Alzheimer's
Floor Speech
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Mr. GARAMENDI. Mr. Speaker, tonight, I want to spend some time with
my colleagues discussing something that we actually can do for every
American family, something that the Congress of the United States can
take action on soon, like this week, when we pass our appropriations
bill or, perhaps, next week if we fail to get the job done this week.
We can help every American family tomorrow, the next day, and on into
the years out ahead if we take action. The subject matter of tonight is
about an issue that affects every American family wherever you are out
there--my own family, your family, the families of my staff, perhaps
even the families of those who are working with us tonight.
This is an illness. This is an illness that has become the most
expensive and will soon become the most pervasive illness in America.
It is Alzheimer's. It is dementia associated with Alzheimer's. It is a
devastating illness.
It is one that robs individuals of their mental abilities. It robs
them of their memories of their families, of their work, of their
lives. It confuses and muddles their thoughts, and eventually, it will
destroy that individual, so tonight, we talk about Alzheimer's.
Is there anyone out there, any family, any individual, who hasn't
seen this illness? I think we all have.
Let's get into it in some detail. A little later, as my colleagues
join us, we will continue the discussion and talk about what we can
do--your Representatives. There are 535 of us--435 here in the House of
Representatives from every part of this Nation and from every walk of
life and from every community, and there are the 100 Senators from
every State. Let's use some of these charts to see if we can get a
better fix on what we are actually facing here in America.
Let's see. Alzheimer's is the most expensive disease in America. One
in five Medicare dollars is currently spent on people with Alzheimer's,
20 percent of every Medicare dollar. In fact, the total cost of
Alzheimer's today--this year, 2014--is over $215 billion--a quarter of
a trillion dollars. More and more of that money will come from Medicare
as the baby boom population begins to move into its more senior years.
This illness is not just found in seniors. We are also learning about
the early onset of Alzheimer's, men and women in their thirties and
forties--early Alzheimer's. Of course, it extends on, mostly in the
more senior population, 60-65 and above.
This is an illness that is also associated with genetics. If you have
Alzheimer's in your family, there is a higher probability that you will
have Alzheimer's yourself, but it is also an illness that is associated
with brain damage that can occur from concussions.
I think we have all heard about the National Football League players
who have suffered with one form of dementia or another and who have
died early because of it. We also know that traumatic brain injuries
are the most common injuries found among our troops who have returned
from Afghanistan and Iraq.
Alzheimer's, it is there. It is very expensive.
What can we look forward to in the future? Let's see. This is
Medicare and Medicaid--the Federal Government expenditures--not the
family expenditures, not the expenditures by health insurance
companies. This is just the Federal Government.
Today, it is about $122 billion. By the end of this decade, it will
be $195 billion. As this wave of baby boomers passes through our
demography and through our society, we expect, by the year 2050, that
the Federal Government will be spending over $880 billion--$120 billion
short of $1 trillion--on this illness, and this may be just two-thirds
of the total cost. Well over $1.2 trillion will be spent in about 35
years on this illness.
Do you want to bust the budget? Do you want to see the deficits of
America soar almost uncontrollably? Then look to Alzheimer's and
dementia and the effect that they will have on the Federal budget
deficit. Pay attention to these numbers because these numbers are the
story of the American Federal budget and of the personal budgets of
families across this Nation--Alzheimer's and dementia, $880 billion of
Medicare and Medicaid money by 2050.
There is another way of looking at it. It is a different graph but
the same story. The already high cost of Alzheimer's will skyrocket as
the baby boom moves through the population. There it is: the same
numbers, the same graph, the same extraordinary challenge facing
America.
I should also mention that this is not just an American issue; this
is an issue for every advanced economy in the world. If you are able to
avoid the childhood illnesses--the illnesses that kill so many in the
developing world--then those economies that have advanced to the more
developed economies face the exact same population surge and costs
associated with Alzheimer's and dementia.
What can we do about it? We can actually do a lot. I suspect, if you
are looking at this on your TV screens or are here in the audience, you
really only see the green line. This speaks of the treatment for
Alzheimer's: today, $250 billion by Federal and local and private.
On this one over here is research, treatment versus research. It is
the old adage: You spend it now or spend a lot more later. A penny
saved is a penny earned.
What does research amount to? I have to pull this up close--oh, here
it is. We are spending $122 billion to $150 billion or so of Federal
and State money. What are we spending on research? $566 million.
Billions? Millions? What does research amount to? It actually works.
Research actually will solve problems, medical research.
How long have we been at polio? I remember growing up around the
issues of polio. It was very common in our communities, then some money
was spent on research and a polio vaccine. You don't see polio in our
communities anymore.
The research worked with the development of the Salk vaccine,
followed by other vaccines to treat polio. It is essentially wiped out
in America. It only exists in a few very isolated places in the world.
If we were to spend the money on a vaccination in those areas, we would
see polio disappear from our world. The same thing happened with
smallpox.
I want to show you something more of today. Let's look at the
research budgets for those programs that are active today: investments
in health research at the National Institutes of Health, $2,014; cancer
research, $5.4 billion on cancer research.
Enough? Probably not. We probably could and should spend more on
cancer research. Should we do so, I would suspect that we would see
even more success in treating cancer in its earliest stages.
HIV/AIDS, nearly $3 billion on HIV/AIDS--have we solved the problem?
No, but we have certainly figured out how people can live with HIV/
AIDS, and we are probably going to see a vaccine sometime in the near
future. This is what we are currently spending--nearly $3 billion--on
HIV/AIDS.
Cardiovascular issues--stroke, heart attacks, other kinds of
cardiovascular illnesses--just around $2 billion or slightly more is
spent on that.
The most expensive, the most prevalent of all of the illnesses is
Alzheimer's, $566 million. It's not billions--not $2 billion, not $3
billion, not $5.5 billion--but $566 million.
What is the result of all of this? What does it mean when you spend
this kind of money on research? It really means something very good
happens, that something really, really good happens when you spend
money on research. With polio research and a polio vaccine, polio is no
longer found in the United States.
Let's look at these major illnesses. What does it mean? What does it
mean when we spend money on cancer research? Let's take a look here at
deaths from major diseases and the change in the number of deaths from
2000 to 2012: breast cancer down 2 percent, prostate cancer down 8
percent.
What happens when you spend $5.5 billion a year on cancer research?
Cancer deaths fall--success. On heart disease--cardiovascular
illnesses--we spend about $2 billion a year, and we see heart disease
dropping by some 16 percent. That is deaths from heart disease dropping
by 16 percent and stroke dropping by 28 percent.
So what is the use of research? Well, if you want to live, it is a
pretty good thing to spend money on, particularly if you are thinking
about getting cancer or any of the cardiovascular illnesses: heart
disease, stroke, heart attacks and the like.
HIV/AIDS, do you remember that number? HIV/AIDS, nearly $3 billion
was spent on HIV/AIDS, and deaths from HIV/AIDS are down 42 percent in
the United States.
So what does it mean when you spend money on research? It means
really good things for Americans, and around the world a similar
result. You spend that money on the research dealing with these major
illnesses, and you will see the death rates drop all across this
Nation.
HIV/AIDS is down by 42 percent, spending $3 billion a year;
cardiovascular, $2 billion a year.
And this purple line over here, what happens when you spend $566
million a year on research for Alzheimer's? Alzheimer's deaths from
2000 to 2010 were up, increased by 68 percent. There is a story here.
There is a lesson here. There is something that 535 of your
Representatives, the American people's Representatives, should be
paying attention to; and that is, if we want to deal with the most
devastating, the most expensive, and, increasingly, the most common
illness in America--the one that always will lead to death, the one for
which there is no cure presently, the one for which there is not the
kind of support needed for those people that suffer from Alzheimer's--
then and we had better start talking about solutions. Research is a
part of it.
How much do we think could be spent this year in the appropriation
bills that are now coming before us? What if we were to add $200
million, about a 40 percent increase? What would it mean? It means that
we will probably, over the next couple of years, begin to see profound
knowledge about the human brain, about how it functions, about the
diseases of the human brain, and about how we can attack Alzheimer's.
I don't expect it to be done in 2 years, but I know that out there,
in the mind institutions at the University of California-San Francisco,
University of California-Davis, down at UCLA and in other research
institutions around this Nation, we are learning how the brain
functions. We are learning about the diseases of the brain. And if we
were to invest this year an additional $200 million, we would see a
flourishing of knowledge. And maybe, maybe in one of those research
institutes, they would find the key to solving the Alzheimer's puzzle.
And if they were to do so, we would see a profound reversal in these
numbers; and this blue dramatic increase of 68 percent more deaths from
Alzheimer's over the last decade, we would see that reverse, and
hopefully we would see it go down.
I would like to continue our discussion here with my colleagues. I
have noticed that my colleague from California, Jackie Speier,
representing the Peninsula, has arrived.
I think your district comes very close to that great research
institution, the University of California-San Francisco. I am not sure
if it is in your district, but I know it is on the border of your
district, if not in your district.
Ms. Speier, if you would join us to talk about this issue, I know it
has been on your mind and in your heart. You have been a leader in
California and back here in Washington on this issue. So thank you so
very much for joining us in our discussion about the most prevalent and
the most expensive of all diseases in America.
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Mr. GARAMENDI. Well, I get to represent the University of California-
Davis, and it is in my district, although the hospital and the research
center are not. So I guess we share the same sadness.
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Mr. GARAMENDI. Thank you very much, Ms. Speier. I really appreciate
you bringing the women's issue to this.
The last 3 years of my mother-in-law's life were spent in our home as
she went through the process of Alzheimer's. And it is, indeed, a
women's issue. Two-thirds, as you say, are women. And we experienced
that. Fortunately, for us, it worked out very well for us and our
family.
But we are not unique, and while our experience was sad but good in
some ways, that is not always the case. This is a huge, huge burden. Not
only are the women the ones who suffer, but the women are often the
ones who care for those who have it.
So I thank you so much.
I notice my friends from the east coast have joined us. We often do
an east-west thing here. My two friends are debating who is going to go
first.
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Mr. GARAMENDI. Thank you so very much, Mr. Fattah, and thank you for
your role on the Appropriations Committee trying to move the money into
this research so that we can address this. You mentioned the Staglins
out in California and their project, which is the One Mind project, our
former colleague Mr. Kennedy involved in that project, trying to pull
together the research from around the world and here in the United
States specifically, so that there is a sharing of knowledge back and
forth from these various research centers, so that the synergy would
come from the knowledge that may exist at Cal Tech or New York, which
we will undoubtedly hear about in a few moments, or in your country out
in Pennsylvania.
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Mr. GARAMENDI. Well, thank you so very, very much. I am going to turn
to my colleague from our normal East-West dialogue here that we have
done so many days, so many times over the last few years.
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Mr. GARAMENDI. Mr. Tonko, thank you so very much for your bringing to
us the information about actions that have already been taken. The
Alzheimer's plan that you discussed lays out a process by which the
National Institutes of Health will develop a program of research, bring
it directly to Congress so that we can then analyze it and hopefully
fund that research. It is the pragmatic way of dealing with it. As you
said, it is based upon a studied step-by-step process to get to the
solution of Alzheimer's.
There is also other legislation. Our former colleague, now Senator
Markey, put together a bill that is called the HOPE Act, and that is
one that would require that Medicare take specific account of
Alzheimer's, and that in the Medicare program, there be a method for
Medicare to fund early diagnosis of Alzheimer's and then the early
treatment. As was said by one of our colleagues earlier, a delay of a
couple of years or 3 or 4 years in the onset of serious Alzheimer's is
extraordinarily beneficial to the individual and to the family, and, in
a larger context, to the budget of the individual family, their
insurance company, as well as the Federal government through Medicare
and Medicaid.
So that program also speaks to the caregiving that is necessary and
Medicare picking this up. It is clearly going to be the illness that
will bust the bank unless we can get ahead of it, and that is where the
research comes into focus and into play. We can do this.
There is another angle to this. I was going to take this up with Mr.
Fattah when he was here. He was talking about other agencies and other
governments that are involved in dealing with this. About a month ago I
had the opportunity to spend about an hour with the new Secretary of
Veterans Affairs, Mr. McDonald, and we were talking about the various
challenges that the Department of Veterans Affairs has dealing with all
of the veterans, and it wasn't long before the conversation turned to
traumatic brain injury and PTSD, post-traumatic stress syndrome, both
of which are illnesses or problems of the human brain.
We were discussing how the Department of Veterans Affairs is dealing
with this. It turns out that they also have a research budget, and we
know that he was unaware of some of the research that was going on both
at the NIH and what Mr. Fattah talked about, the One Mind program that
our former colleague Mr. Kennedy is involved in in pulling together the
research that is available around the world, bringing that research
together so that the synthesis of it could be a much more rapid
solution to the problems that Mr. McDonald faces in the Veterans
Administration dealing with post-traumatic stress illnesses as well as
traumatic brain injury.
So all of these things come together, and in dealing with it,
ultimately we carry a heavy burden of responsibility here in Congress.
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Mr. GARAMENDI. Thank you, Mr. Tonko, for joining us in this Special
Order hour. Working with you has always been a pleasure. I think this
subject is one that you and I and our colleagues will want to take up
as the days go forward.
In the spring, the 2015 Alzheimer's Day will occur once again here in
Washington, DC. There will be thousands of people coming to Congress,
knocking on our doors, grabbing our lapels, and asking us to pay
attention to this illness.
I want to review some of the costs, and then basically wrap this up.
You talked about home care. There are articles that appeared recently
in The Sacramento Bee about elderly people taking care of each other, a
wife taking care of her husband in their 50th year of marriage with
severe Alzheimer's, the love that is so apparent, but also the
difficulty of an elderly person taking care of another elderly person.
We can address that. That is what the HOPE legislation is all about,
bringing Medicare into this.
The research thing that we talked about earlier, I am going to put up
very, very quickly a couple of charts. This one, what is going to
happen to the Federal budget if we do not address Alzheimer's, it is
$122 billion today; in 35 years or 40 years, we are going to look at
over $800 billion, and that doesn't include the private sector. It is
going to be $1.2 trillion spent on this, so we are going to bust the
budget. If you are a deficit hawk, you should be paying attention to
this.
What do we need to address it? Well, we certainly need care for the
caregivers. We have talked about that. We also need research. The plan
that was in the earlier legislation laying out the Alzheimer's plan
called for an additional $200 million this year on top of the $566
million that we are currently spending.
Keep in mind that, for cancer, it is nearly $5.5 billion; for HIV/
AIDS, nearly $3 billion; and cardiovascular illnesses, just about $2
billion annually spent in research at the National Institutes of
Health.
They are very good, it is very important, and not a nickel should be
taken away from that, but we should add $200 million this year as we
complete the appropriation process right now.
People ask, ``Where can we find the money?'' Well, let's see. We just
said we are going to spend $5.6 billion in Syria and Iraq--new money. I
know that my work on the Armed Services Committee--I am on the
Strategic Forces Subcommittee. We are talking about more than $12
billion over the next 6-7 years rebuilding a nuclear bomb that nobody
knows what to do with.
Maybe there are choices that we can make. Would America be better off
with a new nuclear weapon or rebuilt nuclear weapon, spending $12
billion or so on that, or maybe spending it on Alzheimer's research?
Our work is about choices, Mr. Tonko. How are we going to allocate
the resources of this Nation? My suggestion is we go where every family
in America will be affected, every family, either directly as my family
has been directly impacted by this. My mother-in-law lived with us the
last 3 years of her life, dying at the age of 92; yes, we were
affected.
We know the genetic issues. My grandchildren are looking out there
and saying, ``This is a genetic thing, Papa. What about me?'' So that
worry carries through our family, and I suspect it carries through
every family in America, either directly or indirectly.
Let's make a choice. Let's make a choice to attack with research,
with care, with funding the most expensive, most common, most deadly
illness in America and in other developed countries: dementia and
Alzheimer's.
We can do it. This is not an impossible task. This is simply a task
of focusing like a laser on this issue, and when we do, we will find
the same success that we have seen with heart, cancer, and HIV/AIDS--
not cured, not stopped, but a very significant drop in the deaths
associated with those illnesses.
Mr. Tonko, I have completed my statements tonight. I think you have
another comment.
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Mr. GARAMENDI. I thank you very much, Mr. Tonko, for joining us
tonight. I also thank my colleagues, Mr. Fattah from Pennsylvania and
Ms. Speier from California, for joining us on this important subject.
Mr. Speaker, I yield back the balance of my time.
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