[Congressional Record Volume 148, Number 132 (Wednesday, October 9, 2002)]
[Senate]
[Pages S10224-S10225]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




          STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

      By Mr. FRIST (for himself and Mr. Kennedy):
  S. 3083. A bill to amend the Public Health Service Act to extend the 
Advisory Council on Graduate Medical Education; to the Committee on 
Health, Education, Labor, and Pensions.
  Mr. FRIST. Mr. President, I rise today to introduce legislation with 
Senator Kennedy to extend the authorization time for an advisory 
council for graduate medical education. The Council on Graduate Medical 
Education, COGME, was created by Congress in 1986 to provide an ongoing 
assessment of physician workforce trends, training issues and financing 
policies, and to recommend appropriate Federal and private sector 
efforts to address identified needs. The legislation calls for COGME to 
advise and make recommendations to the Secretary of the U.S. Department 
of Health and Human Services, the Senate Committee on Health, 
Education, Labor and Pensions, and the House of Representatives 
Committee on Commerce. In 1998, when we re-autohrized Title 7 programs, 
we re-authorized the Council through September 30, 2002.
  Unfortunately, we have not been able to fully review all of the 
programs outlined in Title 7, including COGME. To give our Committee 
the additional time to review this council, I am introducing 
legislation today with Senator Kennedy to extend the time period for 
its authorization until the end of fiscal year 2003.
                                 ______
                                 
      By Mr. FRIST:
  S. 3084. A bill to provide for the conduct of a study concerning 
health services research; to the Committee on Health, Education, Labor, 
and Pensions.
  Mr. FRIST. Mr. President, I rise today to introduce legislation to 
authorize an Institute of Medicine study to examine the field of health 
services research. The health services research is the primary source 
of information for policy makers, payers, managers, providers and the 
public concerning the organization, financing and performance of the 
American health care system. the Agency for Healthcare Research and 
Quality, AHRQ, is the lead Federal agency in this effort. However, many 
other federal partners, most institutes at the National Institutes of 
Health, the Centers for Disease Control and Prevention, the Health 
Resources and Services Administration, the Centers for Medicare & 
Medicaid Services, the Department of Veterans Affairs and the 
Department of Defense, fund and use health services research 
extensively to advance their mission. The American health care system 
is facing significant problems with rapidly rising costs, a staggering 
number of uninsured, racial and ethic disparities, and a compelling 
need for safer, higher quality care. In the post-September 11 
environment, we add the need to assure adequate public health systems 
and emergency response capacity in hospitals. In this challenging 
environment, I am increasingly concerned that the information needed 
from research to address current and future problems in the American 
health care system may not be available when needed. Therefore, I am 
introducing legislation today that requests AHRQ to contract with the 
Institute of Medicine for a report on the adequacy of the organization 
and financing of the field of health services research for meeting the 
nation's future information needs. The report should focus on the 
Federal role in supporting health services research, and in particular, 
the role of AHRQ in leading the federal effort and coordinating the 
complementary roles of other Federal agencies, as well as the private 
foundations and corporations, that conduct and fund health services 
research.
                                 ______
                                 
      By Mrs. LINCOLN (for herself and Mr. Bingaman):
  S. 3086. A bill to amend title XVIII of the Social Security Act to 
provide coverage under the Medicare program for diabetes laboratory 
diagnostic tests and other services to screen for diabetes; to the 
Committee on Finance.
  Mrs. LINCOLN. Mr. President, I am pleased to introduce the Access to 
Diabetes Screening Services Act of 2002. My colleague Senator Bingaman 
joins me in introducing this important legislation. This bill will 
provide Medicare coverage for laboratory diagnostic tests and other 
services which are used to screen for diabetes.
  Diabetes has reached epidemic proportions among adults in the United 
States. Trend data indicate that by the year 2010 more than 10 percent 
of all Americans will have diabetes. Even today our Nation is feeling 
the effects of this disease, diabetes is the Nation's sixth leading 
cause of death.
  My own home State of Arkansas has had first-hand experience with the 
rising diabetes rates. Arkansas ranks fifth in the Nation for diabetes 
incidence. According to recent health statistics, diabetes is the 
seventh leading cause of death for Arkansans. Recent studies show that 
6.5 percent of all Arkansas adults have diagnosed diabetes, and over 1 
million Arkansans are at risk for undiagnosed diabetes.
  These rising rates are especially evident among our aging population. 
Currently almost 7 million Americans age 65 and older, or 20 percent of 
seniors, have diabetes. Roughly 20 percent of seniors age 65 and older 
have a newly identified condition called pre-diabetes. If left 
untreated, pre-diabetes will develop into diabetes. An additional 
40,000 people living with diabetes and end-stage renal disease under 
the age of 65 participate in the Medicare program.
  Even more distressing is the fact that approximately one third of the 
7 million seniors with diabetes, or 2.3 million people, are 
undiagnosed. They simply do not know that they have this very serious 
condition--a condition whose complications include heart disease, 
stroke, vision loss and blindness, amputations, and kidney disease.
  Those in the medical community and the federal government are only 
too aware of the rising prevalence and serious nature of diabetes. The 
Centers for Disease Control, National Institutes of Health, and the 
Department of Health and Human Services have recently joined together 
in a national education campaign to inform people about diabetes and 
encourage people age 45 and older to get screened for diabetes.
  Unfortunately, current law does not allow Medicare to reimburse for 
diabetes testing, even if a patient presents a physician with serious 
risk factors for diabetes such as obesity, high blood pressure, or high 
cholesterol. Most shockingly, even if a patient is experiencing early 
evidence of diabetes complications like blindness and kidney disease, 
Medicare still cannot reimburse for diabetes testing.
  This nonsensical omission of diabetes screening coverage is even more 
shocking in light of the fact that about 25 percent of the Medicare 
budget currently is devoted to providing medical care to seniors living 
with diabetes. In 1999, Arkansas spent $1.6 billion on direct and 
indirect costs of diabetes. Why would we continue to constantly react 
to the disease in this manner, instead of proactively providing 
screening for our Medicare beneficiaries? This screening can identify 
the disease, even before any symptoms have appeared, and has the 
potential to save and improve thousands of lives.
  The American Association of Clinical Endocrinologists strongly 
believes that patients with diabetes should be identified as early as 
possible in their illness. We have the technology to do this through 
screening.

[[Page S10225]]

  I cannot overstate the need for this legislation. When faced with the 
rising prevalence of diabetes, the high percentage of seniors who 
already have the disease, the alarmingly high number of seniors who 
have diabetes but do not know it yet, and the high cost associated with 
its treatment, it is obvious that Medicare should provide coverage for 
diabetes screening.
  The American Diabetes Association has identified Medicare screening 
coverage as their top legislative priority, and I have worked closely 
with them to craft this legislation. I urge all of my colleagues to 
give serious consideration to the Diabetes Screening Act of 2002.

                          ____________________