[Congressional Record Volume 157, Number 167 (Thursday, November 3, 2011)]
[Senate]
[Pages S7137-S7138]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. KERRY:
  S. 1809. A bill To amend the Public Health Service Act to revise and 
extend the program for viral hepatitis surveillance, education, and 
testing in order to prevent deaths from liver cancer, and for other 
purposes; to the Committee on Health, Education, Labor, and Pensions.
  Mr. KERRY. Mr. President, there is a silent epidemic in our country 
that today threatens the lives of more than 5 million Americans. Of 
those people afflicted with this disease, 150,000 will not survive this 
decade. In 2008 alone, an estimated 56,000 Americans were newly 
infected while as many as 75 percent of all infected people did not 
even know that they carried this disease. Without further preventative 
action, this growing health threat will only cost more lives and 
hundreds of billions in additional health care expenses. This ticking 
time bomb is viral hepatitis.
  That is bad news. But there is also cause for hope.
  Treatment already exists that can eradicate hepatitis C in close to 
75 percent of people with the disease. Another treatment reduces the 
level of hepatitis B in over 80 percent of those treated. There has 
been a vaccine against hepatitis B for decades that has left millions 
immune to that strain of virus. We understand how viral hepatitis is 
spread, how it can be prevented, and how to test people for infection. 
There have just been a string of significant medical advances that will 
improve the effectiveness of viral hepatitis screening and treatment.
  It is clear that we already have the tools at our disposal to 
prevent, treat, and control the vast majority of these infections, now 
what we need is a coordinated strategy to put these tools to work.
  That is why I am introducing the Viral Hepatitis Testing Act of 2011, 
which appropriates $110 million over five years to improve education, 
testing, and care for viral hepatitis across Massachusetts and in local 
communities around the country. This legislation is a down-payment on a 
national effort to fight and ultimately eradicate hepatitis B and C in 
America. I hope

[[Page S7138]]

my colleagues on both sides of the aisle will join me in cosponsoring 
this effort.
  Viral hepatitis is known as a silent killer because it can stay a-
symptomatic for years before it leads to serious liver disease. It is 
the most common cause of liver cancer and yet doctors and patients 
alike are often largely uninformed about this disease. Hepatitis B is 
100 times more infectious than HIV and has spread to an estimated 2 
billion people worldwide while hepatitis C has reached about 170 
million people. Chronic viral hepatitis is widespread and it is 
dangerous.
  Last year, the Institute of Medicine released a report outlining a 
number of specific recommendations on how to combat viral hepatitis. To 
build on those recommendations, Assistant Secretary of Health Dr. 
Howard Koh convened a task force and developed a detailed, 
comprehensive action plan to combat the pervasive spread of this 
disease. These recommendations served as the foundation for the 
legislation I am proposing today.
  As of today, there is no coordinated national strategy in place to 
fight viral hepatitis. The action plan put forward by Dr. Koh and his 
team seeks to rectify that problem by incorporating standardized viral 
hepatitis prevention and treatment programs into the health care 
infrastructure that already exists. The bill I introduced today would 
quickly implement a number of these programs and provides the 
Department of Health and Human Services with the resources to act.
  The first step in prevention is determining who is infected with the 
virus so they can receive the appropriate care and will be less likely 
to pass on this disease to others. In order to determine the prevalence 
of the problem and to increase the number of people who are aware of 
their infection, The Viral Hepatitis Testing Act calls for HHS to work 
with the Center for Disease Control and Prevention, the Agency for 
Healthcare Research and Quality, and the Preventive Services Task Force 
to develop and implement effective surveillance and testing protocols. 
Whereas 75 percent of people carrying viral hepatitis today do not even 
know they are infected, improved testing could flip that disturbing 
statistic on its head in just 5 years.
  It is also a sad reality that a number of minority populations are at 
greatly increased risk for contracting viral hepatitis. Asian-Americans 
and Pacific Islanders account for over half of chronic hepatitis B 
cases. African Americans, Latinos, and American Indians and Native 
Alaskans also have disproportionately high rates of these viruses. 
Additionally, without the proper preventative care, there is a high 
likelihood that pregnant women who carry the virus will pass it on to 
their unborn children.
  For those reasons, the legislation I introduced today also focuses on 
screening and treating high-risk populations and pregnant mothers for 
viral hepatitis. Educational programs targeting high-risk groups will 
empower people to protect themselves from contracting hepatitis, and 
ensuring that people who have viral hepatitis receive the appropriate 
follow-up care will further help to prevent the spread of this 
epidemic.
  Additionally, providing doctors with the proper training on the 
causes, symptoms, and treatments would also go a long way toward 
stemming the tide of transmission and improving outcomes for patients 
who have contracted the disease. This legislation makes supplemental 
viral hepatitis training for health care professionals a priority.
  To do the things we need to do in order to save lives and control 
this deadly epidemic, we are going to have to make a relativelodest 
investment. The Viral Hepatitis Testing Act appropriates $110 million 
over 5 years that will go toward implementing the educational, 
screening, and treatment measures required under this act. Rather than 
creating a whole new hepatitis prevention apparatus, this funding will 
be used to integrate these new and improved procedures into the 
existing health care infrastructure through grants to public and 
nonprofit private entities, including States, Indian tribes, and 
public:private partnerships.
  The human benefits of this legislation are undeniable--these 
provisions will reduce transmission, improve the quality of life for 
people with viral hepatitis, and prevent the deaths of countless 
mothers and fathers and children. It is also undeniable that this is a 
wise investment of resources and good policy. These investments are a 
classic case of using limited resources to maximum impact, as we invest 
a modest amount of money today in order to save lives, pain, and tens 
of billions of dollars tomorrow.
  Today, hepatitis B costs patients around $2.5 billion per year. With 
baby boomers aging into Medicare and accounting for an estimated two 
out of every three cases of chronic hepatitis C, medical costs for 
treating this disease are expected to skyrocket from $30 billion to 
more than $85 billion in 2024. Late diagnosis is a significant driver 
of costs, as more expensive procedures and treatments are required the 
further the infection has progressed. To put this in even starker 
terms, the cost of the hepatitis B vaccine ranges from $75 to $165, 
while treatment can cost up to $16 thousand per year for a single 
person, or up to $110 thousand per hospital visit, should the disease 
develop into liver cancer.
  Viral hepatitis is an increasingly significant issue for 
Massachusetts. The Department of Public Health reports over 2,000 cases 
of newly diagnosed chronic Hepatitis B infection and 8,000 to 10,000 
cases of newly diagnosed chronic Hepatitis C infection each year. Viral 
hepatitis is the highest volume of reportable infectious diseases in 
the state. Additionally, there continues to be a striking increase in 
cases of hepatitis C infection among adolescents and young adults in 
the State, which suggests that there is a new epidemic of the disease 
taking hold.
  Until recently, the Massachusetts State Legislature provided $1.4 
million for surveillance to detect outbreaks and behaviors of concern 
as well as for targeted screening and treatment of high-risk 
populations. Today, however, as this public health threat spreads, all 
of that funding has been eliminated due to budget cuts. Massachusetts 
receives just $104,305 from the CDC for an Adult Viral Hepatitis 
Prevention Coordinator. This is a valuable position but it is not 
nearly enough to support core public health services. The Viral 
Hepatitis Testing Act will allow Massachusetts to invest in a 
sustainable infrastructure that would improve health care for our 
citizens.
  The choice is ours: we can either invest in preventative programs and 
more robust screening now or we can just let this epidemic continue to 
proliferate around the country and foot the bill later for the 
expensive surgical procedures, medicines, and hospital bills that will 
only continue to grow.
  Without action, thousands more Americans will die year from preventa 
seases. We know what we need to do; now it is up to us to do it. Let us 
not make excuses. Let us lower health care costs for American families, 
improve the quality o our care, and save lives. I again urge my 
colleagues to join me in cosponsoring this important legislation.

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