[Congressional Record Volume 152, Number 63 (Friday, May 19, 2006)]
[Senate]
[Pages S4837-S4840]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. BIDEN:
  S. 2915. A bill to amend title 10, United States Code, to improve 
screening for colorectal cancer for TRICARE beneficiaries over the age 
of 50; to the Committee on Armed Services.
  Mr. BIDEN. Mr. President, today I am pleased to introduce a simple 
bill that would give military dependents and retirees the same choices 
for colon cancer screening that every Medicare beneficiary and every 
Federal employee enjoys. This legislation requires Tricare to abandon 
its overly restrictive and outdated policy of limiting coverage of 
screening colonoscopy to a small group of high-risk individuals. By 
contrast, for several years both Medicare and the Federal Employees 
Health Benefits Program have paid for screening colonoscopy to detect 
cancer in average-risk people, and my bill simply applies this same 
standard to the Tricare program.
  Why is this bill so important? Colon cancer is highly curable when 
detected and treated early but extremely lethal when it reaches an 
advanced stage. Early detection and prompt treatment are the keys to 
surviving colon cancer. Among those whose colon cancer has been cured 
by modern diagnostic and treatment methods are President Reagan, 
Supreme Court Justice Ginsburg, and our colleague Senator Burns, to 
name just a few.

[[Page S4840]]

  Why is access to colonoscopy so critical? At present, 
gastroenterologists overwhelmingly recommend colonoscopy as the 
preferred method to use for screening of colon cancer in average risk 
individuals over 50. Colonoscopy is more sensitive than other methods 
of screening in detecting colonic neoplasia, pre-cancerous changes or 
full-blown cancers, at an early stage; colonoscopy is more reliable in 
finding colonic neoplasia in the upper \2/3\ of the colon; and 
colonoscopy permits biopsy and removal of abnormal tissue as soon as it 
is discovered, in a single procedure. In fact, medical specialists 
refer to colonoscopy as the ``gold standard'' for colon cancer 
screening.
  Since, 2001, the Medicare Program has permitted the use of 
colonoscopy to screen for colon cancer in ``average risk'' individuals, 
and the Federal Employees Health Benefits Program has used the same 
criteria since 2003. But the Tricare medical program for military 
beneficiaries clings to an outmoded policy that authorizes screening 
colonoscopy to detect colon cancer only for only a very narrowly 
defined group of ``high risk'' people, not the much broader group of 
``average risk'' individuals covered by the Medicare and FEHBP 
programs. By failing to keep up with modern medical practice, as well 
as with other federal health programs, Tricare seems to be 
inappropriately restricting access to a potentially lifesaving tool for 
early cancer detection. The resulting unnecessary delay in detection of 
colon cancer puts our military community at needless risk.
  To remedy this situation, my bill requires the Tricare program to use 
the same criteria as the Medicare program in paying for screening 
colonoscopy. My bill does not mandate that screening colonoscopy be 
used for colon cancer detection in Tricare beneficiaries; that decision 
is left to Tricare patients and their doctors. Rather, this legislation 
simply affords Tricare participants the same options that Federal 
employees and Medicare beneficiaries have enjoyed for some time.
  Frankly, I see no logical reason why those who have served our 
country in uniform for over 20 years, and the family members of those 
currently on active duty, should not have access to the same high-
quality medical choices offered to our senior citizens and to our 
Federal workers. The policy on colon cancer screening that has worked 
well for 42 million Medicare beneficiaries and 9 million FEHBP 
participants, a policy that is endorsed by most medical specialists, 
seems totally appropriate for the Tricare population. It is time to 
bring the Tricare program's colon cancer screening criteria into the 
21st century.
  Mr. President, I encourage my colleagues to join me in supporting 
this commonsense legislation
                                 ______