[Congressional Record Volume 144, Number 154 (Friday, December 18, 1998)]
[Extensions of Remarks]
[Page E2348]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                BIOMEDICAL RESEARCH COULD SAVE MEDICARE

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                     HON. RANDY ``DUKE'' CUNNINGHAM

                             of california

                    in the house of representatives

                       Friday, December 18, 1998

  Mr. CUNNINGHAM. Mr. Speaker, I rise once again to encourage my 
colleagues to continue supporting increased funding levels for the 
National Institutes of Health (NIH). This funding is critical for 
biomedical research that benefits all Americans. It improves quality of 
life.
  San Diego County is a leader in the field of biomedical research. One 
of our local champions for medical research is Dr. Lawrence Goldstein, 
an investigator in the Howard Hughes Medical Institute and a professor 
in the Division of Cellular and Molescular Medicine and Department of 
Pharmacology at the UCSD School of Medicine. I submit an article from 
the San Diego Union Tribune in which Dr. Goldstein suggests that 
biomedical research could help save the Medicine Trust Fund from 
bankruptcy.

           [From the San Diego Union Tribune, Dec. 11, 1998]

                  Medicare Cure: Biomedical Research?

                       (By Lawrence S. Goldstein)

       While not obvious, part of the solution to the impending 
     Medicare crisis may be greater federal investment in 
     biomedical research.
       This surprising conclusion was recently suggested by a 
     series of studies from Dr. Kenneth Manton and colleagues at 
     Duke University. These researchers analyzed the incidence of 
     disability among the elderly between 1982 and 1994 and found 
     that it fell steadily every year.
       One of the major factors driving these consistent declines 
     in disability appears to be biomedical research, which 
     ultimately leads to improved health care for elderly and 
     other patients. Effectively, this means that biomedical 
     research helps us to do a little bit better every year at 
     keeping the elderly productive, active and healthy and often 
     helping to keep them out of nursing homes.
       The story, however, gets better since keeping the elderly 
     actively engaged in daily life not only keeps them, their 
     children and grandchildren happier, but also saves our 
     country large amounts of money that would otherwise pay for 
     physical support and nursing homes.
       Little wonder that the federal government, with the strong 
     bipartisan leadership and support of members of our local 
     congressional delegation--Randy ``Duke'' Cunningham, Brian 
     Bilbray and Bob Filner--increased biomedical research funding 
     for the National Institutes of Health by 15 percent this past 
     year.
       There are important long-term implications of these studies 
     for our society and the benefits it may reap from biomedical 
     research. Imagine for a moment that the incidence of 
     disability among the elderly in 1994 had been that of 1982. 
     Manton and colleagues estimate that this would have meant 
     that 400,000 more elderly Americans would have been living in 
     nursing homes in 1994 than actually were.
       This would cost $17 billion more in 1994 than was actually 
     spent (assuming that typical annual nursing home residence 
     cost in 1994 was $40,000). Compared to the actual 1994 
     Medical expenditures of 167 billion dollars, this is a 
     significant savings, just by keeping these seniors out of 
     nursing homes. These estimated annual savings on nursing home 
     residence alone are also larger than the National budget for 
     all biomedical research supported through the NIH (15 billion 
     dollars this coming year).
       Imagine, on the other hand, that we could slightly improve 
     the annual rate of decline in disability. Manton estimates 
     that if we could increase the rate of decline from the 
     current 1.2 percent per year to 1.5 percent per year, this 
     small change could completely change future projections for 
     Medicare expenditures and lead to solvency in 2028 instead of 
     bankruptcy.
       Although part of the puzzle to reducing health care costs 
     for the elderly and everyone else is by more efficient 
     delivery of medical care, most of our physicians are already 
     working as hard as they can. Indeed, at this point, it is not 
     clear that additional efficiency can be wrung out of the 
     delivery side of the medical system without sacrificing 
     quality.
       A better and more cost-effective route for reducing health 
     care costs in the long run is biomedical research. Such 
     research is the best way to understand the causes of disease, 
     to ensure that the most appropriate treatments are delivered 
     and to find the best methods of support for the ill. Better 
     understanding of the causes of acute or chronic diseases 
     leads to better prevention, treatment and even cure. 
     Important improvements in lifestyle and diet are also guided 
     by research, which tells us what changes matter the most and 
     what changes are unnecessary or even damaging.
       Finally, research can tell us what therapies are most 
     valuable in each situation, and it can tell us how to apply 
     them in the best and most cost-effective manner. Combined, 
     improvements in health care coming directly from research can 
     lead to significant declines in disability among the elderly.
       Last year, the Senate unanimously passed a resolution in 
     favor of doubling the budget of the NIH in the next five 
     years, even in a time when government reduction is widely 
     supported. The House has been entertaining a similar 
     resolution, and most of our local representatives have signed 
     on as co-sponsors.
       They have done so for good reason. What these members 
     realize is that increased biomedical research will not only 
     help us solve our health problems and save Medicare, but, it 
     is one of the most cost-effective long-term investments to 
     achieve these goals.
       Let us encourage our representatives in this quest and make 
     biomedical research our No. 1 priority as we enter the next 
     millennium. Our children will thank us even as they enjoy our 
     healthier company in the years to come.
       Goldstein is an investigator in the Howard Hughes Medical 
     Institute and a professor in the Division of Cellular and 
     Molecular Medicine and Department of Pharmacology at the UCSD 
     School of Medicine.



     

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