Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2020
Floor Speech
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Mr. FOSTER. Madam Chair, this bipartisan amendment, offered by myself and the gentleman from Pennsylvania (Mr. Kelly), would strike section 510, which bans HHS from adopting standards for a unique patient identifier that would allow patients to be uniquely identified across electronic health record systems.
In the last 21 years that this misguided policy has been in place, thousands of Americans have died due to giving the wrong drug to the wrong patient or due to incorrect or incomplete electronic medical records, all arising from the inability to simply and correctly merge health records from different systems.
Countless man-hours have been lost trying to figure out whether one patient's information is the same as another whose name might be spelled differently, or who has recently moved to a new city or State, or who might be under a maiden name, for example.
Matching records properly requires a unique identifier for each patient. A Federal ban on doing this properly makes our healthcare system more expensive and less safe for patients.
According to a 2016 study of healthcare executives, 86 percent of respondents have witnessed or knew of a medical error that was the result of patient misidentification.
A Johns Hopkins study recently calculated that more than 250,000 deaths per year are due to preventable medical errors. While our data collection on medical errors is not as detailed as it should be, it is reasonable to assume that a unique patient identifier would help save a nontrivial fraction of these lives.
Amidst the wave of digitization of the healthcare industry, most providers have adopted electronic health records, spurred on by the 2009 HITECH Act. But if we cannot ensure that we have the right patient with their full information at the point of care, then we cannot properly utilize the enormous promise of the portability and interoperability of health records.
This ban is also handcuffing us in the fight against opioids. A 2018 roundtable on the opioid crisis cohosted by HHS and the nonprofit Center for Open Data Enterprise recommended the generation of a unique identifier for each patient. This would not only guard against doctor shopping by those struggling with substance abuse disorder, but it could also prevent those in recovery from accidentally being given prescription opioids after an injury, surgery, or childbirth, triggering a relapse.
Repealing this ban tackles a known problem in our healthcare system, and I urge support for this bipartisan amendment.
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Mr. FOSTER. Madam Chair, I yield myself the balance of my time.
I would like to again thank my colleague from Pennsylvania (Mr. Kelly), for cosponsoring this bipartisan amendment so that we can move our healthcare system into the 21st century to save money and, most importantly, to save lives.
Madam Chair, I yield back the balance of my time.
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Mr. FOSTER. Madam Chair, I would like to thank Congressman Andy Kim for cosponsoring this amendment.
This simple amendment would add and remove $1 from the substance abuse treatment fund, which we intend as a signal that HHS should prioritize opioid treatment money where the science shows that it actually works, on medication-assisted treatment.
Unfortunately, addiction is an issue that we have become all too familiar with in our communities and across the country. It has claimed too many loved ones, shattered too many lives, and broken too many families.
It is a devastating reality that drug overdoses have surpassed motor vehicle accidents as the leading cause of injury-related deaths in the United States. In fact, more people die in a single year from overdoses than were killed during the entire Vietnam war.
This is a public crisis that affects people of every race, every income group, and every education level. These are mothers and fathers. They are friends and neighbors.
Honestly, when I was first elected to Congress, I was not prepared for the numbers and the types of stories that I heard from family members who have lost loved ones to substance abuse.
The urgency of this deadly epidemic requires us to work together and work smart as a community and a Nation to fight back. It requires that we use the best available science and spend our money where we know it does the most good.
We should implement evidence-based treatment options, and research has backed medication-assisted treatment. Studies have shown that medication-assisted treatment decreases opioid use, opioid overdose deaths, criminal activity, and infectious disease transmission.
These studies also show that medication-assisted treatment increases social functioning and retention in treatment. Patients treated with medication are more likely to remain in therapy compared to patients receiving treatment that did not include medication.
It is also important in the tragic case of pregnant women who are addicted to opioids. A 2012 study by the American College of Obstetricians and Gynecologists found that the treatment of opioid- dependent pregnant women with buprenorphine improved outcomes for their babies and that medication-assisted treatment reduced withdrawal systems in newborns and decreased the length of hospital stays.
Medication-assisted treatment works, and it is what we should be funding.
Madam Chair, I urge my colleagues to support this amendment.
Madam Chair, I yield 1 minute to the gentlewoman from Connecticut (Ms. DeLauro).
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Mr. FOSTER. Madam Chair, the opioid epidemic has claimed too many lives and torn apart too many families for us to be using anything but the most effective treatments.
It is past time that we stop treating opioid addiction as a moral failing and start treating it like the treatable medical condition that it is.
Madam Chair, I urge my colleagues to support this amendment to make sure that HHS prioritizes funding for medically assisted treatment.
Madam Chair, I yield back the balance of my time.
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Mr. FOSTER. Madam Chair, my amendment highlights the need to think about our future workforce and how it will change because of technology, and to encourage the Bureau of Labor Statistics to accept a wider and more forward-looking range of inputs into its range of projections for the workforce of the future and that BLS should conduct the Contingent Worker and Alternative Work Arrangement Supplement to the Current Population Survey more frequently.
I co-chair the New Democrat Coalition's Future of Work Task Force with my colleagues Congresswoman Lisa Blunt Rochester, Congressman Chris Pappas, and Congresswoman Haley Stevens, all of whom have cosponsored this amendment.
The Future of Work Task Force has held a series of forums to hear from experts on various areas that will require this body's attention in the coming years and decades.
Last Congress, we heard from historians, economists, and policy experts about how technological revolutions of the past have impacted social and political institutions, and the lessons from those experiences and from our current conditions that can help us prepare for the future.
We have also heard from labor and business leaders who are pioneering new ways to attract talent, to retain the services of skilled employees, and to develop skills for the increasingly rapidly changing economy.
It is nearly unanimous among our experts that the economy will change significantly and change faster, but it is less clear just how quickly the workforce will need to adapt.
For decades, the Bureau of Labor Statistics has been doing excellent and invaluable work to track our labor trends, and its projections have proven very reliable and useful to businesses and to our educators in times of slower and relatively predictable technological development.
However, they are based on backward-looking historical data and historical trends, and some of the anticipated changes in technology, such as robotics, self-driving vehicles, and artificial intelligence could fundamentally change our economies in ways that we haven't seen before and are not preparing for.
So in its current form, the way that the Bureau calculates and estimates future development of the workforce may not be able to capture the dramatic changes that our future holds.
One panel convened by the task force suggested that it would be difficult or impossible to do projections in any single way to predict the future of the workforce, but with additional resources, the Bureau of Labor Statistics could model for a variety of scenarios of different rates of technological change in different sectors.
My amendment increases the BLS amount by a dollar and decreases it by a dollar, which we intend to signal that the BLS should submit to Congress an estimate of the resources it would need to make a range of forward-looking estimates, including consultation with those industries that are driving the rapid technological change and those industries that will be affected by that change to account for the increasing rate of technological job displacement.
Technological changes to the workforce are not new. The industrial revolution and the automation of agriculture transformed the way work was performed in our country, and significantly improved, on the whole, our standard of living over time, but the benefits have not been uniform and all communities and all job sectors have not benefited equally.
Past transformations have typically played out over generations so that our social and political institutions had ample time to respond, but today, the development and deployment of our technology is far more rapid, and Congress, business, and our educational system need the best possible data to evaluate policy proposals and to produce the workforce training needed for future employees, to develop educational curricula, and ensure that our economy works for everyone.
Like the industrial revolution, technological development presents the opportunity for greatly improved standards of living, but it will also bring challenges to our workforce.
Businesses, communities, and government must work together.
Madam Chair, I urge my colleagues to join me in voting ``yes'' on my amendment, to begin to establish a range of planning scenarios from the Bureau of Labor Statistics for the future world that we will all inhabit.
Madam Chair, I thank my Future Work Task Force co-chairs, Congresswoman Haley Stevens, Congressman Chris Pappas and Congresswoman Lisa Blunt Rochester, for cosponsoring this amendment, and I urge my colleagues to vote ``yes'' on the amendment.
Mr. Chair, I yield back the balance of my time.
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Mr. FOSTER. Madam Chair, my amendment would increase the Biomedical Advanced Research and Development Authority account by $1 million to support increased R&D for biosecurity.
As the only Ph.D. physicist in Congress, I feel a special responsibility to speak out on issues of national security, especially when they concern emerging technological threats that Congress may not be sufficiently aware of.
For more than 70 years, nuclear weapons have held center stage among the threats to our national security and global safety because of their capabilities to threaten the existence of all mankind.
However, the dangers posed by advanced biological threats are catching up fast.
For example, the ability of genome editing tools, such as CRISPR/ Cas9, to delete, suppress, and amplify specific genes has been a long sought-after capability for treating monogenic disorders and other disorders.
However, this ability could also be abused for nefarious purposes, such as disrupting the normal function of particular biological systems or weaponizing synthetic versions of a virus.
This is a global issue that will require global solutions.
Unfortunately, the advances in this field are outpacing our ability to develop policies that will set international ethical and regulatory frameworks.
Diagnostic platforms that can rapidly detect and characterize bioagents will become increasingly critical to safeguarding human health.
If we are going to stay ahead of these technological threats, we need to be strategic about our investments.
As a leader in technology and innovation, the United States must act now to mitigate any dangers that these technologies might pose.
Madam Chair, the $1 million allocated by this amendment represents truly only a fraction of what will ultimately be needed, but I urge my colleagues to join me and vote ``yes'' on my amendment.
Madam Chair, I yield 1 minute to the gentlewoman from Connecticut (Ms. DeLauro).
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