[Congressional Record Volume 160, Number 76 (Tuesday, May 20, 2014)]
[House]
[Pages H4680-H4682]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                 THE DEVASTATION OF ALZHEIMER'S DISEASE

  The SPEAKER pro tempore (Mr. Stewart). Under the Speaker's announced 
policy of January 3, 2013, the gentleman from California (Mr. 
Garamendi) is recognized until 10 p.m. as the designee of the minority 
leader.
  Mr. GARAMENDI. Mr. Speaker, recently, The Sacramento Bee wrote a 
three-page article on Alzheimer's and the effect that it has.
  I would like to quote from that newspaper:

       Gasps were audible as the images flashed before the 
     gathering scientists at a recent U.C. Davis Alzheimer's 
     Disease Center pathology conference. On the screen before 
     them were photos of a brain, severely wasted with age, with 
     what looked like silver rivers of atrophy cutting deeply 
     through the tissues. Even for the experts, it can be shocking 
     to see the damage that Alzheimer's disease inflicts on the 
     aging brain.
       What can stop the devastation of Alzheimer's?
       Without better answers from researchers, the degenerative 
     brain disease--already the Nation's sixth leading cause of 
     death--will be diagnosed in as many as 16 million aging baby 
     boomers by 2050. Unchecked, it will rob millions of their 
     memories and lives, of their pasts and futures, even as it 
     threatens to overwhelm the health care system.

  Tonight, in a bipartisan 1-hour session, we are going to talk about 
Alzheimer's. Unfortunately, our time is being cut short, but we will 
take this up again in the weeks ahead as we deal with one of the most 
profound and expensive and damaging issues Americans face.
  I have here a diagram that explains what is going to happen with 
Alzheimer's cost to Medicare and Medicaid in the years ahead. Right 
now, it is $122 billion, and it will rise in 2020 to $195 billion, to 
$346 billion in 2030, and by 2050, it will be approaching $1 trillion.
  We have a problem. Americans--every family is facing this issue. My 
family has, and I suspect every other family in this Nation at one time 
or another already has faced this issue, and they will in the years 
ahead.
  This is not a new issue for the Congress. It is an issue that has 
been dealt with. There has been legislation introduced, and in a few 
moments, I will talk about some of the bills that have been introduced 
by my colleagues here in the Congress, both on the Democratic and on 
the Republican sides of the aisle.
  This issue has to be addressed, and the principal thing we need to do 
is to provide research and care and support for the families that have 
this issue in their midsts.
  I want to take up a couple of other charts and then turn to my 
colleague from Kentucky.
  This chart deals with the issue of what is going to happen with the 
funding. If we are going to solve this problem, we are going to have to 
increase the funding. We are, fortunately, spending around $5.5 billion 
a year on cancer through the National Institutes of Health.
  HIV/AIDS is close to $3 billion a year. Cardiovascular issues are 
around $2 billion. Alzheimer's is down here at just over $566 million. 
We are not yet at $1 billion on this. As we can see here, this is going 
to be the most expensive illness facing the Medicare and Medicaid 
populations in the future years.
  We also know of the deaths from the illnesses that have the greatest 
funding--breast cancer down 2 percent, prostate cancer down 8 percent, 
heart disease down 16 percent, stroke down 23 percent, and HIV--a 
remarkable success--with deaths now declining by 42 percent.

[[Page H4681]]

                              {time}  2145

  On the other hand, deaths from Alzheimer's are increasing at a rate 
of 68 percent.
  So we are seeing this extraordinary shift occurring in the illnesses 
that are facing Americans and their families. We are seeing this 
extraordinary increase in Alzheimer's deaths as we see, thankfully, 
success. Often, that success is a direct result of what is happening 
with the research that is going on.
  I would like now to turn to Mr. Guthrie, my colleague from Kentucky, 
as he discusses this issue from his perspective. And then we will spend 
the next 15 minutes in a dialog about this problem.
  Mr. GUTHRIE. I want to thank my friend from California for yielding.
  I rise today, Mr. Speaker, to talk about this devastating disease 
that impacts nearly every family in America: Alzheimer's disease.
  According to the Alzheimer's Association, Alzheimer's is the 
costliest disease in America, with a direct cost of roughly $200 
billion--most of which is paid by Medicare and Medicaid, and accounts 
for 20 percent of Medicare spending. These numbers will only continue 
to increase, making the discovery of a cure, or a way to delay onset, 
critical to our health care economy.
  Across the United States, more than 5 million Americans are living 
with Alzheimer's today. In addition, the Alzheimer's Association 
estimates that someone will develop this disease every 67 seconds. 
Eleven percent of Kentucky's seniors are currently living with 
Alzheimer's. It is the sixth-leading cause of death in the United 
States.
  But it is not the financial drain that is the most devastating.
  My family has been personally touched by Alzheimer's. My great uncle 
suffered from the disease. I will never forget as a little boy hearing 
my grandmother talk to my mother about my uncle getting lost and trying 
to find his way home from the grocery store. Nobody really understood 
it. I remember as a young boy being confused about how this uncle I 
knew could be so confused and lose his way.
  I also experienced it in my family with my wife's grandfather. I will 
never forget when my wife and I went to visit him the first time he 
didn't recognize her. The devastation on her face that someone she 
loved so much didn't know who she was has still stuck with me today.
  This disease is emotionally wrenching for families who are impacted.
  Beyond the direct emotional and physical impact, family members 
serving as primary caregivers are stretched to their limits. Many 
spouses and grown children work full time-jobs and then come home to 
care for their family member.
  Finding a cure or treatment for Alzheimer's is of the utmost 
importance. I was pleased to introduce H.R. 4351 with my colleague, 
Representative Paul Tonko of New York.
  H.R. 4351, the Alzheimer's Accountability Act, seeks to ensure that 
the research and resources needed to find a cure for Alzheimer's are 
properly conveyed to Congress. By receiving a professional judgment 
budget directly, Congress will be in a better position to see the needs 
and promise of researchers and use that information to make critical 
decisions, especially during difficult budgetary situations.
  Today, H.R. 4351 is bipartisan. My friend Paul Tonko and myself filed 
this legislation. We have 80 cosponsors. There is also a Senate 
companion bill, and it is gaining momentum.
  Again, I want to thank my colleague for organizing this evening and 
for allowing me to be part of this effort to shine a light on 
Alzheimer's disease. I would also like to encourage all of my 
colleagues to cosponsor H.R. 4351, and help make fighting Alzheimer's a 
top priority.
  Mr. GARAMENDI. Thank you so very, very much. Thank you for being part 
of what, to my knowledge, is the first bipartisan hour. We ought to do 
this more.
  This issue isn't a Democratic or Republican issue, a left or right 
issue. This is a true American tragedy--and one that is also going to 
be a true American financial as well as a family problem.
  One of the gentlemen that has been involved in this from the very 
early days is my friend from New York (Mr. Tonko).
  Thank you for joining us, Mr. Tonko. I know you have had a very 
difficult evening with one of our colleagues who lost her spouse this 
evening. Thank you for caring for her and joining us this evening.
  Mr. TONKO. Well, we all love Louise Slaughter. We extend our 
condolences for the loss of her beloved Bob, who was part of this 
institution. He was here so much and intellectually invested himself in 
the business of the House.
  Representative Garamendi, let me thank you for bringing us together 
in such a meaningful and bipartisan-spirited way to address the issue 
of Alzheimer's disease.
  It is my honor to sponsor the measure, the Alzheimer's Accountability 
Act, with Representative Guthrie. Alzheimer's knows no boundaries--
political, geographic, age, whatever. It is so important for us to come 
together in a spirit of unity and support for the Alzheimer's 
community.
  Recently, I joined the many advocates that came to the Hill here in 
Washington from around the country. Around a thousand people gathered 
for a breakfast. I heard of folks being diagnosed in their twenties. I 
heard of a gentleman diagnosed in his thirties and who died in his 
forties. It seems to be penetrating deeper and deeper into the younger 
age category.
  So it is important for us to make an all-out effort to invest in 
research and respite care and all sorts of developments that respond to 
the individuals and families who live with Alzheimer's on a day-to-day 
basis.
  The Alzheimer's Accountability Act is, I think, is so sound an 
approach because it addresses a professionally inspired budget that 
will have the scientists, the clinicians, those most in the front lines 
of addressing Alzheimer's, and their patients, forecasting what the 
needs are. As you know, we have set up a national project that requires 
planning from now to the year 2025.
  I think what is so good about the measure introduced by 
Representative Guthrie and myself is that it will require this 
professional judgment that will name the pricetag for each year as we 
go to 2025. It won't be left to us as a political force, but rather to 
the clinical health care provider community that will have the best 
estimates of what is needed.
  As I gather at the town halls that we have so that we can know of the 
progress or lack thereof, you hear heart-wrenching stories. People tell 
you they go to work because their spouse is struggling with 
Alzheimer's. They search employment so as to pull themselves out of 
that day-to-day routine because it is wearing on their relationship. 
And they spend every dollar earned to go toward respite. But they do it 
to save their relationship.
  People have acknowledged to me that they mourn twice. First, when the 
diagnosis happens and they have lost their loved one somewhat. They 
lost their personality or whatever. And then they mourn again with the 
physical departure.
  And others have said to me--one who comes to mind, a high school 
buddy--My husband knows my voice; he doesn't know my name.
  It doesn't get more heart-wrenching than that.
  So this is an immediate need, a priority, an urgency. Let's go 
forward and let's in a bipartisan-spirited way, bicameral, and working 
with the executive branch, get it done. Let's make certain the planning 
is there, that the resources are there for research, for respite care, 
for the entire continuum of services that are required so as to address 
the dignity and deliver hope to the doorsteps of individuals and 
families who face this constant struggle, who live with it on a daily 
basis and who have really seen the entire persona be lost in their mid.
  So it is an honor to be on the floor this evening with both of you 
gentleman and to work with you in tandem, in partnership, in a spirited 
way to make things happen.
  Mr. GARAMENDI. Thank you very much, Mr. Tonko.
  I know Mr. Guthrie may have some additional remarks. We have got 
about 7 minutes. I am going to take maybe 3 minutes and talk about some 
of the legislation that is here. I am going to go through this very 
quickly.
  Mr. Markey, who is now a senator, introduced H.R. 1507 when he was 
here

[[Page H4682]]

in the House. This deals with the Social Security and Medicare 
diagnosis.
  Of course, we have the Accountability Act you have introduced, Mr. 
Guthrie.
  There is H.R. 489, the Global Alzheimer's Resolution. Next month is 
Global Alzheimer's Month. This will be part of that effort to talk 
about this issue around the world.
  We have H.R. 4543, the PACE Pilot Act, to keep elderly people in 
their homes, which was introduced by Chris Smith, who will join us the 
next time we come out on this issue.
  And also, H.R. 2975, the Alzheimer's Caregiver Support Act, was 
introduced by Representative Maxine Waters and, again, deals with the 
kind of support that you and Mr. Guthrie were talking about.
  One more. We have H.R. 2976, the Missing Alzheimer's Disease Patient 
Alert Program, dealing with the issue both of you have talked about 
with elderly or people with Alzheimer's that wander off.
  All of these are bipartisan pieces of legislation. All of them in one 
way or another deal with this problem.
  The one thing that is not among these is specific money for research, 
which I would hope comes from our efforts to talk about this and make 
this a major issue.
  Mr. Guthrie, I know you have some additional comments.
  Mr. GUTHRIE. I will just take a couple of minutes. Thank you for 
yielding.
  I thank Representative Tonko for cosponsoring and working on this 
legislation together.
  I will have to give also my sympathies to Ms. Slaughter. She took me 
in when I first got here. I know she is from upstate New York, but if 
you listen to her accent, it has got a little bit of Kentucky mountain 
in it.
  Mr. TONKO. More than a little.
  Mr. GUTHRIE. She is from our beloved mountains. We had that 
connection. She has been special to me. So my prayers are with her.
  The one thing I want to share, because we are short of time, is we 
are doing research into this. The Alzheimer's Association said by 2050, 
Alzheimer's disease will cost the Federal treasury a trillion dollars.
  So I remember thinking, Well, by 2050 my great grandkids would have 
to take care of that. Then I did the math. I am going to be 86 in 2050. 
So the generation that will be in that category is me. It is not some 
long-off issue. So my children will be dealing with it, as well as me 
and people my age.
  I am the end of the Baby Boom. I was born in 1964. So by the time I 
am 86, the entire Baby Boom will be older than me. At least my age, or 
older. And that will be not just a stress on the Federal budget, but as 
I said, the dignity of the person with the disease and the stress on 
the family dealing with the disease and the emotion of it is why it is 
so important.
  I saw it with my great uncle, with the early onset of Alzheimer's 
when I was a young boy and didn't quite understand what was going on. 
And later on in life, we figured out what was happening. Our whole 
family didn't really understand what was going on in the 1970s. But we 
do now. And I think it is something we need to put the efforts of both 
parties together on--as you see, we are standing here together--the 
effort to move forward. It is when my generation is retired, our 
children aren't going to be able to sustain it financially or 
emotionally. Therefore, it is something we need to do today.
  Mr. GARAMENDI. Mr. Tonko.
  Mr. TONKO. Representative Garamendi, as Representative Guthrie said, 
we are at the $200 billion-plus mark today. And the tragedy of the 
situation is that for every dollar spent on Alzheimer's today, less 
than a penny of every dollar is spent on research to find a cure.
  We have to do better than that. The hope and the miracle lies in 
research. We have trained clinicians, we have a medical community that 
is raring to go. We need to invest in a far more significant way. It 
was a message we heard from our advocates when they came to the Hill.
  Again, I think it goes without saying that we all commit to that 
research budget.
  So, again, it was an honor to join you this evening in this very 
special caucus.
  Mr. GARAMENDI. I would like to close with a statement of hope and a 
statement of opportunity. Here is what happens when you spend money on 
research and on treatment. Breast cancer is down 2 percent, as well as 
deaths from these other cancers. Prostate cancer is down, heart disease 
is down, stroke is down, and HIV has a 42 percent decline. That is what 
research and treatment will do.
  Alzheimer's is up 68 percent. That is what happens when you spend 
this kind of money.
  Cancer, over $5 billion a year. The result, a decline in cancer. HIV/
AIDS, almost $3 billion a year. You see the extraordinary success of 
that. Cardiovascular illnesses, $2 billion.
  Again, a decline in each and every one of these causes of death. With 
Alzheimer's, right around half a billion dollars. The result is this: 
increased deaths.
  So we have a way of answering this question of what to do with this, 
and that is turn our focus on the research and the care and the support 
for the families. That should be our watch word.
  I think that is a bipartisan way of going at this. That is something 
that we can focus on as 435 Members of this House and our colleagues 
over in the Senate. This is a bipartisan issue, a bicameral issue, with 
a known path to a solution.
  With that, we are out of time this evening. I want to thank my two 
colleagues in a bipartisan hour, my Republican colleague from Kentucky 
and my friend who is often on the floor with me, Mr. Tonko.
  We are going to come back and do this for another hour in the last 
half of the month of June. I know that there are several of our 
Republican colleagues that wanted to be here tonight. And I know the 
Democrats do, also. We will see if we can go move forward with a 
solution.
  Mr. Speaker, I yield back the balance of my time.

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