[Congressional Record Volume 161, Number 96 (Tuesday, June 16, 2015)]
[House]
[Pages H4423-H4428]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                 ALZHEIMER'S AND BRAIN AWARENESS MONTH

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 6, 2015, the gentleman from California (Mr. Garamendi) is 
recognized for 60 minutes as the designee of the minority leader.
  Mr. GARAMENDI. Madam Speaker, for the next hour, we will be talking 
about an issue that really confronts every American family, an issue 
that

[[Page H4424]]

has brought devastation, fear, and sadness to virtually every family in 
this Nation.
  We are going to talk about dementia and Alzheimer's. We are going to 
talk about the way in which it literally tears families apart as their 
loved one's mind, recollections, and ability to handle their own 
affairs seems to dissipate.

                              {time}  1815

  This is an issue that currently confronts around 5 million Americans 
and their families. This is an issue that will grow exponentially over 
the next 25 to 30 years to the point where maybe 16 million American 
families are going to be affected by it.
  It is also an issue that we can deal with. It is an issue that we can 
see the cost. Let me put up this chart here, and we will talk about the 
cost of Alzheimer's quickly.
  It is a crisis that is growing rapidly, and it is resulting in 
extraordinary cost increases. If you look at 2015, on Medicare and 
Medicaid programs, the Federal Government will spend $153 billion on 
Alzheimer's. In 2020, it will grow to $182 billion. And then it is 
anticipated--as one of our colleagues spoke during a 1-minute speech--
that by 2050, it will grow to over $1 trillion. This is an issue for 
the Federal Government. It is an issue for every family.
  Let me put up another little chart here that really displays what an 
investment by the American people can do. If you take a look at the 
reasons why people die most commonly in the United States--breast 
cancer, prostate cancer, heart disease, stroke, HIV--you will notice 
that in every one of these, we have seen a decline in the mortality 
from these illnesses.
  Breast cancer declining just marginally. Prostate cancer, a 
significant decline of around 11 percent. Heart disease declined by 14 
percent; stroke by 21; and HIV, while still prevalent and still common, 
the death rate is down by more than 50 percent.
  This one over here is Alzheimer's disease; a 71 percent increase in 
the number of deaths due to Alzheimer's.
  My mother-in-law is in this statistic. She spent the last 2 years of 
her life living with my wife, Patty, and I in our home. We cared for 
her at night. We, fortunately, were able to have someone come in to 
help us during the day. And that is really the story of most 
Alzheimer's now. You are either in a nursing home or you are cared for 
in the home.
  So among those 5 million out there, there are families, like mine, 
that are caring as best they can in a very difficult situation. Ours, 
fortunately, was not so difficult. But, nonetheless, after two-plus 
years, my mother-in-law did die.
  So what can we do about it?
  I want to put up one more chart here, and then I want to turn to my 
colleagues. If you will remember on that chart I just put up, death 
rates are declining for cancer. There is a reason. And the reason is 
the annual expenditure for cancer research has been just under $5.5 
billion for the last few years. For HIV/AIDS, nearly $3 billion of 
research annually. Cardiovascular, heart disease, over $2 billion.
  Alzheimer's, while the death rate climbs, we are spending just over 
$566 million--not billion, million. So we shouldn't be surprised when 
we see this: declines in the cancer rates, deaths from cancer, stroke, 
heart disease, HIV. And then Alzheimer's.
  Mr. Speaker, $1 trillion will be spent in just 25 years on dealing 
with Alzheimer's, and some 16 million Americans will have that illness.
  Now there is good news. The good news just happened today, and I want 
to commend my Republican colleague Tom Cole from Oklahoma, chairman of 
the Appropriations Health and Human Services Subcommittee, who moved to 
increase Alzheimer's research from $566 million to almost $900 million.
  Go for it, Tom. You are the chairman of that subcommittee, and you 
are doing the right thing. You are doing the right thing by 5 million 
Americans who suffer from Alzheimer's today, and you are doing the 
right thing for their families.
  And I think House has the opportunity also to stand with Tom Cole and 
to do the right thing by Americans, and that is, increase this research 
funding.
  There are breakthroughs that are coming. If you read the articles, if 
you read the scientific journals, we are coming to an understanding of 
this very, very difficult disease for which there is no early 
detection, for which there is no cure, and for which there is only one 
exit, and that is death. So we can deal with this.
  The 535 of us, the Representatives of those 5 million Americans with 
Alzheimer's and their families, we can do something. We can increase 
the funding for research.
  Tonight I am joined by several of my colleagues.
  I yield to the gentlewoman from California (Ms. Maxine Waters) who 
carried legislation on this for years. She has been the co-chair of the 
Alzheimer's Caucus. If she will join us and share with us her work and 
what is happening from her perspective.
  Ms. MAXINE WATERS of California. Thank you so very much.
  Madam Speaker, I would like to thank my friend and colleague from 
California, Congressman John Garamendi, for yielding, and I commend him 
for organizing this Special Order on Alzheimer's disease in honor of 
the month of June, which is Alzheimer's and Brain Awareness Month.
  As the co-chair of the Congressional Task Force on Alzheimer's 
Disease, I know how devastating this disease can be for our patients, 
families, and caregivers. I am proud to lead the task force along with 
my co-chairs, Congressman Chris Smith, Congressman Michael Burgess, and 
Congressman Chaka Fattah.
  Alzheimer's is a tragic disease which has no effective treatment, no 
means of prevention, and no method for slowing progression of the 
disease. According to the Centers for Disease Control and Prevention, 5 
million Americans were living with Alzheimer's disease in 2013. This 
number is expected to almost triple to 14 million by the year 2050.
  The bipartisan supported National Plan to Address Alzheimer's Disease 
calls for a cure or an effective treatment for Alzheimer's by the year 
2025. Reaching this goal will require a significant increase in Federal 
funding for Alzheimer's research.
  I, therefore, introduced H.R. 237, a bipartisan resolution which 
calls for a significant increase in Alzheimer's research funding and 
declares that achieving the primary goal of the national plan--to 
prevent and effectively treat Alzheimer's by 2025--is an urgent 
national priority. A similar resolution was introduced in the Senate by 
Senator Susan Collins of Maine.

  I also circulated a letter to the House Appropriations Labor, Health 
and Human Services, Education, and Related Agencies Subcommittee 
requesting robust funding for Alzheimer's research at the National 
Institutes of Health in the coming fiscal year. The letter was signed 
by a bipartisan group of 63 Members of Congress. I was pleased to learn 
that the subcommittee recently proposed a $300 million increase for 
Alzheimer's research.
  As we pursue the goals of a cure for Alzheimer's, we must also do 
everything we can to assist the patients, families, and caregivers who 
are living with Alzheimer's every day. That is why I am introducing 
Alzheimer's Action Now, a set of bills that together will help 
Alzheimer's patients and their families; promote public awareness; and 
encourage voluntary contributions to research efforts. The various 
bills in the Alzheimer's Action Now address different challenges 
presented by Alzheimer's disease.
  The Alzheimer's Caregiver Support Act authorizes grants to public and 
nonprofit organizations to expand training and support services for 
families and caregivers of Alzheimer's patients. With the majority of 
Alzheimer's patients living at home, under the care of family and 
friends, it is important that we ensure these caregivers have access to 
the training and resources they need to provide effective, 
compassionate care.
  The Missing Alzheimer's Disease Patient Alert Program Reauthorization 
Act reauthorizes a Department of Justice program. It helps local 
communities and law enforcement officials quickly identify persons with 
Alzheimer's disease who wander away from their homes and reunite them 
with their families. This program saves law enforcement officials 
valuable time and allows them to focus on other security concerns. It 
also reduces injuries and deaths among Alzheimer's patients, and it 
brings peace of mind to their families.

[[Page H4425]]

  Finally, the Alzheimer's Disease Semipostal Stamp Act requires the 
U.S. Postal Service to issue and sell a semipostal stamp, with the 
proceeds helping to fund Alzheimer's research at NIH. This bill will 
raise public awareness and encourage concerned individuals to get 
involved and to make voluntary contributions to Alzheimer's research 
efforts. The bill is modeled on the popular and successful Breast 
Cancer Research semipostal stamp.
  Our Nation is at a crucial and critical crossroads. The situation 
requires decisive action to search for a cure and protect the millions 
of Americans currently living with Alzheimer's disease. Together, we 
must take every possible action to improve treatments for Alzheimer's 
patients, support caregivers, raise public awareness, and invest in 
research to find a cure for this dreadful disease.
  Once again, I can't say enough to thank John Garamendi, my colleague 
from California, with whom I have worked for many, many years, for, 
again, organizing yet another night's Special Order to bring attention 
to Alzheimer's disease.
  Mr. GARAMENDI. I thank the gentlewoman from California who has been a 
leader in this disease and dealing with the problems of it for many, 
many years. And your work Ms. Waters is paying off. The work that you 
have done organizing us, Members of Congress, to petition the 
subcommittee paid off--a 50 percent increase, a 50 percent increase, 
and I think it has got a good chance of staying in. This is really 
really good news and the rest of the legislation piece by piece we are 
going to get at this.
  I would like now to turn the time over to our colleague from New York 
Brian Higgins. We have spoken on this issue before. Mr. Higgins, thank 
you so very much. If you will share your thoughts with us on this 
disease and what we might do to deal with it.
  Mr. HIGGINS. I thank the gentleman from California and thank you for 
your leadership on this and so many issues that are of critical 
importance to our Nation and our future.
  June is Alzheimer's Brain and Awareness month. It is the sixth-
leading cause of death in this country. Over 5.3 million Americans are 
afflicted with Alzheimer's. By 2050, this number is expected to 
increase to 16 million. In my western New York community alone, 55,000 
people have Alzheimer's or related dementia, and 165,000 people in our 
community are impacted directly or indirectly. Alzheimer's will cost 
the Nation $226 billion this year. By the year 2050, these costs will 
rise to as high as $1.1 trillion. Last year, Congress passed a law, the 
Alzheimer's Accountability Act, which created a bypass budget for 
Alzheimer's research. This will allow the National Institutes of Health 
to prepare a budget that will reach the estimated goal of funding 
effective prevention and treatment for Alzheimer's by 2025.
  This year, I introduced with my colleagues Rosa DeLauro and Peter 
King the Accelerating Biomedical Research Act. Over the next 6 years, 
our legislation would provide an additional $50 billion in funding to 
the National Institutes of Health above what is currently budgeted. We 
also established the House NIH Caucus to rally Members to develop a 
plan to increase the purchasing power of NIH.

                              {time}  1830

  Mr. Speaker, Congress should also pass the HOPE for Alzheimer's Act, 
the Advancing Research for Neurological Diseases Act.
  Mr. Garamendi, again, thank you for your leadership. We obviously, as 
a Congress, have a long way to go. The origins of Alzheimer's disease 
are unknown, but its ends are absolutely certain, and it ends in losing 
your cognitive ability, your dignity, and then it takes your life. It 
is time that Congress, in a bipartisan effort, provide robust funding 
to Alzheimer's research to end this terrible, terrible disease for 
future generations.
  Mr. GARAMENDI. Mr. Higgins, thank you so very much. Your points are 
absolutely on target.
  This little chart here points out much of what you and Ms. Waters 
were talking about, and that is the extraordinary expense. This is 
2015. And we expect to spend $153 billion of Federal tax money, 
Medicare and Medicaid, on treating Alzheimer's. Way over, that little 
tiny purple spot, is the $566 million of research. It would be a little 
bigger if we were able to get that 300, but it is still going to pale 
in comparison to this. This is 261 times more money spent on treatment, 
which ultimately just enables the passage of time and leads to death 
because there is no effective treatment today. That is what we are 
spending on caring for people.
  That number down there, and the efforts and the bills that have been 
introduced and the Alzheimer's Foundation and others that are working 
on this have an opportunity to change this entire dynamic around 
because we can find the solution to this.
  I would like now to turn to my colleague, as part of what we often do 
here, we call it the ``East-West Show,'' my colleague from the great 
State of New York, Paul Tonko.
  Mr. TONKO. Thank you, Representative Garamendi, for bringing us 
together in this very Special Order as we discuss the impact of 
Alzheimer's upon the quality of life not only of the individual living 
with the disease, but on family members and loved ones that surround 
that individual. So much of the work that we do in this House, so much 
of the work done on the Hill here in Washington, needs to be guided by 
the moral compass.
  Our budget priorities should reflect who we are as a people and the 
compassion that is required as we see these numbers continually grow--
balloon--in terms of an impact on the budget. And that should challenge 
us to do all that we can to be not only compassionate, but to be 
effective when it comes to the fiscal impact of what is happening to 
far too many families across this country.
  It is a known fact now that Alzheimer's is the most expensive disease 
in America. That should strike home. That should call upon our hearts 
and our minds to respond with dignity and with effectiveness to the 
given issue at hand. Our efforts for Alzheimer's need to be enhanced. 
There is no mistaking it. This is the most expensive disease in 
America. It is impacting the budget here in Washington. Our national 
numbers are a challenge, and we need to address the budget not only in 
sound strategy for the present moment, but with preventative elements 
brought to bear.
  So when we look at the most recent data--and those data are very 
telling--for 2014, the calendar year of 2014, the numbers are there, 
and it will remind us that $214 billion was the need, the drawdown, for 
speaking to Alzheimer's, responding to the Alzheimer's situation. That 
is a large number that is only projected to grow exponentially. As more 
and more baby boomers ascend the age ladder, climb that ladder, we 
should only anticipate that doing what we are doing is not going to be 
enough, that research needs to take hold here.
  We have the intellectual capacity as a nation. We have resources at 
our fingertips, and the priority here for providing the preventative 
elements of research are important. The President has offered an 
initiative with the study of the mind, the brain, that can provide 
several opportunities. It can release the information, the 
documentation, that is required to move forward to find a cure for this 
ever-growing disease.
  Look at the stats. Representative Garamendi, when we look at the 
research moneys, for every $100 invested in those individuals and 
families that are impacted by Alzheimer's, 25 cents is spent on 
research--for every $100, 25 cents. That is a very minute amount of 
investment, investment that has an anticipated lucrative return, paying 
dividends for all of us to address a cure, a hope for individuals. This 
country requires our government to respond in full fashion so that 
public-private partnerships in research institutes like the NIH, the 
National Institutes of Health, are funded appropriately. Accordingly, 
with the data that have been assembled, knowing what needs to be done, 
we should go forward with those efforts.
  Now, I am reminded, Representative Garamendi, routinely by families--
and many women will draw that perspective for me, that of those who are 
living with Alzheimer's in this country, two-thirds--two-thirds--of the 
individuals living with Alzheimer's, or 3.2 million people, are women. 
This disease is

[[Page H4426]]

impacting women in a disproportionate measure.
  It is extracting from us all sorts of voluntary efforts that are 
required. Volunteers are responding as unpaid caregivers. We know the 
stats. The data are compelling: 15.5 million volunteers, caregivers, 
providing unpaid services, unpaid care, equaling 17.7 billion hours. 
These are staggering numbers, 15.5 million providing 17.7 billion. That 
amasses to $220.2 billion in terms of services provided, unpaid 
services provided.
  So it is not only costing the Federal Government money, projected to 
balloon heavily, but it is also extracting $220 billion worth of unpaid 
services that are provided to individuals by loved ones, by those 
concerned in their community, for the struggles that these individuals 
and their family members are facing. So this behooves us to do much 
better than we are doing.
  We are a compassionate society. We are unique. We have opportunities 
galore. I know what can happen. I have talked to our team in my 
district. Beth and the team from Alzheimer's Association of Northeast 
New York, they have done a tremendous job. I see what they do for 
respite care and what they are doing for services with the Alzheimer's 
Cafe, where people gather and cluster. They are given music therapy. 
There is an enhanced quality of life. It is with dignity that we 
respond. But more needs to be done, and there has to be that element 
that is provided out there that is speaking to prevention, that is 
speaking to a cure.

  So, Representative Garamendi, there is much to be done.
  I was lead Democrat on the Alzheimer's Accountability Act, which 
responded to the planning requirements that were earlier set up 
statutorily in this country. That act, the Alzheimer's Accountability 
Act, that passed successfully in both Houses and was signed into law by 
the President, requires that a professional judgment budget be put 
together. As was stated earlier on the floor, until 2025, there needs 
to be this commitment made for research for Alzheimer's and related 
diseases.
  But we furthered the quality of that legislation, of that statute, by 
requiring professionals to project the numbers that are needed. That is 
a very important element. Clinicians and professionals in the medical 
community will tell us, they will advise what that number ought to be. 
That is speaking with integrity, with the veracity that is required, 
with the dignity, and with the compassion that is so much required for 
the Alzheimer's community.
  So again, I thank you, Representative Garamendi, for having that 
heart, for leading us in this Special Order so as to comprehend what we 
need to do here, to move that moral compass, to be there for those 
individuals, to be there for those unpaid caregivers, and to be there 
for the research community, but most importantly, to be there for the 
soul that is struggling with Alzheimer's or dementia-related diseases. 
We are at our best when we connect emotionally so that we can put 
together the programmatic response and the intellectual response that 
enable us to provide that light at the end of the tunnel which is so 
important and so meaningful to the families that endure.
  I thank you, Representative Garamendi.
  Mr. GARAMENDI. Mr. Tonko, for more than 4 years now, you and I have 
stood on the floor on Special Order hour to talk about Make It In 
America, about the manufacturing system and about the jobs that we need 
to build, transportation infrastructure, and your passion for those 
subjects was so obvious. Your passion and your determination to deal 
with Alzheimer's and to find a cure, to find an understanding of what 
it is and how it affects the brain, and then also to reach out to the 
families that are caring for their loved ones really exceeds and 
mirrors the passion that you have for the working men and women of this 
Nation. I thank you.
  Mr. Speaker, I also want to thank the Alzheimer's Association. They 
organized a lobbying group through here very recently. They were 
wearing their purple ribbons, and they brought to us the stories, the 
individual stories that were of their families. I know that as I talked 
to my colleagues here on the floor and over in the Senate, I get the 
same thing from them: Yes, my mother, my aunt, my sister, my brother, 
they too have suffered from Alzheimer's, and they recently died, or 
they are in very serious condition.
  So we find this illness touching every family. I have yet to find a 
family that I have talked to about Alzheimer's that didn't nod their 
head in understanding: Yes, we know what it is.
  What Americans don't know is the information that you and my 
colleagues, Maxine Waters and Brian Higgins, brought to the floor 
today, and that is the facts, not only the impact that Alzheimer's has 
on the Federal budget--Medicare and Medicaid--the impact that it has on 
family budgets, on insurance, private insurance, but the impact that it 
has on families. You have made that clear.
  I think that the work that has been done by Alzheimer's Association 
and related organizations--Medicare, Social Security, and support 
groups all across this Nation--is having an impact. When a budget for 
any specific program is increased by 50 percent in this era of 
sequestration, something has had an impact. Mr. Cole, as chairman of 
that, and Ms. Waters, as the chairperson or the vice chair, co-chair of 
the Working Group on Alzheimer's, are having an impact.
  We can find a solution here. We can understand. We can do the early 
diagnosis. It is pretty clear there are some breakthroughs that are 
occurring.

                              {time}  1845

  There are certain drugs out there that seem to work if you can 
intervene early in the process. What a change that would be. What a 
change that would be for all families.
  This is not just an issue of Alzheimer's, this is an issue of the 
brain. We have got the U.S. military, the Department of Defense, doing 
significant research on brain injuries, brain trauma, and illnesses 
resulting from the wars--from traumatic brain syndrome and related.
  So if we pool together and we actually put into the Defense 
Authorization Act a paragraph that said: Research done by the 
Department of Defense on the brain, brain injuries, a way in which the 
brain works or doesn't work, they need to take that research and couple 
it with research that is taking place on dementia, on other kinds of 
neurological diseases, including Alzheimer's, and if we can pool all of 
these various research programs together and get them to share the 
information to fertilize each other's research, I think we are going to 
succeed.
  That 2025 goal I think is too far out there. I see we are on the cusp 
of a breakthrough. And if we can push all of the research and focus it 
and, like a dart, hit the center of the target, I think we are going to 
be successful.
  Mr. Tonko, would you like to join in here?
  Mr. TONKO. Absolutely.
  Representative Garamendi, it only takes one visit, but there have 
been many visits that I have made to the centers, the day care center 
operations that are conducted for individuals and families who are 
living with Alzheimer's, and to witness and hear the hurt, the 
confusion, the pain that surrounds the individual. It is enough 
challenge to try and get this done in as quick a fashion as possible.
  But if that doesn't move us, the economics on this. You know, we 
earlier talked about the $214 billion impact in 1 year--some of our 
most recent data. Well, that is 1 in every 5 Medicare dollars. How much 
are we willing to have that take over the Medicare expenditures before 
we come to our senses to say, let's do more in research, let's do a 
preventive response? Does it need to grow that much more? Does the 
drain on Medicare, does the reflection of Alzheimer's-related Medicare 
expenditures need to be that much greater to bring us to a response? 
The challenges are there, the data are there. We need to move 
accordingly.
  Now, earlier, I had expressed that two-thirds of the people living 
with Alzheimer's, the 3.2 million people, happen to be women. Well, 60 
percent of the unpaid caregivers happen to be women. So there needs to 
be a response here to enable people to be addressed with a sense of 
compassion, with dignity brought into the equation. It is absolutely 
essential.
  And when we talk about those caregivers and the $220.2 billion that 
is the calculation for the volunteerism they offer as caregivers, of 
that community of caregivers, they have been worn

[[Page H4427]]

down physically. So the price tag for them is an additional $9.3 
billion in terms of response to their physical health care needs. This 
is a drain on families, on loved ones. It is an undignified outcome for 
far too many Alzheimer's patients who require our support, who have 
earned the respect of this body and Congress moving to provide for 
research opportunities.
  Now, one other effort that I am making now in the aftermath of the 
Alzheimer's Accountability Act, that victory being behind us now, I 
have now served as the lead Democrat on the HOPE for Alzheimer's Act, 
which would authorize Medicare investment in sound planning upon 
diagnosis of Alzheimer's so that individuals and their families who are 
so diagnosed can sit down and plan accordingly for their care, for 
their treatment, for their needs.
  That is an important bit of quality that can be introduced for the 
individual and her or his family so that their life, already severely 
impacted by this outcome, can be as manageable as possible. And we are 
hopeful with some 183 cosponsors of a bipartisan nature who have come 
forward to say, Sign me up for the HOPE for Alzheimer's Act.
  So isn't that what we are supposed to be? Aren't we those agents of 
hope? Do we walk away from this dilemma? Do we walk away from this 
need? Do we walk away from the struggle, the pain, the hurt, the 
confusion that people live with every waking hour of every day? Or do 
we respond in that all-American fashion and say, yeah, we have the 
intellectual capacity as a Nation; yes, we have the resources.
  It is an order of prioritization. And that priority here needs to be 
a response, a full-fledged response, a compassionate response, a loving 
response coming from us as individuals and collectively as Congress to 
say, yes, we support these efforts that are required, that are 
possible. Do not deny the possibilities. Let us go forward and be those 
sound decisionmakers who understand that this issue, when addressed 
accordingly, with human compassion offered, with the humanization of 
this process, we are then offering a cost-effective outcome. A study of 
the brain initiative that the President has advanced should be 
supported.
  These resources that are required for planning, for research, for 
services, for respite need to be funded accordingly. It is within our 
grasp, and it makes sense to do so.
  So, Representative Garamendi, I thank you for leading us in this 
Special Order, which is absolutely key to public information exchange.
  For those who may be viewing, I would suggest that you contact those 
of us who serve you in Washington and let us know that you want this to 
be a priority. Tell us you believe in the research capacity of this 
country. Tell us you want to humanize that response, more deeply 
respond to the individuals and families that are so impacted.
  When we hit so many people, when we see the millions who are living 
with this disease, we can't escape that impact falling upon us. 
Neighbors, family members, friends who we know are living with this 
disease require our attention, require our responsiveness.
  So I thank you for leading us in what is a very valuable discussion.
  Mr. GARAMENDI. Mr. Tonko, thank you for your leadership. Thank you 
for rounding up 180-plus Members of this House. On any issue that is 
tough, but then having them sign on to a piece of legislation that 
would advance the care that individuals receive and the support that 
families need.
  The cure for Alzheimer's, all of those pieces of legislation, which 
Ms. Waters talked about, those are all pieces of the puzzle. And they 
deal with--I am going to end with just two charts, so it is really 
where I started. This is a different version of one of the charts that 
deals with the costs that we are talking about. These are the total 
cost in the system. If you take a look at it, 2015, you are talking 
about a quarter of a billion dollars, just under $226 billion, of which 
the great majority is Medicare and Medicaid, and then out-of-pocket and 
other payers, or the other insurance companies. It will rise each year 
until we get to 2050, which is not that far away. Thirty-five years out 
we will be well over $1 trillion, of which we will bust the bank, the 
Medicare.

  There is a lot of discussion around here about the deficit. The real 
factors in the deficit are this health care issue. That is where we are 
going to find the budget deficit.
  But we have already seen through the Affordable Care Act that the 
projected increases for Medicare have substantially reduced over the 
last 4 years as the Affordable Care Act is providing early diagnosis of 
heart disease, diabetes, other kinds of long-term illnesses that are 
really where most of the expense in Medicare and Medicaid occur. And if 
we can get a grip on Alzheimer's, if we can find a way of delaying the 
onset of it, we are going to save tens and, indeed, hundreds of 
billions of dollars over the passage of time.
  And the next step is the cure. So they think, the researchers, think 
they can find a way of delaying the onset. As they do that, they will 
also find a way of dealing with the disease itself. Then this awesome 
and horrific expense will be reduced.
  There is one other chart.
  Mr. TONKO. Will the gentleman yield?
  Mr. GARAMENDI. I yield to the gentleman from New York.
  Mr. TONKO. That chart is very powerful. The trillions--with a T--will 
really balloon our budget, and really it is undoable. It gets to a 
level where it will exhaust, it will overwhelm other areas of 
investment that are required.
  But translate that from dollars into human suffering, pain, 
confusion, reduced quality of life. That is a calculus that needs to be 
made. If it is going to save us money and at the same time respond with 
that moral compass, why are we not doing that, why are we not 
responding?
  So, to me, that is where we are at. When you see the unleashing of 
technology, of research, of the potential for progress to be made, it 
is there. It is documented from so many perspectives in work that is 
done by the National Institutes of Health and others. For many, they 
will say, well, leave it to the private sector. No, there is a track 
record up there for this country to have stepped up to the plate and 
made a difference, for vaccines and other sought-for outcomes that 
affected people in a positive way. They gave them hope.
  Our government has a track record of having stepped up and invested 
in research where perhaps the private sector wouldn't go or where we 
have shaved some of the risk off of that demand for research in a 
public-private partnership. So it is there within our potential. We 
should not deny our loved ones, our constituents, our country the 
opportunity to advance the cause of research and to respond again with 
a sense of hope for those who are living with this within this 
darkness. We can and we must do better.
  I am happy to work with individuals like Representative Garamendi to 
push to make a difference and to be there in a responsive manner, and I 
thank you.
  Mr. GARAMENDI. Mr. Tonko, you continually come back to the compassion 
and caregiving that I think each human being has somewhere in them. For 
us here in Congress, it is to express that in a meaningful way. That 
meaningful way is to make sure there is support for those families and 
individuals who have Alzheimer's, those who are caring for them, to 
make sure that the medical treatment, such as it is for this illness, 
is available, and to pursue vigorously the research that could and, I 
believe, will lead to a complete understanding of the illness. That is 
our task.
  Mr. Tonko.
  Mr. TONKO. And as we are concluding here, I was just bringing to mind 
one of the Alzheimer's town halls that we are required to conduct, and 
it told me a few things: that this disease is percolating lower and 
lower into the age demographics.
  Mr. GARAMENDI. Yes, it is.

                              {time}  1900

  Mr. TONKO. So it may be--I am just guessing here--that it is more 
than just genetics. It may be environmental in its impact or cause. 
Whatever it is, let's go for that cause.
  At one of these townhalls, a contemporary of mine whom I have known 
for a long time, as I have known her husband for a long time, said: 
``My husband knows my voice, but he doesn't know my name.''
  How do we not say ``yes'' to research? How do we not say we want to 
do all that we can to make a difference?

[[Page H4428]]

  When we do so, we are going to save our budget. We are going to save 
our budget a great number of consequences by being that powerful force 
that will do things academically, soundly, wisely, effectively, 
efficiently.
  That is what this business is about, a thoughtful response, a 
heartfelt response that, by the way, is the budgetwise thing to do.
  Let us respond as a government, as a nation.
  Mr. GARAMENDI. Mr. Tonko, thank you so very much.
  Mr. Speaker, I think we will end there and simply say that this is 
not the last time that we will be speaking on this issue on the floor.
  I would hope the next time that we speak on this issue that the House 
of Representatives will have increased the research budget by 50 
percent, from $566 million to close to $900 million. That is a big 
leap. It is not sufficient. It is not what is necessary to really get 
at this disease, but this is one we can tackle. This is one we have to 
tackle for the strength of the American Government budget. It is one we 
have to tackle.
  This is where you have been with this entire discussion, Mr. Tonko. 
This is about families. It is about individuals. It is about the 
suffering, the angst, and the fear that exists out there with this 
devastating disease. We can do this. We really can.
  My message to the American people is one that you put out a few 
moments ago, Mr. Tonko. That is, for anybody who is watching out there, 
for anybody who is interested in the Federal deficit, for anybody who 
is interested in the quality of life of their families as they age and 
even before they age, talk to us.
  Tell us that you want us to spend your tax money on solving this 
problem, on the research that will lead to the solution for what is now 
an unsolvable mystery.
  Mr. Speaker, I yield back the balance of my time.

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