[Congressional Record Volume 155, Number 48 (Thursday, March 19, 2009)]
[Senate]
[Pages S3571-S3572]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. HATCH (for himself and Mr. Dodd):
  S. 660. A bill to amend the Public Health Service Act with respect to 
pain care; to the Committee on Health, Education, Labor, and Pensions.
  Mr. HATCH. Mr. President, I rise today to introduce the National Pain 
Care Policy Act of 2009. I am pleased to have worked with my good 
friend, Senator Chris Dodd, on this legislation that will create a 
comprehensive framework for addressing coordinated research, public 
education and training in pain and pain management. I also want to 
acknowledge the work of my colleagues in the House, Representatives 
Lois Capps and Mike Rogers, for their efforts in that body to highlight 
this important health issue.
  According to the Centers for Disease Control and Prevention, CDC, 
more than 25 percent of Americans over age 20 report having suffered 
pain. Of the older people reporting pain, more than half say their pain 
lasted for an entire year or longer. But many older people do not 
report their pain because they believe nothing can be done or they are 
unaware that effective treatments may exist.
  Health care professionals are often not adequately trained to manage 
their patients' pain. They may be unfamiliar with the latest research 
and guidelines, or they might hesitate to prescribe medication for pain 
management due to concerns about dosing or dependency. A widely 
acknowledged barrier to patient care includes misconceptions and 
concerns by health care providers regarding laws and policies on the 
use of controlled substances. Some patients do not tell their doctors 
they are experiencing pain because they do not want to bother them or 
appear to be a complainer.
  The National Pain Care Act of 2009 will help researchers, patients 
and health care providers better understand and manage pain care. It 
will coordinate federal research activities by establishing an 
Interagency Pain Coordinating Committee. The legislation also 
authorizes funds for pain research at the National Institutes of 
Health, NIH, and requires a report to Congress on the progress made in 
this area. The Coordinating Committee will summarize in their report 
the advances in pain care research supported or conducted by federal 
agencies and identify the research gaps that, if filled, could shed 
light on the symptoms and causes of pain.
  The bill will establish a public awareness campaign highlighting pain 
as a serious public health issue. The campaign will provide messages to 
the public on the need to appropriately assess, diagnose, treat and 
manage pain, and will alert the public to available treatments options 
for pain care management. It will also help patients weigh the risks 
and benefits of these options so that they may make better informed 
decisions with their health care providers.
  The National Pain Care Policy Act of 2009 also creates greater 
training capacity in health-professions schools, hospices and other 
health care professional training facilities. This training will ensure 
that more health professionals have the capacity to manage their 
patients' pain using the most recent findings and improvements in the 
provision of pain care. Health professionals in a variety of settings 
will learn better means for assessing, diagnosing, treating and 
managing pain signs and symptoms and, as a result, will become more 
knowledgeable about applicable policies on the use of controlled 
substances.
  This bill contains provisions that will help the many Americans who 
suffer from joint pain, one of the most common types of pain reported. 
One-third of adults reported joint pain, aching or stiffness, according 
to a CDC report on the nation's health. It will also reduce 
hospitalization costs that are associated with hip and knee 
replacements that may be unnecessary if the underlying pain can be 
adequately controlled.
  Finally, the National Pain Care Act of 2009 will also help migraine 
sufferers, cancer patients and those experiencing lower back pain. 
Cancer patients should not have to spend their final days in pain. 
Lower back pain is the most common cause of job-related disability and 
relieving that complaint could increase worker productivity and 
alleviate many lost days of work.
  This is an important piece of legislation; it is one that, if passed, 
will improve the lives of many. Quite frankly, I believe it is long 
overdue. Similar legislation was introduced last year in both chambers 
of Congress--the House passed its legislation late in the year, but, 
unfortunately, the Senate did not consider the bill before the 110th 
Congress adjourned. The legislation we introduce today is identical to 
that which the House passed last year. I thank Senator Dodd for his 
leadership on this important issue and I urge my colleagues to support 
the prompt passage of our bill.
  Mr. DODD. Mr. President, I rise today to join my colleague from Utah, 
Senator Orrin Hatch, in introducing the National Pain Care Policy Act 
of 2009. This important legislation would make significant strides in 
the understanding and treatment of pain as a medical condition. Pain is 
the most common symptom leading to medical care and a leading health 
issue. Yet people suffering through pain often struggle to get relief 
because of a variety of issues. This is why we are introducing this 
important legislation.
  Each year pain results in more than 50 million lost workdays 
estimated to cost the United States $100 billion. Beyond the economic 
impact, pain is a leading cause of disability, with back pain alone 
causing chronic disability in 1 percent of the population of this 
country. In the U.S. 40 million people suffer from arthritis, more than 
26 million, ages 20 to 64, experience frequent back pain, more than 25 
million experience migraine headaches, and 20 million have jaw and 
lower facial pain each year. It is estimated that 70 percent of cancer 
patients have significant pain as they fight the disease. Half of all 
patients in hospitals suffer through

[[Page S3572]]

moderate to severe pain in their last days. As with many medical 
conditions, this is a problem that is likely to become worse as the 
baby boom generation approaches retirement and the population ages.
  Sadly, though most pain can be relieved, it often is not. Many 
suffering patients are reluctant to tell their medical provider about 
the pain they are experiencing, for fear of being identified as a ``bad 
patient,'' and concern about addiction often leads patients to avoid 
seeking or using medications to treat their pain. But even if patients 
were more forthcoming about their condition, few medical providers are 
equipped to do something about it. Often they have not been trained in 
assessment techniques or pain management, and are unaware of the latest 
research, guidelines, and standards for treatment. There is also 
concern among most providers that prescribing treatment for pain will 
lead to greater scrutiny by regulatory agencies and insurers.
  But we can do something about these barriers and help individuals 
suffering from pain. The National Pain Care Policy Act would lead to 
improvements in pain care across the country. The legislation would 
call for an Institute of Medicine conference on pain care to increase 
awareness of this issue as a public health problem, identify barriers 
to pain care and determine action for overcoming those barriers. A 
number of years ago, my good friend Sen. Hatch helped establish a Pain 
Consortium at the National Institutes of Health to establish a 
coordinated pain research agenda. This legislation will codify that 
consortium and update its mission. The bill addresses the training and 
education of health care professionals through new grant programs at 
the Agency for Health Research and Quality, AHRQ, and the Health 
Resources and Services Administration, HRSA. And finally this 
legislation creates a national outreach and awareness campaign at the 
Department of Health and Human Services to educate patients, families, 
and caregivers about the significance of pain and the importance of 
treatment.
  I want to thank Senator Hatch for his leadership on this issue and 
urge my colleagues to join us on this important effort to help the 
millions of Americans suffering from severe pain.
                                 ______