A bill to authorize the extension of nondiscriminatory treatment (normal trade relations treatment) to the products of Moldova.

Mr. President, I rise today to introduce legislation designed to extend permanent normal trade relations to Moldova. Moldova is still subject to the provisions of the Jackson-Vanik amendment to the Trade Act of 1974, which sanctions nations for failure to comply with freedom of emigration requirements. This bill would repeal permanently the application of Jackson-Vanik to Moldova.

Moldova is a small country located in Europe between Ukraine and Romania. Throughout the Cold War it was a part of the Soviet Union. It gained its independence from the Soviet Union on August 27, 1991. The United States has supported Moldova in its journey toward democracy and sovereignty.

The United States enjoys good relations with Moldova and has encouraged Moldovan efforts to integrate with Euro-Atlantic institutions. Moldova has been selected to participate in the Eastern Partnership, an initiative proposed by the European Union in 2008, which will facilitate the creation of free trade agreements, energy security plans, and closer economic ties between the EU and Moldova.

Since declaring independence from the Soviet Union in 1992, Moldova has enacted a series of democratic and free market reforms. In 2001, Moldova became a member of the World Trade Organization. Furthermore, Moldovan

President Vladimir Voronin has recently expressed his desire to sign an accord to strengthen relations between Moldova and the European Union this year. Until the United States terminates application of Jackson- Vanik on Moldova, the U.S. will not benefit from Moldova's market access commitments nor can it resort to WTO dispute resolution mechanisms. While all other WTO members currently enjoy these benefits, the U.S. does not.

The Republic of Moldova has been evaluated every year and granted normal trade relations with the United States through annual presidential waivers from the effects of Jackson-Vanik. The Moldovan constitution guarantees its citizens the right to emigrate and this right is respected in practice. Most emigration restrictions were eliminated in 1991 and virtually no problems with emigration have been reported in the 16 years since independence. More specifically, Moldova does not impose emigration restrictions on members of the Jewish community. Synagogues function openly and without harassment. As a result, the administration finds that Moldova is in full compliance with Jackson-Vanik's provisions.

Since declaring independence from the Soviet Union in 1992, Moldova has enacted a series of democratic and free market reforms. Parliamentary elections in 2005 and local elections in 2007 generally complied with international standards for democratic elections.

Moldova has also contributed constructively towards a resolution of the long-standing separatist conflict in the country's Transniestria region, most recently by proposing a series of confidence-building measures and working groups. In addition, trade increased between the two parties by 30 percent in 2007.

The United States and Moldova have established a strong record of achievement in security cooperation. In 1997 the Nunn-Lugar Cooperative Threat Reduction Program responded to a Moldovan request for assistance. The U.S. purchased and secured 14 nuclear-capable MiG-29Cs from Moldova. These fighter aircraft were built by the former Soviet Union to launch nuclear weapons. Moldova expressed concern that these aircraft were unsecure due to the lack of funds and equipment necessary to ensure they were not stolen or smuggled out of the country. Specifically, emissaries from Iran had shown great interest and had attempted to acquire the aircraft. These planes were not destroyed. They were disassembled and shipped to Wright Patterson Air Force Base because they can be used by American experts for research purposes.

Moldova has made small, but important, troop contributions in Iraq. These contributions include significant demining capabilities and contingents of combat troops. I am pleased that the United States remains prepared to assist in weapons and ammunition disposal and force relocation assistance to help deal with the costs of military realignments in Moldova and to assist with military downsizing and reforms.

One of the areas where we can deepen U.S.-Moldovan relations is bilateral trade. In light of its adherence to freedom of emigration requirements, compliance with threat reduction and cooperation in the global war on terrorism, the products of Moldova should not be subject to the sanctions of Jackson-Vanik. The U.S. must remain committed and engaged in assisting Moldova in pursuing economic and development reforms. The government in Chisinau still has important work to do in these critical areas. The support and encouragement of the U.S. and the international community will be key to encouraging the Government of Moldova to take the necessary steps to initiate reform. The permanent waiver of Jackson-Vanik and establishment of permanent normal trade relations will be the foundation on which further progress in a burgeoning economic and energy partnership can be made.

I am hopeful that my colleagues will join me in supporting this important legislation. It is essential that we act promptly to bolster this important relationship and promote stability in this region.

Mr. President, I rise today to introduce legislation designed to extend permanent normal trade relations to Moldova. Moldova is still subject to the provisions of the Jackson-Vanik amendment to the Trade Act of 1974, which sanctions nations for failure to comply with freedom of emigration requirements. This bill would repeal permanently the application of Jackson-Vanik to Moldova.

Moldova is a small country located in Europe between Ukraine and Romania. Throughout the Cold War it was a part of the Soviet Union. It gained its independence from the Soviet Union on August 27, 1991. The United States has supported Moldova in its journey toward democracy and sovereignty.

The United States enjoys good relations with Moldova and has encouraged Moldovan efforts to integrate with Euro-Atlantic institutions. Moldova has been selected to participate in the Eastern Partnership, an initiative proposed by the European Union in 2008, which will facilitate the creation of free trade agreements, energy security plans, and closer economic ties between the EU and Moldova.

Since declaring independence from the Soviet Union in 1992, Moldova has enacted a series of democratic and free market reforms. In 2001, Moldova became a member of the World Trade Organization. Furthermore, Moldovan

President Vladimir Voronin has recently expressed his desire to sign an accord to strengthen relations between Moldova and the European Union this year. Until the United States terminates application of Jackson- Vanik on Moldova, the U.S. will not benefit from Moldova's market access commitments nor can it resort to WTO dispute resolution mechanisms. While all other WTO members currently enjoy these benefits, the U.S. does not.

The Republic of Moldova has been evaluated every year and granted normal trade relations with the United States through annual presidential waivers from the effects of Jackson-Vanik. The Moldovan constitution guarantees its citizens the right to emigrate and this right is respected in practice. Most emigration restrictions were eliminated in 1991 and virtually no problems with emigration have been reported in the 16 years since independence. More specifically, Moldova does not impose emigration restrictions on members of the Jewish community. Synagogues function openly and without harassment. As a result, the administration finds that Moldova is in full compliance with Jackson-Vanik's provisions.

Since declaring independence from the Soviet Union in 1992, Moldova has enacted a series of democratic and free market reforms. Parliamentary elections in 2005 and local elections in 2007 generally complied with international standards for democratic elections.

Moldova has also contributed constructively towards a resolution of the long-standing separatist conflict in the country's Transniestria region, most recently by proposing a series of confidence-building measures and working groups. In addition, trade increased between the two parties by 30 percent in 2007.

The United States and Moldova have established a strong record of achievement in security cooperation. In 1997 the Nunn-Lugar Cooperative Threat Reduction Program responded to a Moldovan request for assistance. The U.S. purchased and secured 14 nuclear-capable MiG-29Cs from Moldova. These fighter aircraft were built by the former Soviet Union to launch nuclear weapons. Moldova expressed concern that these aircraft were unsecure due to the lack of funds and equipment necessary to ensure they were not stolen or smuggled out of the country. Specifically, emissaries from Iran had shown great interest and had attempted to acquire the aircraft. These planes were not destroyed. They were disassembled and shipped to Wright Patterson Air Force Base because they can be used by American experts for research purposes.

Moldova has made small, but important, troop contributions in Iraq. These contributions include significant demining capabilities and contingents of combat troops. I am pleased that the United States remains prepared to assist in weapons and ammunition disposal and force relocation assistance to help deal with the costs of military realignments in Moldova and to assist with military downsizing and reforms.

One of the areas where we can deepen U.S.-Moldovan relations is bilateral trade. In light of its adherence to freedom of emigration requirements, compliance with threat reduction and cooperation in the global war on terrorism, the products of Moldova should not be subject to the sanctions of Jackson-Vanik. The U.S. must remain committed and engaged in assisting Moldova in pursuing economic and development reforms. The government in Chisinau still has important work to do in these critical areas. The support and encouragement of the U.S. and the international community will be key to encouraging the Government of Moldova to take the necessary steps to initiate reform. The permanent waiver of Jackson-Vanik and establishment of permanent normal trade relations will be the foundation on which further progress in a burgeoning economic and energy partnership can be made.

I am hopeful that my colleagues will join me in supporting this important legislation. It is essential that we act promptly to bolster this important relationship and promote stability in this region.

Mr. President, I rise to introduce the Lung Cancer Mortality Reduction Act, calling for a new effort to combat this often deadly form of cancer. I am pleased to be joined by Senator Brownback, the Co-Chair of

the Senate Cancer Coalition, and a strong voice on a variety of cancer issues.

This bill will renew and improve the Federal Government's efforts to combat lung cancer. It will affirm the goal of a 50 percent reduction in lung cancer mortality by 2015.

It will authorize a Lung Cancer Mortality Reduction Program, with interagency coordination, to develop and implement a plan to meet this goal.

It will authorize $75 million for lung cancer research programs in the National Heart Lung Blood Institute, National Institute of Biomedical Imaging and Bioengineering, National Institute of Environmental Health Sciences, and Centers for Disease Control.

It will create a new incentive program in the Food and Drug Administration to be modeled on the Orphan Drug Act for the development of chemoprevention drugs for lung cancer and precancerous lung disease. These are drugs that could prevent precancer from progressing into full-blown disease.

It will improve coordination disparity programs to ensure that the burdens of lung cancer on minority populations are addressed.

We have made great strides against many types of cancer in the last several decades. However, these gains are uneven.

When the National Cancer Act was passed in 1971, lung cancer had a 5- year survival rate of only 12 percent. After decades of research efforts and scientific advances, this survival rate remains only 15 percent. In contrast, the 5-year survival rates of breast, prostate, and colon cancer have risen to 89 percent, 99 percent and 65 percent respectively.

A lung cancer diagnosis can be devastating. The average life expectancy following a lung cancer diagnosis is only 9 months.

This is because far too many patients are not diagnosed with lung cancer until it has progressed to the later stages. Lung cancer can be hard to diagnose, and symptoms may at first appear to be other illnesses. As a result, only 16 percent of lung cancer patients are diagnosed when their cancer is still localized, and is the most treatable.

Lung cancer still lacks early detection technology, to find cancer when it is most treatable. Mammograms can find breast cancer, and colonoscopies can find dangerous colon polyps. But there is no equivalent test for lung cancer at this time.

Under this legislation, the National Cancer Institute has clear authority to work with other institutes on this early detection research. Coordination between all branches of the National Institutes of Health, including those with expertise on lungs, imaging, and cancer will be necessary to make this long overdue progress.

Lung cancer lags behind other cancers, in part, due to stigma from smoking. Make no mistake, tobacco use causes the majority of lung cancer cases. Tobacco cessation is a critical component of reducing lung cancer mortality. Less smoking means less lung cancer. Period.

But tobacco use does not fully explain lung cancer. Approximately 15 percent of the people who die from lung cancer never smoked. A study published in the Journal of Clinical Oncology in 2007 tracked the incidence of lung cancer in 1 million people ages 40 to 79. It found that about 20 percent of female lung cancer patients were nonsmokers and 8 percent of male patients were nonsmokers.

These patients may have been exposed to second hand smoke, or they may have been exposed to radon, asbestos, chromium, or other chemicals. There could be other causes and associations that have not yet been discovered, genetic predispositions or other environmental exposures.

Dana Reeve put a face on these statistics, with her brave fight against lung cancer. Dana Reeve was a nonsmoker, and still was diagnosed with lung cancer at the age of 44. She died a mere 7 months later, leaving a young son.

Dana Reeve's story shows that smoking cannot fully explain lung cancer. Everyone in this country could stop smoking today, and yet we would still face a lung cancer epidemic. According to the Lung Cancer Alliance, over 60 percent of new lung cancer cases occur in those who never smoked, or who quit smoking.

I believe that we have the expertise and technology to make serious progress against this deadly cancer, and to reach the goal of halving lung cancer mortality by 2015.

We need this legislation to ensure that our Government's resources are focused on this mission in the most efficient way possible.

Agency efforts must be coordinated, and every part of the National Institutes of Health that may have some ideas to lend should be participating. That is what the Lung Cancer Mortality Reduction Program will accomplish.

We can do better for Americans diagnosed with lung cancer. I ask my colleagues to support this legislation.

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

Mr. President, in the 6 years since Congress passed the Medicare Modernization Act, life for seniors has become increasingly difficult. The majority of seniors live on a fixed income, but face the challenge of paying more with less as the costs for everything continue to rise. Housing costs, basic nutrition, and healthcare needs are more expensive.

The addition of a prescription drug benefit to Medicare was long overdue, and many senior citizens and people with disabilities are relieved to finally have drug coverage. But the drug benefit was not structured like the rest of Medicare. For all other Medicare benefits, seniors can choose whether to receive benefits directly through Medicare or through a private insurance plan. The overwhelming majority choose the Medicare-run option for their hospital and physician coverage.

Unfortunately, no such choice is available for prescription drugs. Medicare beneficiaries must enroll in a private insurance plan to obtain drug coverage and with that are subjected to the multiple changes drug plans are allowed to impose on seniors year after year.

Each drug plan has its own premium, cost-sharing requirements, list of covered drugs, and pharmacy network. After you have identified the right drug plan, you have to go through the whole process again at the end of the year because your plan may have changed the drugs it covers or added new restrictions on how to access covered drugs.

Seniors are having trouble identifying which of the dozens of private drug plans works best for them. The complexity of the program has made beneficiaries more vulnerable to aggressive and deceptive marketing practices as some insurers try to steer seniors into more profitable Medicare Advantage plans. Some seniors have been signed up for Medicare Advantage plans without their knowledge, and, unfortunately, there have also been dishonest insurance agents who have misrepresented what benefits would be covered. Anyone who has visited a senior center or spoken with an elderly relative knows that the complexity of the drug benefit has created much confusion.

Drug plans often do not tell beneficiaries that they can appeal a drug plan's decision to deny coverage for a drug, even though they are required to do so. Beneficiaries who do appeal soon find that it is a long and difficult process.

Multiple studies have shown that private drug plans have not been effective negotiators, which means seniors end up paying more than they should. A report by Avalere Health released in late 2008 revealed that the average beneficiary will see a 24 percent increase in their monthly premiums for 2009. The top 10 most popular plans by enrollment will increase their premiums by more than 30 percent.

Today, I am introducing the Medicare Prescription Drug Savings and Choice Act. The bill would create a Medicare-operated drug plan that would compete with private drug plans and would give the Health and Human Services Secretary leverage to negotiate with drug companies to lower drug prices.

The Health and Human Services Secretary would have the tools to negotiate with drug companies, including the use of drug formulary. The best medical evidence would determine which drugs are covered in the formulary, and the formulary would be used to promote safety, appropriate use of drugs, and value.

The bill would establish an appeals process that is efficient, imposes minimal administrative burdens, and ensures timely procurement of non-formulary drugs or non-preferred drugs when medically necessary.

This is the kind of drug plan that Medicare beneficiaries are looking for. According to a survey by the Kaiser Family Foundation, two-thirds of seniors want the option of getting drug coverage directly from Medicare, and over 80 percent favor allowing the Government to negotiate with drug companies for lower prices.

Seniors want the ability to choose a Medicare-administered drug plan and deserve a simpler, more dependable, and less costly program that prioritizes their needs. Let's give them this option--just as they have this choice with every other benefit covered by Medicare.

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