Alzheimer's Disease Research Investment

Floor Speech

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Mr. GARAMENDI. Mr. Speaker, we have just heard a very interesting 1 hour on an issue that is important, and I would like to bring to this floor another issue that affects every American family either directly or indirectly, but in a very profound, and in most cases, a very sad, very sad way. One in five American seniors are affected by this disease called Alzheimer's.

I know it has affected my family. My wife's mother at the age of 92 died of Alzheimer's. She spent the last 2 years of her life living with my wife and me in our home, where we were able to provide care for her. I think that that is just one story among the millions of American families that are trying to find a way of dealing with this devastating disease.

In the last years of her life, my mother-in-law always had what seemed to be a bright outlook. She was never a complainer, and she always seemed to recognize her grandchildren, particularly the very young grandchildren. I will never forget a day where our youngest grandchild--her youngest great-grandchild--was climbing into bed with her, and my mother-in-law was, what I thought, was babbling. And that young child who could just barely speak was translating in a very real way what my mother-in-law was saying. It was my wife and I that were unable to understand. Just one moment in a long period of time that my mother-in-law lived with us in her final years.

This story is replicated time after time across America. One in five seniors will have Alzheimer's and will die of it.

If we take a look at the well known diseases that affect Americans, here is the death rate: cancer, clearly, clearly a problem. Heart disease, cancer, and stroke. Over the last 10 years, we are seeing a decline in the death rate for all of these well known and devastating diseases. We have seen the progress of research and the application of medical practices to these diseases, cancer, heart disease, and stroke, all declining, stroke by some 23 percent. HIV/AIDS, another devastating disease in this country, an incredible 42 percent decline in the death rate between 2000 and 2010.

And here is Alzheimer's, the same period of time, a 68 percent increase. My mother-in-law was one of the people that made up this statistic.

Deaths from major diseases. This is a clear indication of what happens when the public, acting through Congress, and governments, State, local, and private organizations, put their shoulder to the wheel and decide that it is time to do something about cancer, heart disease, stroke, and HIV/AIDS.

What is happening here? What is happening with Alzheimer's? Well, part of the answer is the aging population, the baby boomers. That is part of the answer, but it is not the complete answer.

What does this mean to the American taxpayer and the American families? It means it is a very, very expensive disease. In fact, it is the most expensive disease in America. Medicare, the principal source of health insurance for the elderly, 1 in 5 dollars in Medicare is spent on Alzheimer's, well over $240 billion a year for Medicare and Medicaid alone.

And where is this going? Well, here is where the costs are going. The cost of Medicare and Medicaid, 2010, $122 billion; 2022, $195 billion; 2050, $880 billion. So what are we going to do here? Well, we are going to spend an awful lot of money unless we get ahead of this devastating disease.

Looking at it another way, a different graph, same story, the skyrocketing cost of Alzheimer's care. This is not the peak, this is just where we stop counting in 2050. Baby boomers coming on and then this disease taking hold and literally bankrupting the Medicare and Medicaid programs.

So what do we do? Well, here is what we are doing, a neat little chart here, treatment shown here, this is the Medicare portion, this is the Medicaid portion. We are looking at a huge expenditure, $150 billion. This is from the Centers for Medicare and Medicaid Services.

Oh, down here, this is the comparison for research. This year, $566 million of research. Extraordinary expense, a lot of research, but not nearly enough to address the problem.

For example, back to that first graph that showed the decline in cancer research, HIV, heart--I wonder why it happened? Look where we are investing: cancer research, $5.481 billion; HIV/AIDS, $2.978 billion; cardiovascular, $2.15 billion; Alzheimer's, $566 million.

This is a very, very good graph. This is what happens when we invest in research and treatment protocols. Let me remind you of what those investments have meant. Cancer, decline in death rate; heart disease, decline in death rate; stroke, decline in death rate; HIV, decline in death rate. The major reason for it is the investment in research and treatment protocols. Cancer, HIV/AIDS, cardiovascular, Alzheimer's.

So where are we going to go here? Are we going to stay with this and see an increase in Alzheimer's disease and death over the next years? Or are we going to go with something that can solve the problem? And that is investment, investment by the people of America and around the world in addressing this devastating illness for which today there is no cure, there is no way to slow down the progress, and we don't know when it is coming on until it is with us.

And so families across this Nation find themselves in a devastating situation. I would like to recount just one devastating situation. It was on National Public Radio in the Sacramento region. A gentleman from the State park system retired at the age of 65, thinking that he and his wife would be able to spend their next years traveling, enjoying themselves and the benefit

His wife was 1 year younger. No sooner had he retired, his wife came down with early onset of Alzheimer's. The result is a devastation in their family, obviously, to the lady. She doesn't even know today that she is married to her husband of 42 years, but he cares for her, day in and day out, every day, 24/7.

There are many pieces of legislation that are here in the Congress that deal with this caregiving situation. There is also legislation that would ramp up the research necessary to get at the disease to fully understand what it is all about and how we might treat it and prevent it. These pieces of legislation deserve our attention.

Joining me tonight is a colleague from California who is carrying one of those pieces of legislation, a woman who has spent her entire career--public and private--in Congress and in the California legislature, addressing the problems of health care, the problems of the underinsured and the underserved, an incredible woman who has her own story to tell.

Let me introduce to you Maxine Waters, my colleague from California.

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Mr. GARAMENDI. I thank Congresswoman Waters. A couple of things come to mind as we were talking about the research effort.

We will very soon appropriate well over $80 billion--$80 billion--for ongoing military actions in Afghanistan. We make choices here, and it seems to me that we need to understand the import and the importance of the choices we make.

Now, that does not include the CIA and the State Department and the USAID--those are additional expenses over and above that the military will be using--at a time when, presumably, we are pulling out of Afghanistan. What would $1 billion of that $80 billion mean to the Alzheimer's research programs here in the United States?

Well, first of all, we shouldn't appropriate $1 billion because you can't ramp up that fast; but if we spread that over 2, 3, 4 years and go from $566 million to $1.5 billion, what could be accomplished?

I know that, in my own district in the Sacramento Valley, the University of California, Davis, has a very robust and breakthrough opportunity on brain research. I know in your own area of Los Angeles, the University of California, Los Angeles, and the University of Southern California are, together, operating major research programs on the mind, on the human brain, and how it is harmed, what is it that sets off Alzheimer's.

We can do this, but these are choices that your Representatives, the American people, your Representatives are making choices here in this House about how to spend your money. When one in five seniors comes down with Alzheimer's and we make a choice to spend $80 billion in Afghanistan, you should be questioning this. As to our rationality, are we making the right choice? I think not.

Let me just comment on your legislation, Congresswoman Waters. Your Alzheimer's Caregiver Support Act, H.R. 2975, I am thinking what it would have meant to Patty and I as we took upon the task of caring for her mother.

We really didn't know much about Alzheimer's and really didn't know much about the kind of care and the kind of reaction and different things we might do and she might do.

It would have been so helpful to us to have had that kind of information available, that kind of support. Now, we got through it very well. We had a lot of ability to search out information, and we are not unique, but I think the general public who is facing this personal crisis of a husband or a wife--and as you said, two out of three are going to be women--as they face that crisis, if they had the support that your bill would give to them, here is what you should expect, here is what you can do, here is where you can get help.

It is a good bill. We ought to pass it. We ought to pass this bill. So, Congresswoman Waters, thank you for doing that. If you want to comment back on how you came to put this bill in, what was your motivation? How did you come to see it, from your own experiences? I know you have friends and, perhaps, even family that faced this situation.

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Mr. GARAMENDI. Well, this chart clearly shows--clearly shows--what happens when you make an investment: cancer, HIV, cardiovascular. I remember, 20 years ago, nobody thought you could solve HIV. It was there and it was going to devastate the entire planet, but research--research--paid off. While this disease is not under control and is still all too prevalent, there is an ability to stem the impact of it and to be able to live with that disease. We can make progress here.

I am just thinking again about your piece of legislation, about the kind of help that people need and, really, education beyond just what you have talked about in your bill. Every family goes through this in either their own family or a neighboring family in the early onset, early in the progress of the disease. The change in the way in which a person functions and works and interacts with the family is profoundly disturbing to the family, even more so if the family doesn't understand and doesn't know what is happening.

So the ability to diagnose Alzheimer's early becomes very, very important to the well-being of the family, as you said. If that family understands what is happening, they are better able to cope with a very, very difficult situation. If they have no idea and Mama or Dad just suddenly seems to be off in some strange and unimaginable direction, the family can be torn apart. I know we have seen this many, many places across the people that I have known over the years. But your bill ought to be law, and we ought to be funding those kinds of nonprofit and social organizations that can address and help an individual understand what is going on in the Alzheimer's situation.

Another one, your second bill dealing with the Patient Alert Program, I remember very well a situation that occurred years ago where a neighbor simply wandered off and it created a community crisis: Where did he go? Where is he? After a couple of days, it turned out to not be a devastating situation. Your bill would provide assistance in tracking and keeping track of and finding those men and women that will and have wandered off. This is very much a part of this illness. So thank you for introducing these pieces of legislation.

My plea to my colleagues here is let's focus on this. There are many, many things we focus on here. All too often it is just political one-upmanship. This is not a Democratic issue; it is not an Republican issue. This is an American issue affecting nearly every American family. I like your legislation. I would hope the President would have this on his desk tomorrow morning, would sign this and get the help that people need.

There are several other pieces of legislation that are also introduced. I would like to introduce my colleague, who is carrying a piece of legislation on this matter, and yield to him for his exposition. So if you would care to join us, we will hear from, actually, the other side of the aisle. It is a bipartisan 1-hour, so please.

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Mr. GARAMENDI. I thank you so very, very much.

One of the challenges that I find in the House, there are 435 of us, and I never had the opportunity to work with you directly on committees. We just are not on the same committees, so I hardly know you, but I already like where you are headed. I like the way in which you speak to this issue and the way in which you show your compassion. I really look forward to working with you. These are bipartisan issues.

If you just hang on a few seconds, there are about seven bills that have been introduced thus far. Representative MARKEY, who is now a Senator, introduced H.R. 1507, which I think one of our colleagues has picked up here. That deals with the Social Security Act and makes this illness, a comprehensive Alzheimer's disease diagnosis, part of the Medicare program.

There is a bill introduced by a Republican, Mr. Guthrie. It is the Alzheimer's Accountability Act. This one basically says, okay, there is a plan. How are we doing with the plan? What is the plan to deal with Alzheimer's research, the support necessary? And it would require that a report be prepared every year so that we can keep track of progress or lack thereof. I like that bill because I think accountability is really important for us. Ultimately, these will be our decisions.

You can jump in on any one of these you may be involved in.

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Mr. GARAMENDI. Well, we are doing some of that tonight.

There is another one. This issue is not an American issue. This issue is a worldwide issue. Every society, every ethnic group in the world faces Alzheimer's, some more severely than others. There is another piece of legislation introduced by Chris Smith, who is the cochair of the Alzheimer's Caucus here in Congress. This one is H. Res. 489, the Global Alzheimer's resolution by Mr. Smith. It says it is the policy of the U.S. Government to encourage and facilitate the following efforts concerning Alzheimer's disease and other forms of dementia. This goes to the World Health Organization and other nations that are involved in research, the sharing of knowledge and research.

We can, as you just said, leverage, leverage what we are doing with what is going on in other countries--certainly the European countries; we know China is doing a lot of research on this--together the whole world facing a common issue, and perhaps we can find a much better and a faster solution.

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Mr. GARAMENDI. Well, we are doing some of that tonight.

There is another one. This issue is not an American issue. This issue is a worldwide issue. Every society, every ethnic group in the world faces Alzheimer's, some more severely than others. There is another piece of legislation introduced by Chris Smith, who is the cochair of the Alzheimer's Caucus here in Congress. This one is H. Res. 489, the Global Alzheimer's resolution by Mr. Smith. It says it is the policy of the U.S. Government to encourage and facilitate the following efforts concerning Alzheimer's disease and other forms of dementia. This goes to the World Health Organization and other nations that are involved in research, the sharing of knowledge and research.

We can, as you just said, leverage, leverage what we are doing with what is going on in other countries--certainly the European countries; we know China is doing a lot of research on this--together the whole world facing a common issue, and perhaps we can find a much better and a faster solution.

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Mr. GARAMENDI. No doubt about it. There is research going on all around the world. Major drug companies are involved. Countries are doing their own research. It is all possible.

One other bill that I would like to bring up, this one is introduced again by Chris Smith, and this is called the PACE Pilot Act. This is a program for all-inclusive care for the elderly, which currently helps those over 55, to provide a continuity of care and comprehensive care for them. It is more than just Alzheimer's. We know that nursing home care is extraordinarily expensive. This is an effort to try and keep people in their home with appropriate care and support.

So this is another piece of the puzzle, together with the two bills that our colleague Maxine Waters had introduced, giving us a package of legislation that we ought to work on.

The other piece of legislation which is not among these bills is the annual appropriation bill. Last year, we increased Alzheimer's research by $100 million, a very, very good thing.

But, again, we could do much more. And if we were to do that, I am convinced we would be able to advance the knowledge, the early detection, and, as you said a moment ago, a cure for this devastating illness. It is there. The only thing we need is to focus our attention and the world's attention on this, put the money into research, and then we can see a solution.

If you would care to wrap up, I have had my say on this.

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