Service Members Home Ownership Tax Act Of 2009 - Motion To Proceed

Floor Speech

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Mr. WYDEN. Mr. President, transforming American health care so that more Americans get good health care at home, instead of only in a doctor's office, is an idea whose time has come.

Quality, affordable home-based care makes sense for patients. It generates good-paying jobs for our people and sparks development of exciting technologies through research that will pay even bigger dividends in the years ahead. Care at home is an idea that Democrats and Republicans, conservatives and progressives, can all come together on and get behind.

Right now, getting to see a doctor in their office can be an onerous process. You start by calling the doctor's office and testing your patience while you sit through menu after menu of options just to get past the doctor's voicemail system. You are in trouble if you don't listen carefully and miss the option you wanted. You might get sent to records or accounting and have to start all over again. After you have run that gauntlet, you have to match your schedule up to whatever days the doctor's in. With doctors having other obligations like surgeries or teaching, you could be up against a schedule where the doctor only has office hours a few days a week. That will lead to your getting an appointment two months from now. That won't do much good if you are sick today.

Once you have won that prized appointment, you have to navigate to the doctor's office on the day in question. In rural areas, you might end up driving yourself and your family long distances to get there. In urban areas, workers lose a big part of their day getting themselves, or maybe their elderly parent, to and from the doctor's office or hospital. That can be a difficult task if your parents have a hard time getting around at home--never mind getting them from the car to the doctor's office safely. By the time you get to the doctor's waiting room, you feel like you have run a marathon. It's the opposite of the well-oiled machine you would expect from a country that leads the world in health care innovation.

Our current health care system seems modern, but it is actually based on a 19th century model of institutionalized health care. It is like riding a horse-drawn wagon all the way from here to Oregon. Just because the Pioneers did it and found the beauty of Oregon at the end, it doesn't mean that is the best way to get there in 2009. Likewise, just because the majority of American health care is delivered in a doctor's office or hospital doesn't mean that is the best way either.

There is a lot of wasted time and effort spent on services that could be done more easily--and in some cases, more effectively--done from home thanks to something called ``telehealth technologies.'' Telehealth technologies are simple-to-use, home-based systems that use tools, such as home security sensors and the internet to connect patients to their medical providers. Home telehealth has already been used by the Veterans' Administration and has lowered costs for treating patients with multiple chronic diseases like diabetes and high blood pressure.

Here's how it works. Some systems help patients with chronic conditions like diabetes or high blood pressure send their daily blood sugar or blood pressure readings straight to their medical professional. There, the readings can be checked and monitored for signs that the patient's care needs to be adjusted. Sudden weight gains, which can be a sign that someone's about to go into congestive heart failure, can also be noted and addressed right away, so that the patient can be treated and avoid that outcome.

These are just a few of the ways that telehealth technologies can help patients better manage their health issues from home, instead of waiting for their occasional checkup in a doctor's office, when it might be too late to correct their health problems. Telehealth technologies give medical professionals a new tool by increasing the amount of data they can collect on their patients over a long period of time. That aggregated information improves the quality of care that the patient then receives when they do visit the doctor's office.

Some of these telehealth technologies are so advanced they sound like science fiction, but they are real, they are here today and they need to be part of building our new health care system. They offer more than just unique, time-saving solutions. Telehealth technologies also open a new world of jobs and services that will shore up our economy with good-paying work right here at home.

Researchers from around the country are working to tap the potential of these technologies, and I am proud to report that much of the cutting edge work is being done in the Pacific Northwest. Their discoveries address everything from depression to neurological disorders. For example, new technologies can help isolated seniors stay connected to the world through a variety of social networking sites. This would be a simple, high-tech fix that can help cure the loneliness that so many seniors suffer from, and that often leads to depression. Some seniors with cognitive issues are being taught how to use personal computers to play games that exercise the brain, like Sudoku puzzles. Neurologists can then analyze the changes in patients' success at the games over time and to understand how and when their cognitive abilities start to deteriorate.

Technologies like this give us the chance to learn about devastating diseases like Alzheimer's so that, hopefully, we can one day find new drugs and treatments for those who suffer from it.

Other technologies are moving forward to help those with memory loss and help to improve the quality of life for our seniors. ``Caller ID on Steroids'' is what one technology has been called that would be life-changing, and give them more confidence as they age, despite possible memory loss. It is a system that brings up a whole host of information on a senior's telephone every time someone calls. The system would show a photo of the person and their name. It would tell them the last time they spoke on the phone--and even a brief description of what they talked about. Another new invention would help seniors remember to take their medications on schedule.

There is a day-a-week pill caddy with sensors built it to tell whether or not a patient had come close to it or opened the particular day's drawer. A screen on the caddy displays reminders or hints about how to take the medication. This kind of technology improves patients' adherence to taking their medications as prescribed, which increases their effectiveness and improves their overall health. Imagine the differences these kinds of technology would make in the life of a senior who is suffering frightening and debilitating memory loss.

In the case of neurological illnesses like Parkinson's disease, telehealth has been shown to be a better way to manage medications and personalize treatment. Parkinson's patients can perform neurological tests on a laptop at home and have their success at these tasks reported to the doctor in real time. No longer will an annual visit to the doctor be the only opportunity to demonstrate how their illness is progressing and be the basis for the prescription the doctor writes. This kind of innovation could improve the quality of life for such patients and reduce the physical and economic toll that unnecessary medications cause.

But telehealth technologies do more than just help patients. There are some that also help the people who care for them. Many caregivers for people with Alzheimer's find themselves, caring for their patients in the middle of the night. Telehealth technologies have been developed to let someone else from their caregiver support group know that they're up and available to talk, even at 3:30 in the morning. A ``presence lamp'' system uses simple home security sensors and the internet to turn on a lamp in one person's home when their friend also happens to be awake in the middle of the night, and vice versa. It becomes a lifeline between family caregivers who could reach out for emotional and social support, even in those darkest and bleakest of hours.

All these innovations point to the fact that a technological revolution is going on right now in home health care solutions, and it's time health care reform brought those solutions into the mix. If done right, reform should do more than give affordable, quality care to all Americans. As these technologies prove, health care reform should also stimulate the economy with new jobs and industries that will allow us to care for our rapidly aging population.

Home health care will help put America at the forefront of a new health care services industry that will generate more than a million new jobs that can never be outsourced. Those jobs will come from inventing new home-based care technologies and using those technologies to deliver virtual and remote care services here at home and abroad.

I have already introduced legislation that uses the concept of coordinated home health care to help people on Medicare live healthier by managing their chronic conditions and reducing duplicative and unnecessary services, hospitalization, and other health care costs. This bill has broad bipartisan support, from Senators BURR and CHAMBLISS to Senators STABENOW, MIKULSKI, and, previously, the late Senator Kennedy.

My bill, the Independence at Home Act, establishes a 3-year Medicare pilot project that helps Medicare beneficiaries with multiple chronic conditions remain independent for as long as possible in a comfortable environment. It provides for coordinated-care programs that hold physicians, nurse practitioners, physician assistants, and other team members accountable for quality, patient satisfaction, and mandatory minimum savings. The act was accepted into the Senate Finance Committee health reform bill and I will pull out all the stops to see it included as part of the final health reform legislation that the Senate will vote on.

Before Congress finishes writing the bill for 21st century health care reform, it is important to define what Americans are paying for, how best to deliver much-needed personalized care to patients where they live, work, and play, and how to make the U.S. a world leader in home-based care industries. The home can become a fundamental location for health and wellness and also a priority for reform. In addition, all this can be done with a focus on stimulating our economy with new jobs, technologies, and services for a world that will share the challenge of caring for an aging population.

I encourage my colleagues to ensure that health care reform is about new approaches to patient care, quality of life, and growing old with independence and dignity, not just about who's paying the bill. This is a chance to redesign our health care system with a new vision that sees the patient as the center of a more efficient and effective system. It is a chance to change our health care system to one that helps prevent disease, treat patients, support family caregivers, and enable seniors to maintain their independence, by bringing health care reform home.

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