[Congressional Record Volume 154, Number 151 (Tuesday, September 23, 2008)]
[House]
[Pages H8686-H8688]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




         SENSE OF HOUSE REGARDING PREVENTION AND PUBLIC HEALTH

  Mr. PALLONE. Mr. Speaker, I move to suspend the rules and agree to 
the resolution (H. Res. 1381) expressing the sense of the House that 
there should be an increased Federal commitment prioritizing prevention 
and public health for all people in the United States, as amended.
  The Clerk read the title of the resolution.
  The text of the resolution is as follows:

                              H. Res. 1381

       Whereas the United States has the highest rate of 
     preventable deaths among 19 industrialized U.N. nations and 
     lags behind 28 other U.N. nations in life expectancy;
       Whereas various research studies estimate that nearly 60 
     percent of premature deaths in the United States could be 
     addressed through prevention activities;
       Whereas of the more than $2,200,000,000,000 spent 
     nationally on health care in the United States every year 
     (more than any other nation in the world), approximately 
     $88,000,000,000 (or about 4 percent) is estimated to be spent 
     on prevention and public health;
       Whereas chronic diseases are the leading causes of 
     preventable death and disability in the United States, 
     accounting for 7 out of every 10 deaths and killing more than 
     1,700,000 people in the United States every year;
       Whereas these often preventable chronic diseases account 
     for 75 percent of health care

[[Page H8687]]

     spending in the United States, including more than 96 cents 
     out of every dollar spent in Medicare and more than 83 cents 
     out of every dollar spent in Medicaid;
       Whereas these chronic diseases cost the United States an 
     additional $1,000,000,000,000 each year in lost productivity, 
     and are a major contributing factor to the overall poor 
     health that is placing the Nation's economic security and 
     competitiveness in jeopardy;
       Whereas the number of people with chronic conditions is 
     rapidly increasing, and it is estimated that if we do not 
     intervene now that by 2025 nearly half of the population will 
     suffer from at least one chronic disease;
       Whereas current research has shown that increasing to 90 
     percent the use of just 5 preventive services, including--
       (1) the portion of adults who take aspirin daily to prevent 
     heart disease;
       (2) the portion of smokers who are advised by a health 
     professional to quit and are offered medication or other 
     assistance;
       (3) the portion of adults age 50 and older who are up to 
     date with any recommended screening for colorectal cancer;
       (4) the portion of adults age 50 and older immunized 
     against flu annually; and
       (5) the portion of women age 40 and older who have been 
     screened for breast cancer in the past 2 years, would save 
     more than 100,000 lives each year in the United States; and
       Whereas research has shown that prevention and community-
     level interventions that promote and enable proper nutrition, 
     increased access to physical activity, and smoking cessation 
     programs can prevent and mitigate chronic diseases, improve 
     quality of life, increase economic productivity, and reduce 
     health care costs: Now, therefore, be it
       Resolved, That the House of Representatives--
       (1) recognizes that in order to reduce the disease burden 
     and health care costs associated with preventable disease and 
     injury, it is imperative that this Nation strengthen its 
     public health system to--
       (A) encourage all persons in the United States to obtain 
     the proper information and educational resources they need to 
     make healthier choices and live healthier lives; and
       (B) protect all people in this country from health threats 
     beyond their control, such as bioterrorism, natural 
     disasters, infectious disease outbreaks, and environmental 
     hazards;
       (2) encourages the creation of public health strategies in 
     the public and private sectors to improve the health of all 
     people in the United States regardless of race, ethnicity, or 
     socioeconomic status;
       (3) supports public and private partnerships focusing on 
     the prevention of disease and injury, and encourages 
     community-based programs to support healthy lifestyles, 
     including those that promote proper nutrition and increased 
     access to physical activity;
       (4) emphasizes the importance of the 5 prevention 
     strategies of daily aspirin therapy, smoking cessation, 
     colorectal cancer screening, annual flu immunizations, and 
     breast cancer screening that can save more than 100,000 lives 
     each year;
       (5) believes that the congressional budget process should 
     reflect the significant savings associated with investments 
     in prevention of disease and injury, and therefore strongly 
     encourages the Congressional Budget Office to consider the 
     health care savings associated with reduced chronic disease 
     burden due to clinical and community preventive services and 
     programs when formulating its health care cost estimates; and
       (6) supports helping the United States be the healthiest 
     nation by encouraging an increased focus on public health and 
     prevention efforts in the public and private sectors.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from New 
Jersey (Mr. Pallone) and the gentleman from Texas (Mr. Burgess) will 
each control 20 minutes.
  The Chair recognizes the gentleman from New Jersey.


                             General Leave

  Mr. PALLONE. Mr. Speaker, I ask unanimous consent that all Members 
may have 5 legislative days to revise and extend their remarks and 
include extraneous material on the resolution under consideration.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from New Jersey?
  There was no objection.
  Mr. PALLONE. I yield myself such time as I may consume.
  Mr. Speaker, I rise this evening in support of H. Res. 1381, 
expressing the sense of the House that there should be an increased 
commitment to prioritizing prevention and public health for all people 
in the United States.
  At a time when our health care costs are rising exponentially, it's 
important now more than ever for us to prioritize public health 
spending. Spending on chronic diseases is particularly egregious as 
these diseases are the leading cause of preventible death and 
disability costing the Nation approximately $1 billion a year. If we 
can better manage this type of disease, we can dramatically reduce the 
costs of health care spending.
  We know from our past efforts with screenings and vaccines that 
prevention has proven to work to reduce incidences of illness. 
Accordingly, any step that we can undertake to prevent the spread of 
illness and disease needs to be implemented.
  I want to thank my colleague and friend, the gentlewoman from 
California, Congresswoman Roybal-Allard, for her and her staff's late-
night work to bring this resolution to the floor this evening.
  I urge my colleagues on both sides of the aisle to join me in support 
of its adoption.
  I reserve the balance of my time.
  Mr. BURGESS. Mr. Speaker, again, in deference to the author of the 
bill, I will reserve the balance of my time.
  Mr. PALLONE. Mr. Speaker, I yield 5 minutes to the sponsor of the 
legislation, the gentlewoman from California, Congresswoman Roybal-
Allard.
  Ms. ROYBAL-ALLARD. Mr. Speaker, the passage of H. Res. 1381 gives us 
an opportunity to send a clear message to the 111th Congress that 
public health and prevention must be an essential part of any health 
care reform package.
  I introduced H. Res. 1381 because as we began the debate on national 
health care reform, focusing on prevention strategies is a key 
component to our ultimate success.
  Currently our country spends a staggering $2.2 trillion each year on 
health care, more than any other country in the world, yet we are dying 
younger and we have the highest rate of preventible deaths among 19 
industrialized nations.

                              {time}  2115

  Research tells us that nearly 60 percent of premature deaths in the 
United States could be prevented by strategies that address 
environmental conditions, social circumstances, and behavioral choices.
  But we have not prioritized prevention in this country, and the 
serious consequences of neglecting prevention strategies has both an 
economic and a human toll.
  When we survey the economic components of our health care budget, we 
see that chronic diseases account for 75 percent of the health care 
spending in the United States, including more than 96 cents out of 
every dollar spent in Medicare and more than 83 cents out of every 
dollar spent in Medicaid.
  The human cost is reflected in the fact that each year these largely 
preventable chronic diseases account for seven out of ten deaths in the 
United States every year.
  Science and the medical community are warning us that if we do not 
focus on prevention now, by the year 2025 nearly half of our U.S. 
population will suffer from at least one chronic disease.
  Mr. Speaker, the entire public health community agrees that 
prevention is a critical component to successfully addressing our 
Nation's public health crisis and to reining in the astronomical cost 
of health care.
  A study by the Partnership for Prevention found that each year there 
is the potential to save 100,000 lives through five simple behavioral 
changes.
  And an analysis by the Trust for America's Health found that an 
annual investment of just $10 per person in proven community-based 
programs could save the country more than $60 billion annually within 5 
years.
  It is time for our country to adopt a proactive and strategic 
approach to health care aimed at preventable conditions.
  H. Res. 1381 calls on our Nation to prioritize prevention and public 
health for all people in the United States.
  The resolution urges community-based programs to support healthy 
lifestyles, and it promotes the expansion of prevention strategies like 
daily aspirin therapy, smoking cessation, colorectal and breast cancer 
screening, and annual flu immunizations.
  The resolution also calls for the creation of public health 
strategies to improve our Nation's health and eliminate health 
disparities.
  Finally, H. Res. 1381 challenges the Congressional Budget Office to 
consider the savings associated with the prevention of chronic disease 
when formulating its health care cost estimates.
  I extend my sincere thanks to the bipartisan group of original 
cosponsors

[[Page H8688]]

who join me in this effort, including my co-chairs from the Study Group 
on Public Health, Kay Granger and Jim McGovern; my colleagues, Jim 
Moran from the Prevention Caucus and Diana DeGette and Mike Castle from 
the Diabetes Caucus.
  We share a passion for improving public health and preventing chronic 
disease.
  I also thank The Trust for America's Health and the Campaign for 
Public Health, in addition to over 150 public health organizations that 
have endorsed this resolution.
  Mr. Speaker, the future health of our Nation depends on the 
priorities we set as we begin the process of health care reform.
  By passing H. Res. 1381 today, we are sending an important message to 
the new 111th Congress that Public Health and Prevention must be a 
priority in any health reform package.
  I urge my colleagues to vote ``yes'' on the passage of H. Res. 1381. 
We cannot solve the health care crisis in this country until we get 
serious about prevention.
  Mr. BURGESS. Mr. Speaker, I yield myself such time as I may consume, 
and I also rise in support of House Resolution 1381, a resolution 
expressing the sense of the House that there should be an increased 
public and private commitment prioritizing prevention and public health 
for all people in the United States.
  Each year almost 2 million people in the United States die from 
chronic diseases that are often preventible and also account for almost 
three-quarters of health care spending. It costs the United States 
almost $1 trillion a year in lost productivity that erodes our national 
competitiveness.
  In an effort to alleviate chronic diseases, Americans need to eat 
right, quit smoking, and get exercise. You probably don't need to be an 
economist to understand why that will help increase economic 
productivity, and it's intuitively obvious to the most casual observer 
that this can help prevent the onset of chronic disease and improve the 
quality of our lives.
  This resolution urges the people of the United States to use the five 
prevention strategies to create healthier lifestyles. It encourages 
daily aspirin therapy, smoking cessation, colorectal cancer screening, 
annual flue immunizations, and breast cancer screenings that can save 
more than 100,000 lives each year by addressing behavioral choices.
  In addition, the resolution suggests that the Congressional Budget 
Office process should reflect the significant savings associated with 
prevention of disease and injury. And that's of particular concern to 
me and something that I argue for in many other vocations and other 
legislation that we have to have the ability to do dynamic scoring when 
we follow policies that are likely to result in savings.
  So the line in the bill, that it is the sense of the House we believe 
``the congressional budget process should reflect the significant 
savings associated with investments in prevention of disease and 
injury,'' and that is an important concept and one that this Congress 
and the next Congress would do well to recognize and encourage our 
Congressional Budget Office to follow likewise.
  I would like to thank the author of this resolution, Representative 
Lucille Roybal-Allard of California, for her leadership in improving 
the awareness of the benefits of prevention and her efforts to lower 
the number of preventable chronic diseases in the United States.
  I encourage all of my colleagues to vote in favor of this resolution.
  Ms. JACKSON-LEE of Texas. Mr. Speaker, today I stand for a commitment 
to making public healthcare a priority. I stand for universal 
healthcare as a universal right. I stand to support H. Res. 1381, 
``expressing the sense of the House that there should be an increased 
Federal commitment prioritizing prevention and public health for all 
people in the United States.'' I thank my colleague, Representative 
Roybal-Allard for introducing this important resolution.
  I would be remiss if I did not also thank my dear colleague from 
Michigan, Chairman of Judiciary, and Congressman John Conyers, for his 
tireless work on prioritizing healthcare in this Congress. His 
bimonthly meetings to bring together the healthcare community, 
congressional Members and staff, and other stakeholders; speaks to his 
commitment to making universal healthcare a priority.
  Sadly, the United States is the only wealthy, industrialized nation 
that does not have a universal health care system. Some of the other 
disturbing healthcare statistics are that:


                      Health Insurance Statistics

  In 2006, the percentage of Americans without health insurance was 
15.8 percent, or approximately 47 million uninsured people. Source: US 
Census Bureau.
  Among the 84.2 percent with health insurance in 2006, coverage was 
provided through an employer 59.7 percent, purchased individually 9.1 
percent, and 27.0 percent was Government funded (Medicare, Medicaid, 
Military). Source: US Census Bureau.
  The primary reason given for lack of health insurance coverage in 
2005 was cost (more than 50 percent), lost job or a change in 
employment (24 percent), Medicaid benefits stopped (10 percent), 
ineligibility for family insurance coverage due to age or leaving 
school (8 percent). Source: National Center for Health Statistics.
  Medicare, a federally funded health insurance program that covers the 
health care of most individuals 65 years of age and over and disabled 
persons, accounted for 13.6 percent of health care coverage in 2006. 
Source: US Census Bureau.
  Medicare operates with 3 percent overhead, non-profit insurance 16 
percent overhead, and private (for-profit) insurance 26 percent 
overhead. Source: Journal of American Medicine 2007.


                        Health Care Expenditures

  In 2005, personal health care expenditures were paid by private 
health insurance 36 percent, federal government 35 percent, state and 
local governments 11 percent, and out-of-pocket payments 15 percent. 
Source: National Center for Health Statistics.
  The United States spends twice as much on health care per capita 
($7,129) than any other country * * * and spending continues to 
increase. In 2005, the national health care expenditures totaled $2 
trillion. Source: National Center for Health Statistics.
  75 percent of all health care dollars are spent on patients with one 
or more chronic conditions, many of which can be prevented, including 
diabetes, obesity, heart disease, lung disease, high blood pressure, 
and cancer. Source: Health Affairs.
  From 2000 to 2006, overall inflation has increased 3.5 percent, wages 
have increased 3.8 percent, and health care premiums have increased 87 
percent. Source: Kaiser Family Foundation.
  Mr. Speaker, it is time we make public health a priority for all 
Americans. Children cannot do well in school when they do not have 
proper healthcare. Parents are afraid to change jobs because of 
possible loss or reductions in healthcare coverage. Our elders, our 
seniors have to choose between groceries and prescriptions.
  Healthcare will become a priority when we make it one. This body has 
the power to create a fundamental change in how our country views and 
manages its healthcare system. We have the power to make a change in 
the lives of everyday Americans for the better. For it does not matter 
how much money you have, how many languages you speak, or how many 
degrees you have earned--without your health, you have nothing. A 
healthier America--starts right here, right now. Let's make it a 
priority Today!
  Mr. Speaker, I encourage my colleagues to join me in supporting 
American families in their struggle to provide basic needs to their 
children, to their parents, and for themselves. I encourage my 
colleagues to remember that they hold the power of the pen and the 
vote, to make universal healthcare a priority.
  Mr. Burgess. Having no other requests for time, I yield back the 
balance of my time.
  Mr. PALLONE. Mr. Speaker, I have no further requests for time, I 
would urge support of this resolution for an increased commitment to 
prevention in public health, and I yield back the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from New Jersey (Mr. Pallone) that the House suspend the 
rules and agree to the resolution, H. Res. 1381, as amended.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the resolution, as amended, was agreed to.
  The title was amended so as to read: ``A resolution expressing the 
sense of the House that there should be an increased public and private 
commitment prioritizing prevention and public health for all people in 
the United States.''.
  A motion to reconsider was laid on the table.

                          ____________________