[Congressional Record Volume 149, Number 50 (Thursday, March 27, 2003)]
[Senate]
[Pages S4529-S4530]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. LIEBERMAN (for himself, Ms. Collins, Mr. Bunning, Mr. 
        Hollings, Mr. Dayton, Ms. Landrieu, Ms. Stabenow, Mr. 
        Lautenberg, and Mr. Graham of South Carolina):
  S. 740. A bill to amend title XVII of the Social Security Act to 
improve patient access to, and utilization of, the colorectal cancer 
screening benefit under the medicare program; to the Committee on 
Finance.
  Mr. LIEBERMAN. Mr. President, I rise to introduce the ``Colon Cancer 
Screen for Life Act of 2003.'' I am pleased that my colleagues Senators 
Collins, Bunning, Dayton, Hollings, and Landrieu have joined me in 
introducing this very important bill.
  As many of my colleagues know from personal experience, colon cancer 
is a devastating disease, taking the lives of 57,000 Americans each 
year. It is the fourth most commonly diagnosed cancer in both men and 
women and the second most common cause of cancer-related death in the 
nation. Close to 150,000 new cases are diagnosed each year.
  But colon cancer can be combated, controlled, and potentially 
conquered if it's caught in the earliest stages. In fact, colon cancer 
is a rare form of cancer in that it can even be prevented through 
screening--if pre-cancerous polyps are quickly identified and removed.
  The survival rate when colon cancer is detected at an early, 
localized stage is 90 percent. But only 37 percent of such cancers are 
discovered at that stage. The later the disease is caught, the lower 
the survival rate.
  That's why, in 1997, Congress led the fight against colon cancer by 
making screening for the disease a covered benefit for every Medicare 
recipient. That is especially significant because the risk of colon 
cancer rises with age.
  Heightened awareness and greater access to treatment are working. 
Over the last 15 years, we've seen steady, if slow, annual declines in 
both incidence rates and mortality rates tied to colon cancer.

[[Page S4530]]

  But we can do more, because barriers to screening still exist. Since 
the preventive benefits were enacted in 1997, there has been only a one 
percent increase in utilization by Medicare beneficiaries of either a 
screening or diagnostic colonoscopy. The Centers for Disease Control 
reports that screening for colon cancer lags far behind screening for 
other cancers.
  We must do better and we can.
  Modern technology has blessed us with extremely accurate screening 
tools, in particular the colonoscopy--which results in higher colon 
cancer identification rates and better long-term survival rates. A 
consultation with a doctor before a colonoscopy is required to ensure 
that patients are properly prepared before they undergo the procedure.
  Unfortunately, Medicare does not pay for that consultation before a 
screening, creating an obvious obstacle to preventive treatment for 
many men and women. The Colon Cancer ``Screen for Life'' Act would 
cover these medical visits so that more Medicare beneficiaries will 
have easy access to screening.

  Further, with this legislation, just as Congress has done for 
screening mammography, screening colonoscopy will not count toward a 
senior's Medicare deductible. This will remove additional financial 
disincentives to screening.
  Finally, with this bill, we're breaking through another big barrier 
to early detection and treatment.
  The medical reality is that colonoscopy procedures are invasive and 
require sedation to perform--making it safer for them to be conducted 
in a hospital setting, where safety standards and emergency procedures 
are in place, rather than in a private doctor's office. But when 
doctors perform colonoscopies for Medicare patients in a hospital, they 
take a hit on cost--because reimbursement for the procedure performed 
there has decreased by nearly 36 percent since 1997.
  As a result, to balance their budgets, doctors and hospitals may 
choose to space out their Medicare patients, creating long waits for 
and limited access to these vital screenings.
  The job of medical services should be cutting cancer, not cutting 
costs. Unfortunately, today something as critical as colon cancer 
screening is moderated not by the real needs of patients and their 
medical doctors, but by market forces and market forces alone.
  To address the problem, the ``Screen for Life'' Act would increase 
the payment rates for colonoscopies performed in hospital facilities by 
30 percent. The result will be more access to early detection and 
treatment and thousands of lives saved.
  Colon cancer is a formidable foe, but we can make a difference in the 
fight against it. Early detection and treatment is our first line of 
defense.
  With the help of the Colon Cancer ``Screen for Life'' Act, I hope 
that in a decade we'll have fewer cancer cases to contend with and more 
survivors to celebrate the simple fact that screening saves lives.
                                 ______