[Congressional Record Volume 144, Number 145 (Tuesday, October 13, 1998)]
[Senate]
[Pages S12451-S12452]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                                 ASTHMA

  Mr. DeWINE. Mr. President, I rise today to talk about a landmark 
report released a week ago about asthma, and about how well we as a 
Nation are dealing with it. The report, called ``Asthma in America'', 
frankly concludes that we are doing a poor job. Asthma is a disease 
that we know how to treat and that we know how to manage. But every 
year, thousands of Americans die from asthma--and millions more have to 
be rushed to hospitals to treat emergency asthma symptoms. Let me 
repeat--we have people dying from asthma--even though we know how to 
treat this disease. This really is something that we as a nation must 
address.
  Mr. President, there's been enough public attention about asthma that 
I would hope we all know the basics by now. But let me restate some 
basic facts. Asthma is a chronic lung disease caused by inflammation of 
the lower airways. During an asthma attack, these airways narrow--
making it difficult and sometimes impossible to breathe.
  Nearly 15 million Americans have asthma--and 5 million of them are 
children. for some reason, the prevalence of asthma is rising--in the 
last two decades, the number of asthma cases have doubled.
  The good news for the 15 million Americans with asthma is that we 
know a lot about how to treat and manage the disease. We know how to 
handle asthma attacks once they occur. The most common way, of course, 
is to use one of the types of asthma inhalers, inhalers such as the one 
I carry with me just about every day. Millions of Americans use this 
type of inhaler. Importantly, we now know a lot about how to prevent 
asthma attacks. Through drug therapy and through avoiding many well-
known triggers that cause asthma attacks, we know enough to make sure 
these attacks and other complications from asthma are rare indeed. In 
fact, our knowledge is comprehensive enough that the National 
Institutes of Health have set some ambitious--but reachable--goals 
for asthma treatment. For example, one of the NIH goals is zero missed 
days of school or work. Given what we know, we should be able to reach 
this and the other goals NIH has set. At a minimum, we should be able 
to come close.

  But the bad news for Americans with asthma is that we are not 
managing this disease well--and we are not coming anywhere close to 
meeting the NIH goals. This is the bad news that was spelled out very 
clearly in the Asthma in America report. Let me go over a few of the 
findings from the report.
  The NIH goal is that Americans with asthma miss zero days of work or 
school. But the report tells us that 49 percent of children with asthma 
and 25 percent of adults with asthma missed school or work because of 
the disease last year.
  The NIH goal is that the sleep of people with asthma should not be 
disrupted by difficulty to breathe. But the report tells us that almost 
one in three asthma patients awaken with breathing problems at least 
once a week.
  The NIH goal is that we have only a small need for emergency room 
visits or hospitalizations due to asthma attacks. But the report tells 
us that nearly six million Americans were hospitalized, treated in 
emergency rooms, or required other urgent care for asthma in the last 
year. One out of every three children with asthma--about 1.5 million of 
them--had to go to an emergency room because of asthma.
  The NIH goal is that individuals with asthma should be able to 
maintain normal activity levels. But the Asthma in America survey shows 
that 48 percent of asthma patients say that asthma limits their ability 
to participate in sports and recreational activities, and 36 percent 
have difficulty maintaining their usual levels of physical activity.
  Mr. President, all of this is simply unacceptable. If we know how to 
do better, we must do better. As a nation, we need to seriously 
evaluate why these shortcomings in the treatment of asthma remain--
despite the fact that we do know better. All of us--policymakers; 
doctors; health insurance companies and HMOs; people with asthma and 
parents of children with asthma--all of us need to look at this report 
and try to figure out what's going wrong.
  The report released Tuesday should be viewed as a wake-up call. We 
knew there were some problems with how well we deal with asthma, but I 
don't think anybody realized it was this bad. We must and can do 
better.
  For example, Asthma in America suggests that one of the reasons we 
are not meeting the national goals for asthma is lack of knowledge 
among patients. Many of the survey participants were not able to state 
what the underlying cause of asthma is, how asthma medication should be 
used, and how to prevent asthma attacks from occurring. It is clear 
that we should be doing a better job of educating patients, their 
families and health care providers about the importance of properly 
managing asthma.
  As a United States Senator, as an American with asthma, and as the 
father whose children have had asthma, I intend to look at this issue 
to see what I can do personally and what the federal government can do 
to address the shortcomings in asthma treatment this

[[Page S12452]]

report reveals. We only have a day or two left in the 105th Congress. 
But if we need legislation--if we need greater resources to deal with 
this problem--I will do everything I can to make sure the 106th 
Congress addresses this issue and does what is necessary.

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