Nomination of Gerald J. Pappert to be United States District Judge for the Eastern District of Pennsylvania

Floor Speech

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Mr. BLUMENTHAL. Mr. President, I am honored to be joined with my distinguished friend and extraordinary colleague Senator Harkin of Iowa to support continued funding of the Prevention and Public Health Fund.

He has been a leader in this area, so I am particularly privileged to stand with him on behalf of a fund that is absolutely necessary to address prevention of serious and chronic diseases. It is fiscally and morally and absolutely essential that we approach health care in this way.

I am going to ask for permission to continue to speak. I am not sure what the allotted time is. If there is no objection, I ask unanimous consent for the time through 5 o'clock for myself, Senator Harkin, and others who may join us in this colloquy.

The PRESIDING OFFICER. Without objection, it is so ordered.

Mr. BLUMENTHAL. Our Nation currently spends 75 cents of every $1 on health care for the treatment of preventable conditions.

These diseases can be stopped and prevented in people through simple, commonsense measures. Yet a meager 3 cents of every $1 goes toward those treatments, therapies, and practices that can help prevent the diseases that are so wasteful to our economy, to individuals, and their livelihoods.

Our young people are on track to be the first generation of Americans to live a shorter, unhealthier life than their parents. The responsibility to change the course of this history is in our hands.

One step this body--led by Senator Harkin--has taken is to establish the Prevention and Public Health Fund. It is the only dedicated Federal fund for the prevention and improvement of our Nation's public health. Prevention is the most effective way to improve the health of Americans while reducing health care costs in the United States. This funding supports efforts to reduce our Nation's rate of infant death, cancer, diabetes, heart disease, and tobacco use. They are the killers and they kill unnecessarily and avoidably.

Sadly, many Connecticut residents suffer from those very same chronic diseases I mentioned. Thirty percent of Connecticut residents have high blood pressure, 9 percent have diabetes, 21,000 residents of Connecticut are diagnosed with cancer annually, and 16 percent still use tobacco.

The Prevention and Public Health Fund invests in a broad range of evidence-based activities--not speculative, not abstract, conceptual, theoretical--including community and clinical prevention initiatives that can help stop all Americans from developing debilitating and chronic disease in the future.

So far grants from this fund were awarded to support four Connecticut projects, including mental health and addiction, diabetes management in older and disabled adults, and the establishment of an electronic birth registration system to improve the ability to track the health and well-being of infants. It sounds pretty rudimentary--and it is--using technology to track the health and well-being of infants.

The Centers for Disease Control and Prevention has a hard-hitting anti-tobacco media campaign--funded from this fund--focused on the destructive health effects of smoking. It is not only effective, but it is supported by the efforts that we have advocated on prevention in health management.

Over the next 3 years this campaign is expected to save the country $170 million in nonincurred health costs and lowered productivity that results from smoking. The CDC has estimated that this campaign will assist 50,000 tobacco users to quit smoking.

I know from my own work in suing the tobacco companies and establishing the fund to support exactly these kinds of efforts, that millions of Americans across the United States want to quit. They have tried repeatedly. Ninety-nine percent of all smokers want to quit and also try to quit, but quitting is hard because nicotine is one of the most powerfully addictive drugs known to man and cigarettes are a powerfully effective nicotine delivery tool.

These 50,000 tobacco users who quit smoking are better off, not only in their health but their pocketbooks. They save countless dollars that they would otherwise squander on unhealthy tobacco products. They are healthier, their families are happier, and they save themselves from a lifetime of addiction and disease. The preventive efforts of the CDC as a result of this fund are preventive in stopping young people from beginning to smoke as well.

It is monumental, it is historic, and it is a fund that should be fully supported by Congress. The fund accorded the CDC the ability to run another tobacco education campaign called ``Tips from Former Smokers.''

According to a recent study, this campaign led 1.64 million Americans to attempt to quit smoking. Those who have completely quit smoking as a result of the campaign added half a million quality-adjusted life years to the population of the United States.

I know these numbers sound abstract and obtuse. They are real lives, and they have been saved from the evils of tobacco addiction and smoking, which in turn could cause cancer, heart disease, and all kinds of preventive diseases.

This funding is essential to running the local departments of health in many areas of our Nation. Workers at those departments of public health are in the forefront of preventing infectious diseases, an issue that most recently came into focus as part of the domestic Ebola response.

Without adequate funding for these departments, the people most closely tasked and most immediately responsible for providing services and information to people in the time of a crisis may be unable to respond when communities are most in need.

We must change the focus of our health care from sickness and disease to wellness and prevention.

We grew up, many of us, with our mothers telling us that an ounce of prevention is worth a pound of cure. That is not only an adage that is commonly repeated, it is commonly proved in everyday life.

I strongly encourage my fellow Members to support the Prevention and Public Health Fund to help ensure the future well-being of our fellow citizens.

I yield to my colleague Senator Harkin, one of the leaders in this effort.

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Mr. BLUMENTHAL. I want, again, to thank my great friend, Senator Harkin, for the legacy of public health advocacy that he will leave for all of us. I pledge to him that I will carry on, among many others, I am sure, that legacy and advocacy.

The Senator mentioned that it is easy to be unhealthy and harder to be healthy. Part of the reason is lack of awareness and education, and perhaps, in some instances, even a lack of income and wherewithal. Just let me pose the question to him of whether that impression is true.

Mr. HARKIN. If my friend will yield, I think that is absolutely true. First of all, it is true that a lot of times low-income people don't have access to a more healthy environment. The food deserts we call them in our inner cities, where they do not get the fresh fruits and vegetables and items like that. That has to be addressed also, making it easier for them to be healthy. Again, it is an awareness.

I would say to my friend one other thing, and I hope my friend will take a look at what is now undergoing a trial period. It is something that was put in the last farm bill as a trial period for food stamp recipients--people who are on what they call food stamps, which are not food stamps anymore, as the Senator knows--to provide incentives for low-income people, people who use food stamps, to purchase more fruits and vegetables rather than just starches, fats, and sugars. That project is ongoing now. So I would say to the Senator that perhaps next year he might want to take a look at that with the Secretary of Agriculture and see how that project is doing.

Again, this is just a trial, an experiment, to see what we can do to incentivize people who are on food stamps to use them more for more healthy foods. But it is that lack of awareness. The Senator is absolutely correct.

Mr. BLUMENTHAL. My impression also is--and perhaps the Senator has some views on this--that, in a way, we have a responsibility in this body to create that awareness and to spend the money on what should be regarded as an investment. It is spending, and it involves funding. But really the way to look at it is as an investment in education, in the clinics and the doctors and the services that can make Americans healthier and save us dollars over the long term--not only in the money spent on truly preventable diseases but also avoiding the suffering and the pain that is involved in many of those diseases, whether it is cancer or heart disease or diabetes, which are connected to so many preventable conditions.

Mr. HARKIN. I thank my friend. I remember Dr. Andrew Weil, who is very well known in this country and a good friend of mine, once made the statement sometime ago in a hearing that the default state of the human body is to be healthy. The body wants to be healthy. After all these millennia of changes, the body wants to be healthy. The problem is we put all these obstacles in the way.

I think that is true of people. People want to be healthy. They may not know that some of their lifestyle choices, some of what they do is provoking their illnesses. So I think it is our job to make people more aware of that and to help to provide some assistance, to provide some incentives for them to have a more healthy lifestyle.

I say to my friend from Connecticut, people will be here, I hope, for the next highway bill. We haven't been able to get one for a long time. I was here for the last one. I had an amendment I thought was going to pass. It was simply this: Any time Federal funds are involved in communities for streets or roads or highways or bridges or whatever, there must be incorporated in the plan provisions for walkways or bike paths along the side. I didn't say they had to build them. I just said they had to be put in the plans.

They are doing that in Europe, by the way. Every road, every street built has a walkway or a bike path--both for walking or biking.

Someone here objected to it, and we didn't get it. But I still think that would be something, again, to make people more aware. If they are incorporated in the plans, they might see it doesn't cost that much more to add it on to a road or bridge or whatever--the streets we are building in this country. Again, it makes it easier for people to be healthy--just a little thing like that. So I hope the Senator would take a look at that the next time the highway bill comes up.

Mr. BLUMENTHAL. Mr. President, I certainly will pledge to do so and will think of the Senator from Iowa when we do, hopefully, consider the next such highway bill. But let me just say, in conclusion, for myself, I was not going to mention the ``R'' word--the retirement word--because it seems almost impossible to imagine this body without the Senator from Iowa not only because of his advocacy of the Prevention and Public Health Fund but also his constant reminding us and his unceasing advocacy for better public health, for championing the interests of ordinary working men and women. So I thank him for that legacy to me and for so many others.

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