WHO YEEDS TIME TO THE SENATOR.
           

           MR. HATCH: OH, I'M SORRY. WOULD THE SENATOR FROM MASSACHUSETTS
           YIELD SOME TIME TO ME?
           
           

           THE PRESIDING OFFICER: THE SENATOR FROM MASSACHUSETTS HAS ONE
           HOUR AND 58 MINUTES REMAINING.
           

           MR. KENNEDY: YES, I'D YIELD SUCH TIME AS THE SENATOR MAY NEED.
           

           MR. KENNEDY: MAY I ASK IN THE CONSENT THAT THE SENATOR FROM
           SOUTH DAKOTA BE RECOGNIZED AFTER THE SENATOR FROM UTAH FOR
           WHATEVER TIME...
           

           THE PRESIDING OFFICER: IS THERE OBJECTION?
           THE SENATOR FROM MISSOURI.
           
           MR. BOND:
           

           MR. ASHCROFT: HOW MUCH TIME IS REMAINING?
           
           

           MR. KENNEDY: I THINK THE SENATOR FROM SOUTH DAKOTA INDICATES
           SIX, SEVEN MINUTES?
           HATCH HAIFM EA NOT SURE. IT WON'T BE TOO LONG. I'LL TRY NOT TO
           CONSUME TOO MUCH.
           

           THE PRESIDING OFFICER: WITHOUT OBJECTION, THE SENATOR FROM UTAH
           IS RECOGNIZED.
           

           MR. HATCH: MR. PRESIDENT, AS I SAID, I LISTENINGED TO THE
           ARGUMENTS OF THE PAST AND OF TODAY IN OPPOSITION TO THE POM
           NATION OF DR. DAVID SATCHER AS SURGEON GENERAL AND ASSISTANT
           SECRETARY OF HEALTH. AND I FEEL COMPELLED TO RISE AGAIN IN
           SUPPORT OF THIS NOMINATION. LET ME MAKE PERFECTLY CLEAR THAT I
           DO NOT AGREE WITH ALL OF DR. SATCHER'S POSITIONS. I DO NOT
           AGREE WITH ALL OF THE POGSZ INDEED WITH MANY OF THE POSITIONS
           THAT -- OF THIS ADMINISTRATION IN WHICH HE WILL REPRESENT. BUT

           ON BALANCE, MY OVERRIDING CAN AFTER HAVING SPOKEN EXTENSIVELY
           WITH DR. SATCHER, IS MY CONVICTION THAT HE HAS EXEMPLARY
           QUALIFICATIONS AND EXPERIENCES THAT WILL ENABLE HIM TO HOLD
           THIS VERY IMPORTANT OFFICE WITH GREAT DISTINCTION. I KNOW THAT
           OTHERS LIKE MY FRIENDS FROM MISSOURI AND INDIANA WHO HAVE
           SPOKEN HERE TODAY, AS SENATOR ASHCROFT AND SENATOR COATS AND
           OTHERS, EARNESTLY BELIEVE THAT DR. SATCHER SHOULD NOT BE
           CONFIRMED AS SURGEON GENERAL. I RESPECT THEIR POINT OF VIEW.
           ESPECIALLY SENATOR ASHCROFT'S AND SENATOR COAT'S POINT OF VIEW.

           I BELIEVE THAT THEY HAVE RAISED SOME NECESSARY QUESTIONS FOR
           THE NOMINEE TO ANSWER. THE DEBATE OVER THIS NOMINATION HAS
           FOCUSED ON IMPORTANT ISSUES OF PUBLIC POLICY SUCH AS
           PARTIAL-BIRTH ABORTION AND THE APPROPRIATE ROLE OF THE UNITED
           STATES IN ITS CONDUCT OF CLINICAL TRIALS IN THE THIRD WORLD.
           THESE ARE INDEED SERIOUS ISSUES WORTHY OF DEBATE BY THIS
           CHAMBER OF IT IS IMPORTANT FOR THIS BODY KNOW WHAT THE SURGEON
           GENERAL THINKS ABOUT KEY ISSUES PERTAINING TO THE HEALTH OF THE
           AMERICAN PUBLIC AND THE HEALTH OF OUR INTERNATIONAL NEIGHBORS.

           THIS YEAR, CONGRESS HAS THE OPPORTUNITY TO PASS HISTORIC PUBLIC
           HEALTH LEGISLATION THAT CAN PROTECT OUR NATION'S TEENAGERS BY
           MATERIALING REDUCING THE NEXT GENERATION OF SMOKERS. IF WE
           ACCOMPLISH THIS, AND I THINK WE SHOULD, BECAUSE EACH DAY 3,000
           YOUNG PEOPLE BEGIN TO SMOKE AND 1 THEM WILL DIE EARLY FROM
           SPOKEING-RELATED DISEASES, A PORTION OF THIS SUCCESS MUST BE
           ATTRIBUTED TO THE INVOLVEMENT OF PAST SURGEON GENERALS. IN
           1964, IT WAS SURGEON GENERAL LUTHER TERRI, WHO FIRST REPORTED
           TO AMERICANS THAT SMOKE SAG MAJOR CAUSE OF DISEASE. FRANKLY, IT

           WAS THIS SURGEON GENERAL'S REPORT THAT DID AS MUCH AS ANYTHING
           THAT SET THE COURSE THAT PLACES US ON THE VERGE OF THIS
           HISTORIC LEGISLATION. SINGS 1964, ALL SUCCEEDING SURGEON
           GENERALS HAVE PLAYED AN ACTIVE ROLE IN WARNING THE PUBLIC OF
           THE RISKS OF TOBACCO USE. IN THE 1980'S, IT WAS SURGEON GENERAL
           C. EVERETT KOOP WHO DID SO MUCH TO PUT THIS ISSUE BACK ON THE
           FRONT BURNER OF PUBLIC DISCUSSION AND OPINION. I DON'T THINK
           THAT THERE'S ANY QUESTION ABOUT THE FACT THAT ONE OF THE MOST
           IMPORTANT LEGACIES OF THE OFFICE OF SURGEON GENERAL OF THE

           UNITED STATES OVER THE PAST 35 YEARS IS THE GREAT CONTRIBUTION
           THAT THESE OFFICIALS HAVE PLAYED IN SUGGESTLY CUTTING DOWN THE
           NUMBER OF AMERICANS WHO USE TOBACCO PRODUCTS -- ABOUT 25% OF
           OUR TOTAL POPULATION. BUT 25% IS STILL TOO HIGH BECAUSE IT
           RESULTS IN AN ESTIMATED 400,000 PREMATURE DEATHS ANNUALLY AND
           RUNS UP BILLIONS OF UNNECESSARY DOLLARS IN EXTRA HEALTH CARE
           COSTS. IN MY VIEW, WE MUST HAVE A SURGEON GENERAL WHO IS ABLE
           TO COMMUNICATE EFFECTIVELY WITH THE AMERICAN PEOPLE ABOUT THE

           RIKS OF TOBACCO USE. ON THE "TODAY" SHOW LAST FRIDAY MORNING,
           FORMER SURGEON GENERAL KOOP, A STRONG SUPPORTER OF DR. SATCHER,
           POINTED OUT IN THE YEAR SINCE THE OFFICE OF SURGEON GENERAL HAS
           BEEN VACANT, CERTAIN TYPES OF YOUTH TOBACCO USE HAVE GONE UP
           4%. IT JUST SEEMS TO ME THAT IT IS CRITICAL AT THIS TIME TO
           HAVE AN OFFICE OF SURGEON GENERAL THAT CAN LEAD THE GOVERNMENT
           ANTITOBACCO USE EFFORTS. FROM HIS PAST EFFORTS IN THIS BATTLE
           AGAINST SMOKING WHILE AT THE CENTERS FOR DISEASE CONTROL AND
           FROM MY PERSONAL CONVERSATIONS WITH HIM, I AM CONVINCED THAT
           DR. DAVID SATCHER CAN BE A MAJOR PUBLIC FIGURE IN THE COUNTRY'S

           BATTLE AGAINST TOBACCO USE. NO ONE IS SAYING THAT A POLICY OF
           PROHIBITION FOR TOBACCO WOULD BE WORKABLE. THIS MAKES IT ALL
           THE MORE IMPORTANT THAT PUBLIC OPINION LEADERS LIKE THE SURGEON
           GENERAL BE ABLE TO COMMUNICATE THE RISKS OF TOBACCO USE IN A
           FASHION THAT CONVINCES THE PUBLIC ABOUT THE BENEFITS OF
           STOPPING TO USE THESE DEADLY PRODUCTS. I THINK DR. SATCHER CAN
           PLAY THE ROLE OF AN EFFECTIVE PUBLIC SPOKESMAN IN AN EFFECTIVE
           FASHION BECAUSE WHEN THE AMERICAN PEOPLE GET TO KNOW HIM, HE
           WILL HAVE EARNED THEIR RESPECT AND WILL LISTEN TO THEIR ADVICE
           ON -- AND THEY'LL LISTEN TO HIS ADVICE ON MATTERS OF PUBLIC

           HEALTH. WHILE TOBACCO ALONE IS CRITICALLY IMPORTANT, THERE ARE
           MANY OTHER PUBLIC HEALTH HAD ISSUES THAT CRY OUT FOR THE
           NATIONAL FOCUS AND LEADERSHIP THAT A STRONG SURGEON GENERAL CAN
           PROVIDE. IN MANY RESPECTS, WE ARE AT A CRITICAL JUNCTURE IN THE
           BATTLE OF H.I.V. TRANSMISSION AND OTHER SEXUALLY-TRANSMITTED
           DISEASES. FORTUNATELY, THE LATEST TRIPLE-COMBINATION THERAPIES
           HAVE SHOWN AT LEAST IN THE SHORT-RUN GREAT PROMISE IN COMBATING
           THE PROGRESS OF THE AIDS VIRUS. BUT, UNFORTUNATELY, THIS MAY
           LEAD SOME PEOPLE TO FALSELY CONCLUDE THAT H.I.V. HAS BEEN CURED

           OVER OR IS AT LEAST NOT VERY DANGEROUS. THIS MAY LEAD SOME
           YOUNG PEOPLE TO ENGAGE IN SEXUAL BAHAVIORS AND DRUG ABUSE
           BAHAVIORS THAT ARE NOT ONLY MORALLY TROUBLE TROUBLESOME BUT CAN
           BE POTENTIALLY LETHAL. THERE ARE SOME INDICATIONS THAT CERTAIN
           TYPES OF SEXUALLY TRANSMITTED DISEASE ARE ONCE AGAIN ON THE
           RISE. WE NEED A STRONG SURGEON GENERAL TO HELP TEACH OUR YOUNG
           CITIZENS THAT ABSTINENCE FROM PROMISCUOUS BEHAVIOR IS GOOD FOR

           YOUR HEALTH. THAT IS, ABSTINENCE IS GOOD FOR YOUR HEALTH. I AM
           PLEASED TO TELL YOU THAT DR. SATCHER HAS A STRONG TRACK RECORD
           IN GETTING THIS RECORD OUT AND AS A LONGTIME HEALTH EDUCATOR,
           HE KNOWS HOW TO GET THIS MESSAGE OUT IN WAYS THAT YOUNG PEOPLE
           WILL LISTEN TO T AND GIVEN HIS TIE TO THE MINORITY COMMUNITY
           FROM HIS WORK AT MOREHOUSE COLLEGE AND THE KING DREW MEDICAL
           CENTER, DR. SATCHER PROMISES TO BE ABLE TO USE HIS LEADERSHIP
           POSITION AS SURGEON GENERAL TO DIRECT GREATER ATTEMPTS INTO
           HEALTH PROBLEMS THAT DISPROPORTIONATELY AFFECT MINORITY

           COMMUNITIES. I HAVE NO DOUBT IN MY MIND THAT DR. SATCHER WILL
           BE ABLE TO SERVE EFFECTIVELY AS SURGEON GENERAL FOR ALL THE
           PEOPLE IN THIS COUNTRY. UNDER HIS LEADERSHIP AT C.D.C., THE
           AGENCY PUT GREATER EMPHASIS ON PREVENTION. I THINK THERE'S MUCH
           TRUTH IN THE OLD ADAGE "AN OUNCE OF PREVENTION IS WORTH A POUND
           OF CURE." AS A CONSERVATIVE, I THINK THE GOVERNMENT DEBATES
           POUNDS AND POUNDS OF CURES HAVING COMPLETELY LOST SIGHT OF THE
           LITTLE OLD-FASHIONED NONGOVERNMENTAL OUNCE OF CURE. I HAVE BEEN

           INVOLVED IN A NUMBER OF CONFIRMATIONS OF SURGEON GENERALS.
           DURING THE BUSH ADMINISTRATION IEN USE THISIAS STICKLY
           SUPPORTED THE NOMINATION AND CONFIRMATION OF SURGEON GENERAL
           ANTONIO NOVELLO. DR. NOVELLO QUAIM FROM A RESEARCH BACKGROUND
           OF THE NATIONAL INSTITUTES OF CHILD HEALTH AND DEVELOPMENT AND
           DID A VERY GOOD JOB FOR THIS COUNTRY. DR. NOVELLO SPENT MUCH OF
           HER EFFORTS ON PEDIATRIC PROBLEMS, SUCH AS PEDIATRIC RAIDS AND
           THE PROGRAMS INVOLVED IN PEDIATRIC AIDS. BEFORE THAT I WAS
           INVOLVED IN THE THEN-VERY CONTROVERSIAL NOMINATION OF DR. C.

           EVERETT KOOP BY PRESIDENT REAGAN. THE AT THE TIME OF HIS
           NOMINATION, MANY HAD CONCERNS OF DR. KOOP, A PEDIATRIC SURGEON
           BY TRAINING WOULD TURN THE SURGEON GENERAL'S ROLE IN A
           POLARIZING POSITION BECAUSE OF THE POLITICS OF ABORTION. DR.
           KOOP H. KOOP AND I WENT TO HIS OPPONENTS AND EXPLAINED THAT THE
           RESPONSIBILITY OF THE SURGEON GENERAL'S OFFICE IS NOT TO STRESS
           ISSUES THAT DIVIDE AMERICANS BUT TO ACT TO UNITE THE PUBLIC BY
           EDUCATING OUR CITIZENS ABOUT THE MEDICAL AND SCIENTIFIC FACTS

           OF HEALTH HISHS. I MIGHT MENTION THAT WAS A BIG BATTLE T TOOK
           EIGHT MONTHS TO GET DR. KOOP APPROVED BECAUSE OF SENATORS WHO
           WERE OF THE PRO-CHOICE MODE. BUT FINALLY, HE WAS APPROVED AND
           MOST SENATORS, ALONG WITH THE SENATORS ON OUR SIDE OF THE
           FLOOR, BECAME HIS STRONGEST SUPPORTERS THROUGH THE YEARS. I
           AGREE WITH DR. K507'S REPEATED STATEMENT THAT THE JOB TITLE IS
           SURGEON GENERAL OF THE PUBLIC HEALTH SERVICE NOT CHAPLAIN OF
           THE PUBLIC HEALTH SFMTS I THINK THAT HISTORY WILL JUDGE THAT I
           WAS CORRECT IN MY ASSESSMENT THAT DR. KOOP WAS THE RIGHT MAN

           FOR THE JOB. IT TOOK MANY MONTHS OF DEBATE, BUT HE WAS FINALLY
           CONFIRMED. I'M SURE THAT THERE ARE MANY WHO VOTED AGAINST HIM
           WHO WOULD NOW AGREE THAT DR. KOOP WAS AN OUTSTANDING SURGEON
           GENERAL. IT IS SOMEWHAT IRONIC THAT ONE OF THE ISSUES THAT WAS
           RAISED IN THE KOOP NOMINATION OR CONFIRMATION HAS ALSO BEEN
           RAISED IN THE SATCHER CONFIRMATION. THAT MATTER IS ABORTION. IN
           PARTICULAR, THE NOMINEE'S VIEW OF PARTIAL-BIRTH ABOGS. LET ME
           BE ABUNDANTLY CLEAR. I AM FIRMLY AND RESOLUTELY OPPOSED TO
           PARTIAL-BIRTH ABOFERMENTGS I DISAGREE WITH THE VIEWS OF BOTH

           THE PRESIDENT AND DR. SATCHER ON THIS ISSUE. I THINK THAT THEY
           ARE IN THE MINORITY ON THIS ISSUE. NEVERTHELESS, I DON'T THINK
           THAT DR. SATCHER'S VIEWS ON THIS ISSUE SHOULD DISQUALIFY HIM
           FROM THIS POSITION SO LONG AS HE DOES NOT MAKE IT A MATTER OF
           PUBLIC POLICY. AND DOES NOT ADVOCATE FOR THAT. AND HE HAS
           INDICATED TO ME THAT HE WILL NOT. THAT HE WILL NOT BRING
           ABORTION INTO THE DEBATE WHILE SURGEON GENERAL. WHILE OTHERS
           WHO HAVE HELD THIS POST HAVE ENDEAVORED TO USE IT AS A BULLY
           PULPIT FOR A CONTROVERSIAL SOCIAL POLICY AGENDA, I AM ASSURED

           BY DR. SATCHER THAT HE FULLY UNDERSTANDS THE EXTREME
           SENSITIVITY OF THESE ISSUES PARTICULARLY ABORTION. IN MY
           DISCUSSIONS WITH HIM, HE HAS ASSURED ME THAT HE WILL NOT USE
           THE SURGEON GENERAL'S OFFICE AS A PRO-ABORTION PLATFORM. AND I
           BELIEVE HIM. AND WITH THAT ASSURANCE, I AM WILLING TO SUPPORT
           HIM HERE TODAY. AS DR. SATCHER HAS WRITTEN TO THE CONGRESS,, "
           LET ME STATE UNEQUIVOCALLY THAT I HAVE NO INTENTION OF USING
           THE POSITIONS OF THE ASSISTANT SECRETARY FOR HEALTH AND SURGEON
           GENERAL TO PROMOTE ISSUES RELATED TO ABORTION. I SHARE NO ONE'S

           POLITICAL AGENDA, AND I WANT THE USE OF POWER THESE POSITIONS
           TO FOCUS ON ISSUES THAT UNITE AMERICANS, NOT DIVIDE US." HE
           GOES ON TO SAY, "IF I AM CONFIRMED BY THE SENATE, I WILL
           STRONGLY PROMOTE A MESSAGE OF ABSTINENCE AND RESPONSIBILITY TO
           OUR YOUTH, BUT I BELIEVE WILL HELP TO REDUCE THE NUMBER OF
           ABORTIONS IN OUR COUNTRY." LET ME TELL YOU, I CAN'T TELL YOU
           HOW MUCH THAT MEANS TO ME. THAT WE HAVE A DEMOCRAT APPOINTED
           ATTORNEY GENERAL -- EXCUSE ME, SURGEON GENERAL WHO IS WILLING
           TO PREACH ABSTINENCE THROUGHOUT THIS COUNTRY TO OUR YOUTH OF

           THIS COUNTRY. AND TO PREACH -- OR SHOULD I SAY "TEACH" WOULD BE
           A BETTER WORD GOOD MEDICAL ROLES AND GOOD HEALTH PRACTICES. I
           HAVE TO SAY, SOME OF OUR REPUBLICAN SURGEON GENERALS HAVEN'T
           DONE THIS AS WELL ACE THINK DR. SATCHER IS INCLINED TO DO T SO
           THAT'S ONE REASON ALONE FOR VOTING FOR DR. SATCHER. AND IT'S
           ABOUT TIME. IT SEEMS TO ME THAT DR. SATCHER AND DR. KOOP --
           THAT WHILE HAVING ALMOST COMPLETELY OPPOSING VIEWS ON

           AABORTION, SHARE THE VIEW THAT THE SURGEON GENERAL'S POST IS
           NOLT THE PLACE TO POST THE DEBATE ON THIS CONTENTIOUS ISSUES.
           GIVEN HIS PUBLIC ASSURANCES, I AM SATISFIED THAT DR. SATCHER
           CAN EFFECTIVELY HELP SHET THE PUBLIC HEALTH AGENDA OF THIS
           COUNTRY AND CAN DO IT IN A WAY THAT PERHAPS NO OTHER PERSON AT
           THIS TIME CAN. I THINK IT'S TIME TO GET THIS POSITION FILLED,
           AND I THINK HE WILL REAL ESTATE DO A GREAT JOB IN IT AND I
           INTEND TO SAY THAT -- TO SEE THAT HE DOES. I REALIZE THAT A LOT

           OF THESE COMBAIT IS FOCUSED ON CERTAIN A.Z.T. TRIALS IN
           THAILAND AND ON THE IVORY COAST. I THINK THAT THIS DEBATE HAS
           BEEN HEALTHY AND HELPFUL IN FACILITATING A BETTER UNDERSTANDING
           OF THE PROPER ROLE OF THE UNITED STATES PUBLIC HEALTH AGENCIES
           IN CONDUCTING RESEARCH IN THE THIRD WORLD. FIRST OFF, LET PEE
           JUST MAKE THE POINT THAT I BELIEVE THAT ANY COMPARISONS WITH
           THE INFAMOUS TUSKEGEE SPIRMTES IS WAY OFF THE MARK. THESE
           NATURAL HISTORY STUDIES HELD NO PROMISE OF TREATMENT AND IN
           FACT RAF A TREATMENT WAS FOUND THIS TREATMENT WAS DENIED TO THE

           PARTICIPANTS OF THE STUDY. UNLIKE TUSKEGEE, THESE A.Z.T. TRIALS
           HAVE A STRONG INFORMED CONSENT COMPONENT. THESE TRIALS WERE
           UNDERTAKEN IN CLOSE COOPERATION WITH THE WORLD HEALTH
           ORGANIZATION AND THE NATIONAL AND LOCAL PUBLIC HEALTH OFFICIALS
           OF THE COUNTRY WHERE THE TRIALS TOOK PLACE. AS A PROPONENT OF
           THE SUCCESSFUL F.D.A. EXPORT BILL IN 1995, THE HATCH-GREGG
           AMENDMENT, I BELIEVE THAT IT IS IMPERATIVE IN FORMING PUBLIC
           HEALTH POLICY THAT THE UNITED STATES MUST RECOGNIZE AND RESPECT
           THE DIFFERENCES IN HEALTH AND WELFARE CHARACTERISTICS OF OUR

           FOREIGN NEIGHBORS. WHAT IS THE STANDARD OF CARE IN UNITED
           STATES MAY SIMPLY NOT BE APPROPRIATE IN ANOTHER COUNTRY. AS
           FORMER SECRETARY OF HEALTH AND HUMAN SERVICES HAS POINTED OUT,
           DR. SULLIVAN, WITH RESPECT TO THE A.Z.T. TRIALS AND THIS LETTER
           TO ME, HE SAID, "PART OF THE PROBLEM IS THAT THE COST OF THE
           DRUGS INVOLVED IS BEYOND THE RESOURCES OF THE DEVELOPING
           NATIONS. IN MALOWEI, FOR INSTANCE RNS THE REGIMEN FOR ONE WOMAN
           AND HER CHILD IS MORE THAN 600 TIMES THE ANNUAL PER CAL CAPITA

           ALLOCATION FOR HEALTH CARE." I ASK UNANIMOUS CONSENT THAT THIS
           LETTER BE PRINTED IN THE RECORD AT THIS POINT.
           

           THE PRESIDING OFFICER: WITHOUT OBJECTION, SO ORDERED.
           

           MR. HATCH: LET ME BE CLEAR. THIS ECONOMIC CIRCUMSTANCE IS A SAD
           FACT OF LIFE IN MANY DEVELOPING NATIONS BUT IT IS A FACT OF
           LIFE, NEVERTHELESS. THE KEY QUESTION IS HOW BEST TO BRING NEW
           TREATMENTS AND NEW
{END: 1998/02/09 TIME: 15-00 , Mon.  105TH SENATE, SECOND SESSION}