Sheldon Urges Reform of Health Care Delivery and Chronic Care

Sheldon Urges Reform of Health Care Delivery and Chronic Care

Mr. WHITEHOUSE. Mr. President, I thank the distinguished Chairman very much for those very kind and gracious remarks, and I am indeed here to discuss the budget, and particularly the health care aspects of the budget. This is the season, here we go again into the annual budget process. And as we've seen today on the Senate floor, our friends across the aisle are doing a great deal of complaining and not a great deal of contributing.

Are their complaints sincere? Well, perhaps. I'm sure some are sincere. But in evaluating them we should bear this in mind.

Under George Bush the difference between the budget projections that he inherited from President Clinton and the budget performance that he left for President Obama was a negative nearly $9 trillion, a massive, reckless orgy of fair weather debt. The Bush Debt.

So we have this litany of complaint from the side that is responsible for the Bush Debt of nearly $9 trillion. And now that President Obama has to dig out from under the Bush economic collapse; now that we are in a deep economic recession - now in the one time when government spending and borrowing is justified to get us through the economic trough we're going through - now, we are treated to lectures about debt from our free-borrowing friends.

Now, the party of "deficits don't matter" wakes up to this concern, just in time, coincidentally, to thwart our new President.

The grotesque folly of the Bush Debt was that it addressed things like lowering tax rates for America's billionaires, not the core American priorities we need to address in a country that is failing to educate its children as well as its international competitors do; a country whose energy policy hurts everyone except oil-producing nations and the oil and coal industry; and a country mired in a disastrous health care system.

President Obama's budget addresses these priorities. Indeed, one of the highest priorities in our budget proposal for Fiscal Year 2010 is a badly-needed, and long-overdue, reform of that broken and dysfunctional health care system.

I have spoken on this subject in the chamber many times, because unless something is done soon, health care's massive costs will overwhelm us. Already the system costs well over $2 trillion a year. And as our population ages, we face $35 trillion in unfunded Medicare liabilities. Not a nickel set aside against those liabilities.

So no one seriously now questions the need for fundamental health care reform. And it's time to come together to determine what that reform will look like, and how we can get it done. That would be a productive thing to talk about about this budget.

An event last Thursday marked an important step forward on health care reform. The American Cancer Society, the American Diabetes Association, the American Heart Association, and Consumers Union came together to issue a joint statement on the vital importance of including health care delivery system reform as part of any comprehensive health care legislation that Congress should move this year. I was proud to join them at their announcement, together with Senator Schumer and Senator Rockefeller.

These organizations represent tens of millions of Americans. Americans living with chronic illness, with cancer, with diabetes, with heart disease, and millions more who are consumers of health care in this country. These organizations and their members understand the failures and the tragedies of our health care system. Separate and together, their voices are powerful, and I would like to share some of what they said:

"The number of uninsured Americans exceeds 45 million; health care costs are rising faster than incomes...we spend at least twice as much per capita on health care as our major trading partners, [and] we rank 37th in the World Health Organization's evaluation of health systems worldwide. ...

"The major chronic diseases -- cancer, diabetes, cardiovascular diseases, and stroke -- account for three out of every four deaths in the United States and the estimated total direct and indirect health care costs for these chronic disease areas exceed $700 billion each year...Much of America's chronic disease burden could be avoided through better coordination of care, and by applying known best practices to prevent the onset and progression of these conditions, at the primary, secondary and tertiary levels.

"While insurance coverage for all Americans is an important goal, we must give equal weight in the health care reform debate to changes that improve the quality of care, increase and improve the delivery of preventive services, and ensure that individuals always receive care that is safe, efficient and without unnecessary interventions, tests, and treatment.

"To achieve these goals, we must make structural changes: improve our health information technology infrastructure; align financial incentives with evidence-based and cost-effective decision making; and develop a reliable process for assessing the health value of new technologies."

That is a part of the joint statement the American Cancer Society, the American Diabetes Association, the American Heart Association, and Consumers Union issued last Thursday, and I request unanimous consent that the full text be inserted into the record at the conclusion of my remarks.

Also on Thursday, Consumers Union presented new polling data about Americans' experiences with the health care delivery system that confirms the urgent need for delivery system reform.

In the poll, 18 percent of respondents reported that either they or an immediate family member contracted an infection following a medical procedure, and more than 60 percent of those reported that the infection was severe or life-threatening.

Thirteen percent of respondents have had their medical record misplaced. Nine percent have received the wrong prescription from the pharmacist.

Only half of adults - only half of adults - receive routine preventive medical tests, and for adults 35 years and younger, only 30 percent even visit a doctor for routine testing.

At our event last week, these organizations emphasized the importance of preventive care. As is so often the case in our health care system, no data or information is as compelling as a personal story, and we were fortunate on Thursday to hear an extraordinary one.

Gina Gavlak is a Diabetes Center and Emergency Department nurse and the Vice Chair of the American Diabetes Association's Advocacy Committee. She was diagnosed with diabetes at age 10, and she's been living with the disease for the last 29 years. She's worn an insulin pump 24 hours a day, seven days a week, 365 days a year for the past 12 years. Before using that pump, Gina took over 21,000 insulin injections, an average of 6 times a day.

Gina battled pre-existing condition rules and outrageously high insurance premiums, but her biggest battle was the daily management of her disease. She took on that battle with extraordinary determination and diligence, and with exemplary results.

Through extremely careful monitoring and management, she has had only two hospitalizations and one emergency department visit ever as a diabetic since the age of ten. She has never missed a day of work because of diabetes. She has had two uncomplicated pregnancies resulting in the birth of two healthy children.

Gina's story is poignant and important because it shows the tremendous benefits that come from comprehensive management of chronic disease - both in quality of life and reduced cost of care. But not everyone has Gina's unique drive and commitment. Many patients will need to be supported by an interactive, organized, and prevention-focused health care system to help them effectively manage their care.

Unfortunately, this is not the health care system we provide. The Cancer Society, the Diabetes Association, the Heart Association, and Consumers Union wrote: "The promise of...delivery system reform measures to lower costs is the most humane avenue to a financially sustainable health care system...

"Although coverage for all Americans is a vital component of this change - a simultaneous effort aimed at securing high-quality, cost-effective preventive care is equally important...the time for comprehensive health care reform has arrived and our organizations will work together to help create a health care system capable of consistently delivering the most effective, patient-centered care.

"These efforts will improve the quality of life and health outcomes for millions of people who suffer from a chronic disease, and lead to more efficient use of our nation's health resources."

Mr. President, the time has indeed come, not only for coverage reforms that will bring all Americans the security and stability that health insurance provides, but also for a fundamental overhaul of the way our delivery system delivers care. That is a necessary investment for our country that this budget at last makes.

We have to be smart about this. We know how bad the system is; we see its looming catastrophic costs; we must invest the time, the money and the effort to transition to a modern, safe, efficient and healing health care system. That's why this President's budget matters. That's why President Obama's budget is worth passing. Because it looks beyond the sorry politics of today and addresses the real problems that Americans have to cope with day-to-day in their regular lives.

Mr. President, in conclusion, in addition to the statement of Gina Gavlak from yesterday, I also ask unanimous consent to insert into the record the statements of Jim Guest of Consumers Union, Dr. Timothy Gardner of the American Heart Association, Dan Smith of the American Cancer Society, who all spoke eloquently on this topic last week, as well as the summary of the Consumers Union poll on delivery system reform to be appended at the end of my remarks.

Mr. President I thank you, and I yield the floor.

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