discretionary Government programs such as education, roads, parks, and housing.

Last Congress, we passed an enormous expansion of Medicare. I voted against it. I thought it was bad policy and would add hundreds of billions of dollars to an already unsustainable program. I am supportive of efforts to reopen the Medicare reform bill and fix it. But for political reasons, I doubt that will happen soon, although we will be forced to deal with it in the future.

The Social Security system is not in crisis today, but there is clearly a crisis on the horizon. In 2018, more money will be paid out of Social Security than comes in. In 2042, the Social Security trust fund will be insolvent. Beyond the next 75 years, there is only a black hole of unfunded liability for future generations. The longer we do nothing, the more difficult it will be to protect Social Security and the promise our Government made to future generations of Americans.

This reality is daunting, but there is good news in all of this. The system can be fixed. It is within our power to preserve the Social Security net for this Nation. It has been done before. In 1983, President Reagan worked with congressional Democrats and Republicans to make tough choices and extend the life of Social Security. Dealing with this problem now means less dramatic and difficult choices later. The earlier we confront the reality of the coming crisis, the more options we will have to come up with a wise and sustainable course of action.

Allow me to now lay out the main points of the Social Security reform bill that I will introduce today.

My bill would ensure the vitality of Social Security for future generations. There are no easy choices to fix the demographic challenges and realities facing Social Security. Understanding this, we must make choices that address the problem responsibly and fairly.

My bill would make changes to Social Security only--only--for those Americans under the age of 45. No American age 45 or older will see a change in Social Security or their benefits. For Americans under 45, my bill would provide the option of voluntary personal accounts. Providing personal accounts is good policy for both the long-term viability of Social Security and for individuals. Government should be about empowering individuals and enhancing personal freedoms and their futures. Personal accounts help do this for those under 45.

My bill would continue to provide a guaranteed Social Security benefit from the Social Security trust fund. Under my plan--under any plan--Americans still need the security of knowing that the portion of their Social Security benefits that comes from the traditional Social Security system will be guaranteed. My bill will continue to guarantee survivor and disability benefits as they currently are.

Social Security provides benefits for more than 6 million spouses and children of breadwinners who have died

prematurely or have become disabled. For these families, their benefits should not be touched.

I know something about this. When I was 16 years old, my father died. The Social Security benefits my mother received were critical in helping her raise four young boys in Nebraska. I well remember my mother's relief when that Social Security check arrived each month.

We must remember that the first obligation of Social Security is to the most needy Americans. My bill does not raise taxes. I believe we can fix Social Security without raising taxes. We need to begin reforming Government programs so they do not become so large and so expensive that future taxpayers will be unable to pay for them. Young wage earners and small businesses are the most vulnerable to tax increases, and they would be the ones most adversely affected by higher taxes to save Social Security.

Additionally, whenever we increase the cost of labor, we hurt our competitive position in the world and make job creation more difficult. This is not abstract economic theory; it is reality that has an impact on every future American.

Those are the principles that form the foundation of the bill I will introduce today. Here is how it would work.

Upon passage of the bill, Americans 44 and younger would be given two voluntary options. One, they can invest 4 percent of their payroll tax into a personal investment account modeled on the same accounts now offered to all Federal Government employees. I participate and my staff participates in this program. The remainder of their payroll tax contribution would continue to go into the traditional Social Security system. Option 2, individuals can continue to invest their entire payroll tax in the traditional Social Security system.

If they choose the personal account option, then individuals will be able to invest in the same five funds that collectively make up the current Federal Thrift Savings Plan--again, the program that I am in, Members of Congress are in, and Federal Government employees are in.

The first is the common stock index fund. Over the last 10 years, this fund has earned an average annual rate of return of 11.99 percent.

The second fund is the fixed income index investment fund. Over the last 10 years, this fund has earned an average annual rate of return of 7.72 percent.

The third is the Government securities investment fund, and over the last 10 years, it has earned an average annual rate of return of 5.75 percent.

The fourth is the small capitalization index. Over the last 10 years, it has earned an average annual rate of return of 11.84 percent.

Fifth is the international stock index fund. Over the last 10 years, it has earned an average annual rate of return of 5.45 percent.

These five funds provide a range of excellent investment options.

My bill would also provide a default account for those Americans who, for whatever reason, do not want to deal with choosing a fund or funds for their accounts. This fund would invest differently in an individual's early working years than in their later working years.

The Thrift Savings Plan has been a success for Government employees. Last year, returns on the different accounts ranged from just over 4 percent to 20 percent, and in the last 10 years, the returns have been between 5.5 and 12 percent. Compare this with the 3-percent return provided by Treasury bonds that Social Security now invests in today.

These private accounts are in addition to the guaranteed Social Security benefits and personal savings pensions and retirement account programs individuals build up during their working years.

Under my bill, personal accounts would be administered by a board within the Social Security Administration called the Social Security investment board. The board would be composed of the Secretary of the Treasury, the Chairman of the Federal Reserve Board, the Chairman of the Securities and Exchange Commission, and two Senate-confirmed appointments nominated by the President. One of the President's appointments would serve as chairman of the board.

Upon retirement, those who choose to enroll in a personal account will have two accounts: their personal account and their traditional Social Security benefits account. They will be required to convert a portion of their personal account to an annuity which, when added to their guaranteed Social Security, would be at least 135 percent of poverty. There is no such guarantee in our Social Security system today. The remainder of the personal account will be theirs to spend as they wish. It could be used to help with health care costs and retirement living costs, or it could even help an account holder's children or grandchildren put a downpayment on a home or pay college tuition.

There are those who say that allowing individuals to invest through personal accounts is too risky. Their concerns are serious, and they deserve a serious response. Under my plan, no person is required to have a personal account. An individual who does not want to invest can keep all of their money in the traditional Social Security system.

I believe the policies which enhance personal freedom and responsibility encourage the ethic of saving and limit the role of Government in their lives. These are the policies which will be more flexible and successful for America's future.

It is true that there is no guarantee with market-based investments; however, the historic success of markets is not a theory, it is a fact. Columnist George Will pointed out in a recent Washington Post column that in no 15-year period over the past eight decades has the growth of stocks ever been negative. In no 20-year period has the average growth been less than 3 percent, which exceeds the rate of return on Social Security assets today. This includes down times, significant down periods in the stock market.

We are blessed in America. We are blessed in America because the vast majority of Americans live healthier, longer lives than they did a few decades ago. Continued advances in medicine, education, and personal health will continue to increase not only the length of our lives, but also the quality of our lives, providing opportunities for older Americans to remain healthy, vital, and productive members of the workforce.

When Social Security was created in 1935, there were too many workers and not enough jobs. According to the Social Security Administration, in 1950, there were 16.5 workers per retiree. Incentives were created to move people out of the workforce. This dynamic is changing. Today there are 3.3 workers for every retiree. In 25 years, there will be about 2 workers for each retiree.

Why is this important? This is important because Social Security is a transfer program. The money comes in and the payroll taxes from the workers go out at the end of the month to the retirees.

So when there are less workers, there is less money coming into the system. My bill makes three adjustments to Social Security that will make it solvent for future generations. First, my bill would raise the current full benefit retirement age by 1 year from 67 to 68. Second, my bill would maintain the current earlier retirement age at 62 but would adjust benefits for those who choose to retire early.

Currently, workers who retire early today receive 70 percent of their full retirement benefits. My bill will provide these early retirees with 63 percent of the traditional benefits.

Third, currently an individual's base Social Security benefit is determined by two factors: their average income over 35 years and the wage index. My bill adds a third component, life expectancy. We are living longer. That means as we live longer, we will draw more from the Social Security fund.

Over the life of the program Social Security benefit calculations have never been adjusted to reflect increased life expectancy. By factoring increased life expectancy into the base benefit calculation, the rate of increase in benefit payments will be slow. No other changes will be made to the annual consumer price indexing of benefit increases.

In addition to making Social Security solvent, these adjustments can help confront the challenges of increasing Medicare costs and shortages in the workforce. It is important to protect

the option of early retirement, but our laws need to encourage individuals to stay in the workforce, not leave it.

Medicare costs, Medicaid costs, and labor shortages can be significantly reduced by keeping people healthy, vital, happy, and productive in the workforce. My bill pays for these changes in Social Security by using the existing $3.7 trillion unfunded liability to ensure the long-term health of the Social Security system. Doing nothing will mean at the end of 75 years, Social Security will have chewed up $3.7 trillion in taxpayer money to help keep Social Security solvent, but it will not, and we will still have an insolvent program with trillions of dollars more of unfunded liabilities staring us in the face.

In recent testimony before the Senate, Alan Greenspan said Social Security's total unfunded liability could be as high as $10 trillion over the life of the program. I have introduced this bill because I believe that leaders have a responsibility to deal with the great challenges of their time, not defer them, not make excuses for them, but to try to fix them and come up with solutions.

I do not hold my bill up as the only way to address the solvency of Social Security. It is one way. There may be better ways. No comprehensive bill will be immune from critical evaluation, nor should it be. However, I think my bill is a commonsense, responsible, and fiscally accountable place to start.

All Americans need to ask tough questions about the future of Social Security. We need to begin the process of refining ideas to forge the best, most responsible policy for the future of Social Security.

President Bush deserves great credit for making the modernization of Social Security a central part of his second-term agenda. There is no possibility for success in modernizing Social Security without strong Presidential leadership.

As I said at the beginning of my speech, Social Security is one of the most important and successful Government programs in American history. Since 1935, it has provided a safety net for our society's most vulnerable. We have a high moral obligation to ensure that future generations continue to benefit from this safety net and social contract we have with our citizens. But in order to do this, we must fix the system.

This is a personal issue for me. Forty years from now a young mother in Columbus, NE, may be left to raise four children on her own. I want her family to have the same access to the same safety net that my family had, and the promise that no matter where one starts in life, with a little help they can finish where they want.

I am 58 years old. I am at the front of the baby boom generation. My daughter is 14 years old. My son is 12 years old. I do not want to fail their generation. That means addressing these entitlement program issues now, while we have time to do it in a wise, careful, and responsible way. This is a defining debate for today's leaders. Doing nothing is irresponsible and cowardly. It is in America's interest to deal with our challenge today. We have it in us to do what needs to be done. We can preserve, protect, and improve Social Security for all future generations of Americans.

I send my bill to the desk and ask that it be assigned to the appropriate committee.

I yield the floor.

Mr. President, I am pleased to introduce the Native American Omnibus Act of 2005 to amend a variety of Federal statutes affecting Indian tribes and Indian people. This Act contains nineteen provisions, including technical amendments to several laws, extensions of expiring authorizations, and provisions relating to particular Indian tribes, and certain Native American programs.

Section 101, amends the Indian finance act of 1974 to clarify that non-profit tribal entities are eligible for the BIA Loan Guaranty program. It also raises the limit on the amount of loans to $1.5 billion from $500 million.

Section 102 extends the authorization for the Indian Tribal Justice Technical and Legal Assistance Act to through fiscal year 2010.

Section 103 extends the Indian Tribal Justice Act for three more years.

Section 104 cures a problem specific to New Mexico and the 1924 Indian Pueblo Lands Act. Recently, the New Mexico State Court of Appeals ruled that a change from Indian to non-Indian title for a parcel of land within a Pueblo land grant area eliminated that parcel's status as ``Indian Country.'' This ruling created a jurisdictional void for criminal acts occurring on

land within the original Pueblo land grant once its' title has changed. Consistent with existing law, this amendment clarifies that the state maintains jurisdiction over non-Indians, the tribe has jurisdiction over Indians and its members, and the federal government has jurisdiction pursuant to the Major Crimes Act. This amendment does not expand Indian civil jurisdiction and only applies to criminal jurisdiction. I understand that it is uniformly support by all affected parties.

Section 105, conveys approximately 1290 acres of the Lock and Dam #3 lands to the Prairie Island Tribe. The provision prohibits gaming or structures for human habitation on the conveyed lands.

Section 106 is a technical amendment to allow binding arbitration in all contracts and not just leases on the Gila River Indian Community reservation.

Section 107 conveys several parcels of land in the State of Washington to be held in trust for Puyallup Indian Tribes.

Section 108 amends Native American graves Protection and Repatriation Act by clarifying that the term ``Native American'' refers to a member of a tribe, a people, or a culture that is or was indigenous to the United States.

Section 109, the amends the Fallon Paiute Shoshone Tribe's water rights settlement act to permit the expenditure of six percent of the average market value of the Fund over three years.

Section 110, the Washoe Tribes Lake Tahoe Access Act, corrects the 1990 settlement and includes 24.3 acres of land near Lake Tahoe for the Tribes. The amendment does not affect the number of acres conveyed to the Tribe in the original settlement.

Section 111 amends the Indian Arts and Crafts Act. A major source of tribal and individual income comes from the sale of handmade Indian arts and crafts, but millions of dollars are diverted each year from these artists and tribes by those who reproduce and sell counterfeit Indian goods. Enforcing the criminal law that prohibits the sale of Indian arts and crafts misrepresented as an Indian product is often stalled by the other responsibilities of the FBI including investigating terrorism activity and violent crimes on Indian lands. This amendment supplements the existing federal investigative authority by authorizing other federal investigative bodies, such as the BIA, in addition to the FBI, to investigate these offenses.

Section 112, the Colorado River Indian Reservation Boundary Correction Act, corrects the south boundary of the Reservation by reestablishing the boundary as it was delineated in the original survey.

Section 113, reauthorizes the Native American Programs Act of 1974 and establishes the Inter-Departmental Council of Native American Affairs.

Section 114 amends the Native Hawaiian Education Act to include research and education activities relating to Native Hawaiian law.

Section 121 amends the Carl D. Perkins Vocational Act to include the registration of Indian students in the Spring semester.

Section 122, the Native Nations Leadership, Management and Policy Act of 2005 authorizes funding for leadership training, strategic and organizational development, and research and policy analysis to assist American Indian nations to achieve effective self-governance and sustainable economic development. This provision renews authorized funding for NNI's programs for a period of 10 years, beginning in fiscal year 2007. Dedicated funding for NNI is necessary to ensure the continuation of these important programs without further draining funds from the Udall Foundation's other educational activities.

Section 132 authorizes the Secretary of Homeland Security, to establish a pilot program to enhance an Indian tribe's response to border activity. Some Indian tribes that inhabit land on or easily accessible to the United States and Canada or Mexico, bear extraordinary costs in responding to illegal immigration crossing and drug smuggling and almost always divert funds intended for local services to do so. While Federal and State law enforcement resources may supplement tribal efforts, tribal police, fire and emergency services provide the first and often only response because of their access to the border. A tribe's proximity to the border and its responsibility to the community for public safety and welfare, requires that they respond. This program would enhance tribal first responder capabilities, provide assistance for aerial and ground surveillance technologies, and communication capabilities, and facilitate coordination and cooperation with Federal, State, local and tribal governments in protecting the border. The Secretary may establish the selection criteria for participation in the program including the tribes' proximity to the border and the extent to which border crossing activity impacts existing tribal resources.

Section 201, Authorization of 99 year leases, amends Title 25 USC Section 415 providing for leases of restricted lands by adding several additional tribes to the list of tribes that have requested 99-year lease authority.

Section 202, Certification of rental proceeds, amends Title 25 USC Section 488 to permit actual rental proceeds from a lease to constitute the rental value of that land, and to satisfy the requirement for appraisal of that land.

Section 211, will permit the Navajo Nation's Sage Memorial Hospital to be considered a tribal contractor under the Indian Self- Determination Act, which will allow the hospital to obtain the benefits of coverage under the Federal Tort Claims Act and secure VA drug discounts.

Section 221, amends the American Indian Probate Reform Act of 2004 by correcting provisions relating to non-testamentary disposition, partition of highly fractionated Indian land, and Tribal probate codes.

I look forward to working with my colleagues on both sides of the aisle to enact this important legislation.

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

Mr. President, I rise today to re-introduce a bill that I offered last year that I hope will be the first in a series of proposals to simplify the Tax Code for small business owners. Once enacted, these provisions will reduce not only the amount of taxes that small businesses pay, but I believe they also will reduce the administrative burden that saddles small companies in trying to satisfy their tax obligation.

Let me begin by saying how pleased I am that the President has made simplifying the Tax Code one of his top priorities for his second term. Clearly, a world-class economy such as that of the United States requires a world-class revenue collection system, meaning we need a Tax Code that is simple, consistent, and fair. For that reason, I look forward to seeing the recommendations that the President's tax reform panel will offer on how best we can reform the current Tax Code to improve its efficiency and strengthen our overall economy.

In the interim, the proposal that I am re-introducing today will simplify the code by permitting small business owners to use the cash method of accounting for reporting their income if they generally earn fewer than $10 million during the tax year. Currently, only those taxpayers that earn less than $5 million per year are able to use the cash method. By increasing this threshold to $10 million, more small businesses will be relieved of the burdensome record-keeping requirements that they must deal with currently in paying their income taxes.

Before I talk about the specifics of this particular provision, let me first explain why it is so critical that we simplify the Tax Code. As you know, Mr. President, small businesses are the backbone of our nation's economy. According to the Small Business Administration, small businesses represent 99 percent of all employers, employ 51 percent of the private-sector workforce, and contribute 51 percent of the private- sector output.

Yet, the despite the fact that small businesses are the engine that drives our improving economy, the current tax system imposes entirely unreasonable burdens on them when they try to

satisfy their tax obligations. As you know, the current tax code imposes a large, and expensive, burden on all taxpayers in terms of satisfying their reporting and recordkeeping obligations. The problem, though, is that small companies are disadvantaged most in terms of the money and time spent in satisfying their tax obligation vis-a-vis larger firms.

For example, according to the Small Business Administration's Office of Advocacy, small businesses spend more than 8 billion hours each year filling-out government reports, and they spend more than 80 percent of this time on completing tax forms. What's even more troubling is that companies that employ fewer than 20 employees spend nearly $6,975 per employee in tax compliance costs, and this amount is nearly 60 percent more than companies spend with more than 500 employees.

These statistics are disconcerting for several reasons. First, the fact that small businesses are being required to spend so much money on compliance costs means they have fewer earnings to reinvest into their business. This, in turn, means that they have less money to spend on new equipment or on worker training, which unfortunately has an adverse effect on their overall production and the economy as a whole.

Second, the fact that small business owners are required to make such a sizeable investment of their time into completing paperwork means they have less time to spend on doing what they do best--namely running their business and creating jobs.

Let me be clear, however, that I am in no way suggesting that small business owners are unique in having to pay income taxes, and I am certainly not expecting them to receive a free pass. In order to benefit from the freedoms and protections that our great country provides, individuals and businesses alike are required to pay taxes, and this duty inevitably imposes some minimum administrative and opportunity cost. What I am asking for, though, is a fairer, simpler Tax Code that allows small companies to satisfy this obligation without having to expend the amount of resources that they do currently.

For that reason, the package of proposals that I hope to introduce will provide not only targeted, affordable tax relief to small business owners, but they also will simplify the rules that exist currently. By simplifying the Tax Code, small business owners will be able to satisfy their tax obligation in a cheaper, more efficient manner, and they consequently will be able to invest more time and resources into their business.

As I mentioned earlier, the provision that I am introducing today will permit more taxpayers to use the cash method of accounting rather than the accrual method. Generally, current law permits only those taxpayers that earn fewer than $5 million in gross receipts during the tax year to use the cash method in reporting their income. In addition, current law precludes taxpayers that have inventory from using the cash method. This means that thousands of small businesses that should be entitled to report their income and expenses under the cash method of accounting are required to follow the accrual method, which tends to impose additional financial and administrative costs that should be eliminated.

My bill changes these existing rules so that more small businesses will be able to use the cash method. In short, my bill increases the gross receipts test under current law to $10 million and indexes this higher threshold to account for inflation. As the current $5 million threshold is clearly outdated, it makes little sense to have such an obsolete standard for this most important provision.

My bill also changes current law to permit those taxpayers with inventory to qualify for the cash method of accounting. Notably, however, my bill will not give these taxpayers an opportunity to simply recover costs associated with these otherwise inventoriable assets in the year of purchase. Rather, my bill will require these taxpayers to account for such costs as if they are a material or supply that is not incidental. This standard already exists under current law, and it is one with which many small businesses are already familiar. As such, this less-burdensome standard should ease the existing compliance burden for eligible taxpayers and allow them to devote more time and resources to their business.

Importantly, these changes will not reduce the amount of taxes a small business pays by even one dollar. Indeed, the overall amount of taxes a qualifying small business pays will remain the same. Rather, this bill simply permits more taxpayers to report income and account for costs in the year of the receipt or expenditure. Clearly, this method is much easier and simpler for small taxpayers, and it will reduce both their time and monetary expenditures spent on complying with the Tax Code.

Mr. President, I rise today to introduce legislation to address the problem of substance abuse in our country.

The Robert Wood Johnson Foundation has called substance abuse America's No. 1 health problem. I don't think that overstates it.

Most of us knows someone--a family member, maybe a neighbor, a colleague, or a friend--who is addicted to drugs or alcohol. In fact, nearly 15 million people in this country abuse alcohol or are alcoholics. More than 19 million use drugs, and an estimated 4 million are in need of treatment but not receiving it.

Drug and alcohol abuse has far-reaching consequences. It exacerbates social ills. It is a public safety problem. It is a public health problem. It is a public expenditure problem. There is an undeniable correlation between substance abuse and crime. Eighty percent of the 2 million men and women behind bars today have a history of drug and alcohol abuse or addiction or were arrested for a drug-related crime. Illegal drugs are responsible for thousands of deaths each year. They fuel the spread of AIDS and hepatitis C. They contribute to child abuse, domestic violence, and sexual assault. And we all pay the price.

It costs this Nation almost $275 billion in law enforcement, criminal justice expenses, medical bills, and lost earnings each year. That means that preventing and treating substance abuse makes sense. It makes good criminal justice sense. It makes public health sense. It makes budgetary sense. Not to mention the fact that it is the right thing to do.

Yet there remains a reluctance to recognize substance abuse as a health issue. There is a reluctance to accept addiction as a disease. It is a reluctance that has kept public policy from asserting that addicts should be in treatment. Whether addicts are in prison or out, it seems to me, treatment is the only legitimate choice.

But it is not only about increasing access to treatment. It is also about moving treatment into the medical mainstream. Unless family doctors, nurses, physician assistants, and social workers can identify addiction when they see it, unless they know how to intervene, we will never make any real progress.

That aspect of the challenge came into sharp focus for me when I read a report a few years ago by the National Center on Addiction and Substance Abuse at Columbia University, CASA.

That report said that fewer than 1 percent of doctors presented with the classic profile of an alcoholic older woman could diagnose it properly. Eighty-two percent misdiagnosed it as depression, some treatments for which are dangerous when taken with alcohol. A follow-up study showed that 94 percent of primary care physicians fail to diagnose substance abuse when presented with the classic symptoms, and 41 percent of pediatricians fail to diagnose illegal drug use in teenage patients.

No one recognizes this problem better than the doctors themselves. Fewer than one in five--only 19 percent--feel confident about diagnosing alcoholism. And only 17 percent feel qualified to identify illegal drug use. Having said that, even if they diagnose it, most doctors don't believe that treatment works.

Among practitioners, as well as policymakers, we need to get the message out loud and clear: Addiction is a chronic relapsing disease, and as with other such diseases, while there may not be a cure, medical treatment can help control it.

The medical professionals have to be educated to recognize the signs of substance abuse and to pursue the effective therapies that are available. That is why I am introducing legislation to help train medical professionals to prevent and recognize addiction and refer patients to treatment if they need it. Representative Patrick Kennedy will introduce companion legislation in the House of Representatives.

Like treatment, training works. According to a study published in the Brown University Digest of Addiction Theory and Application, 91 percent of health professionals who took part in training on addiction at Boston University were using the techniques they learned 1 to 5 years later.

Every family doctor does not need to be an addiction specialist, but they do need to be able to recognize the signs. And they need to know what help is available.

My legislation does the following three things: authorizes $9 million in grants to train medical generalists to recognize substance abuse in their patients and their families and know how to properly refer them for treatment; authorizes $6 million to fund substance abuse faculty fellows at educational institutions to teach courses on substance abuse, incorporate substance abuse issues into to required courses at the institution, and educate health professionals about issues related to non-therapeutic uses of prescription medications; and establishes centers of excellence at medical centers or universities across the United States to (1) initiate, promote and implement training, research and clinical activities related to special areas of substance abuse and (2) provide opportunities for interdisciplinary collaboration in curriculum development, clinical practice, research and policy analysis. The bill authorizes $6 million for this purpose.

These are additional steps--and, in my view, crucial ones to help bridge the divide between research and practice. They will help chip away at the incredible substance abuse-related costs we face each year in human as well as monetary terms.

I hope my colleagues will join me to support this important legislation.

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

Mr. President, I rise today to introduce legislation to address the problem of substance abuse in our country.

The Robert Wood Johnson Foundation has called substance abuse America's No. 1 health problem. I don't think that overstates it.

Most of us knows someone--a family member, maybe a neighbor, a colleague, or a friend--who is addicted to drugs or alcohol. In fact, nearly 15 million people in this country abuse alcohol or are alcoholics. More than 19 million use drugs, and an estimated 4 million are in need of treatment but not receiving it.

Drug and alcohol abuse has far-reaching consequences. It exacerbates social ills. It is a public safety problem. It is a public health problem. It is a public expenditure problem. There is an undeniable correlation between substance abuse and crime. Eighty percent of the 2 million men and women behind bars today have a history of drug and alcohol abuse or addiction or were arrested for a drug-related crime. Illegal drugs are responsible for thousands of deaths each year. They fuel the spread of AIDS and hepatitis C. They contribute to child abuse, domestic violence, and sexual assault. And we all pay the price.

It costs this Nation almost $275 billion in law enforcement, criminal justice expenses, medical bills, and lost earnings each year. That means that preventing and treating substance abuse makes sense. It makes good criminal justice sense. It makes public health sense. It makes budgetary sense. Not to mention the fact that it is the right thing to do.

Yet there remains a reluctance to recognize substance abuse as a health issue. There is a reluctance to accept addiction as a disease. It is a reluctance that has kept public policy from asserting that addicts should be in treatment. Whether addicts are in prison or out, it seems to me, treatment is the only legitimate choice.

But it is not only about increasing access to treatment. It is also about moving treatment into the medical mainstream. Unless family doctors, nurses, physician assistants, and social workers can identify addiction when they see it, unless they know how to intervene, we will never make any real progress.

That aspect of the challenge came into sharp focus for me when I read a report a few years ago by the National Center on Addiction and Substance Abuse at Columbia University, CASA.

That report said that fewer than 1 percent of doctors presented with the classic profile of an alcoholic older woman could diagnose it properly. Eighty-two percent misdiagnosed it as depression, some treatments for which are dangerous when taken with alcohol. A follow-up study showed that 94 percent of primary care physicians fail to diagnose substance abuse when presented with the classic symptoms, and 41 percent of pediatricians fail to diagnose illegal drug use in teenage patients.

No one recognizes this problem better than the doctors themselves. Fewer than one in five--only 19 percent--feel confident about diagnosing alcoholism. And only 17 percent feel qualified to identify illegal drug use. Having said that, even if they diagnose it, most doctors don't believe that treatment works.

Among practitioners, as well as policymakers, we need to get the message out loud and clear: Addiction is a chronic relapsing disease, and as with other such diseases, while there may not be a cure, medical treatment can help control it.

The medical professionals have to be educated to recognize the signs of substance abuse and to pursue the effective therapies that are available. That is why I am introducing legislation to help train medical professionals to prevent and recognize addiction and refer patients to treatment if they need it. Representative Patrick Kennedy will introduce companion legislation in the House of Representatives.

Like treatment, training works. According to a study published in the Brown University Digest of Addiction Theory and Application, 91 percent of health professionals who took part in training on addiction at Boston University were using the techniques they learned 1 to 5 years later.

Every family doctor does not need to be an addiction specialist, but they do need to be able to recognize the signs. And they need to know what help is available.

My legislation does the following three things: authorizes $9 million in grants to train medical generalists to recognize substance abuse in their patients and their families and know how to properly refer them for treatment; authorizes $6 million to fund substance abuse faculty fellows at educational institutions to teach courses on substance abuse, incorporate substance abuse issues into to required courses at the institution, and educate health professionals about issues related to non-therapeutic uses of prescription medications; and establishes centers of excellence at medical centers or universities across the United States to (1) initiate, promote and implement training, research and clinical activities related to special areas of substance abuse and (2) provide opportunities for interdisciplinary collaboration in curriculum development, clinical practice, research and policy analysis. The bill authorizes $6 million for this purpose.

These are additional steps--and, in my view, crucial ones to help bridge the divide between research and practice. They will help chip away at the incredible substance abuse-related costs we face each year in human as well as monetary terms.

I hope my colleagues will join me to support this important legislation.

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