[Congressional Record Volume 162, Number 55 (Tuesday, April 12, 2016)]
[House]
[Pages H1630-H1632]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                        DEMENTIA AND ALZHEIMER'S

  The SPEAKER pro tempore (Mr. Bishop of Michigan). 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. Mr. Speaker, my colleague just finished a very good 
recitation of the problems of mental health. I am going to pick up 
another piece of this issue which has to do with dementia and 
Alzheimer's, which I believe the gentleman spoke to very briefly during 
his presentation.
  I thank him for his concern and for the work that he has been doing 
these many years on this profoundly important issue of brain health.
  My role tonight will be kind of working off the previous presentation 
and taking it just a little bit in a slightly different direction, and 
it has to do with dementia and Alzheimer's, which is obviously a rather 
important issue.

[[Page H1631]]

  I want to just put up a couple of placards here to try to demonstrate 
the overall nature of this problem. One way to look at it is just in 
terms of the numbers, and the numbers are staggering.
  The number of people: Right now in America, there are about 5.1 
million Americans with Alzheimer's. We expect that number to grow not 
just because the baby boomers are moving into their older years, but 
also because of the growth of the population and the increasing 
incidence of Alzheimer's.
  If you look at this chart, you can see it growing over the years so 
that, in about 2050, we expect to have 13,800,000 Americans with 
Alzheimer's. It is not just an issue with individuals who are 
suffering, whose lives are seriously disrupted. It is a serious issue 
for the financing of this Nation.
  If you look at this, you can see this line of growth in the number of 
Americans with Alzheimer's and you can see the ever-rising cost. These 
are not inflated numbers. These are constant dollars over the years.
  So when we reach 2050, not too many years from now, we are going to 
see an extraordinary expense of nearly three-quarters of a trillion 
dollars annually spent with the Medicare-Medicaid budget.
  Now, many, many people on this floor are concerned about deficits. We 
all are. The deficits are driven by many issues: the ever-increasing 
cost of programs, new programs, increasing military expenditures, the 
growth of Medicare, Social Security, and the like.
  Well, Alzheimer's is the single biggest budget issue within all of 
those programs. Under the Medicare-Medicaid programs, it is going to 
explode--you can see what we are looking at here--from $153 billion in 
2015 to three-quarters of a trillion, $735 billion, in the year 2050. 
This will bust the budget.
  Many of the deficits that we are so concerned about, in fact, that 
are in play today, as this House has been unable with our Republican 
majority to fashion a budget and all of the disruptions that that 
creates and then the ongoing appropriation process, which is delayed 
and made rather confusing as a result of not having a budget--inherent 
in that debate is the ever-increasing cost of Medicare and Medicaid.
  Well, why is it increasing? Well, largely it is increasing because of 
these types of illness, such as Alzheimer's. You can see here what we 
are looking at, almost a $30 billion increase in just the next 4 
years--or 3 years, actually.
  So no wonder we are unable to get control of our budgets and our 
appropriations here when we are faced with this inexorable increase in 
an illness that affects every family in America.
  It has affected my family. My mother-in-law spent the last 3 years of 
her life living with my wife Patty and I in our home where we took care 
of her. We were fortunate enough to be able to have a day nurse come 
in. But then in the early morning and on through the evening and night, 
my wife and I were responsible for caring for my mother-in-law.
  It was a duty that we found to be very worthwhile. It was a duty that 
brought our family together in close relationship as we watched this 
illness take hold of a lovely lady, a very smart, very capable woman 
who became ultimately an invalid and died of this disease.
  It is not unique. Millions of families across this Nation are taking 
care of their husband, wife, mother, father, and mother- or father-in-
law as Alzheimer's creeps into their family's life.
  Now, this problem can be addressed. We know there is a solution. This 
is not a hopeless case. Five years ago, if I were standing here, I 
would probably say that this is simply hopeless and we are going to be 
faced with these costs no matter what happens. That is not the case 
today, not at all, because today research is having an effect.
  Let me show you what research has done on other illnesses that plague 
Americans and, indeed, humans around the world:
  Breast cancer: Well, we have had an enormous increase in breast 
cancer research. We have seen a 2 percent decline in the number of 
deaths from breast cancer.
  Similarly, we have looked at other cancers, like prostate cancer, and 
we have seen an 11 percent decline in the deaths from prostate cancer.
  Heart disease: There is an enormous amount of money going into heart 
disease, less than for cancer, but, nonetheless, an enormous amount of 
money. We have seen a 14 percent decrease in deaths from heart disease 
as a result of treatments that are now available. Research money led to 
those treatments.
  Stroke: There is a 23 percent decline in the number of deaths from 
strokes. Again, research money into heart disease, into diseases of the 
circulatory system, have resulted in very, very significant decreases 
in the deaths.
  HIV/AIDS: Dramatic. There has been an enormous amount of money spent 
into research of HIV/AIDS. The result? There has been a 52 percent 
decrease in the deaths from HIV/AIDS.
  So we know that, if we spend money on research, we will see a decline 
in the death rate from those illnesses.
  Alzheimer's disease: In 2015, we spent just over 20 percent of the 
amount of money on researching Alzheimer's disease as we did on heart 
disease and on cancer. So don't be surprised with this chart.
  There is a 71 percent increase in the death rate from Alzheimer's. 
There is a relationship here. There is a relationship between the 
investment that we make in research and the resultant increase or 
decrease in the disease.
  In the case of cancer of nearly all kinds, we have seen a significant 
and, in many cases, dramatic decline in the death rate from those 
cancers.
  In the case of heart disease, similarly, money spent on research, on 
more effective treatments, and on drug treatments has resulted in a 
very significant decrease in strokes and other heart disease issues.
  HIV/AIDS is the most dramatic where, again, research is leading to 
better lives, longer lives, less death and less cost.
  Alzheimer's? No. No. In 2015, we spent just over $500 million.
  Is there a lesson for us here? You bet there is. Here is the lesson: 
You invest up front. You invest up front with research.
  I want to thank the President. I want to thank the Members of 
Congress and the Senate, who, in this current year's appropriation, 
2016, have added another $300 million to the Alzheimer's research 
program.
  Let me put another chart up here. Alzheimer's spending, research 
versus treatment: In 2015, Medicare and Medicaid will spend over 261 
times as much on treatment as the NIH will spend on research toward a 
cure.
  So, in 2015, a year ago, we spent $153 billion on treating--this is 
Medicare and Medicaid, not private insurance, not money out of 
individual pockets--we spent $153 billion of your Federal tax money on 
caring for Alzheimer's. That was 261 times the amount of money spent on 
research.

                              {time}  2045

  Now, let's see, let's be accurate here because we did have an 
increase, as I just said. We have actually spent $936 million in 2016 
on Alzheimer's research. So this 261 times is significantly less now. 
But we are not at the goal. We are not at the goal that we want to have 
in place for the treatment and the care of Alzheimer's.
  The goal of the Alzheimer's Association is to raise the amount of 
research money to the level of about $1.5 billion. It is anticipated--
and I will explain why this is a sound anticipation--it is anticipated 
that if we were to be able to spend that amount of money in 2017, 
keeping in mind that we are now just under a billion dollars for 
research, but if we bring it up another $500 million to $1.5 billion, 
if we were to do that, it is anticipated that by 2025--that is just 9 
years from now--we would see a dramatic change in the incidence of 
Alzheimer's.
  Many people would not be suffering from it, and those who do would 
see the onset of Alzheimer's pushed back into their later years so that 
they would be able to live a better, more sound, mentally sound life 
and more productive life and, for the taxpayers of this Nation, a 
significantly reduced amount of Federal support through Medicare and 
Medicaid.
  How much does it amount to?
  So if we spent that $936 million this year and in the next year ramp 
it up another 200 and in the following year another $300 million so 
that we get to the goal of $1.5 billion of research in the years 
between now and 2020, we would see a dramatic reduction and a

[[Page H1632]]

dramatic improvement in the lives of Americans, much better lives.
  If this were available to my mother-in-law, perhaps she would have 
been able to live another 2, 3, 5 years without the onset of 
Alzheimer's. And what would that mean to the quality of her life as 
well as to her family's?
  So let's assume that the research pushes back the onset of 
Alzheimer's by 5 years, so that in 2025 what would we see?
  Well, for Medicare and Medicaid, we would see in the years 2025 to 
2030 a 121-billion-dollar reduction in the cost to Medicare and 
Medicaid to your taxpayer dollars, and from 2025 to 2030--that is 10 
years of the new treatments being in place--we would see a half-
trillion-dollar reduction in the cost of Medicare and Medicaid.
  Now, this isn't pie in the sky. This isn't just wishful, hopeful 
thinking and a prayer and a song. This is a real possibility. Those of 
you who have been reading the press or listening to the television news 
programs over the last year, you will note a significant change from 
hopelessness to hope. Yes, hope. There is real hope that we will be 
able to attack this debilitating dementia Alzheimer's, that we will be 
able to delay the onset and quite possibly stop it, to cure it.
  Now, that may be off into the future, but we are now gaining an 
understanding because of the research that is being done on Alzheimer's 
and much of the research that was discussed earlier in the discussion 
of mental health programs and research that is going on by the United 
States military as they attack the problem of post-traumatic stress and 
brain damage from the men and women who have served in the recent wars.
  All of that research is coming together with an understanding of how 
the human brain works, what the elements are that cause the damage of 
mental health, schizophrenia, and post-traumatic stress, as well as 
brain damage, perhaps for the football players in the NFL and beyond.
  So here is what we are going to do. We are going to fight this year 
to increase this funding from beyond $236 million to just over $1 
billion. We know it is a tough budget year. We know that the 
Republicans have been unable to even come to grips to put together a 
budget, let alone increase the appropriations.
  But where could money be better spent than on research that is 
actually moving forward toward an understanding of what Alzheimer's is 
and how the brain is attacked, how we can stall--not yet reverse, but 
stall the onset of the damage that occurs as a result of Alzheimer's.
  We have seen it. You have seen the stories. We know that drug 
treatments that were once thought to be ineffective, treatments that 
were done in the mid-1990s didn't work, or so they thought. Then some 
statisticians looked at those results of those drug trials and noticed 
something really important. They noticed that while the overall program 
didn't seem to work, they noticed that there was a subset of patients 
who were being treated by that drug, and they noticed that that subset 
was the early onset of Alzheimer's, and what they noticed was that that 
drug seemed to push back, seemed to hold steady that onset of 
Alzheimer's. Whoa, it was a eureka moment that maybe using drugs of 
that type applied early in the process would result in the delay, the 
arresting of the Alzheimer's onset.
  That is what we are talking about here. If we are able to invest this 
money in research, we can see the probability that there are a series 
of drugs that do have an effect on the onset of Alzheimer's and seem to 
delay that onset.
  Each year that goes by, what is the effect for the individual, for 
the family of the individual?
  It means their life will be better. It means that the kind of stress, 
strain, and financial cost that is put on a family with Alzheimer's 
will be arrested. It will be delayed. Not 1 year, maybe 2 years, maybe 
3, maybe 5 years. And the cost is enormous.
  As I said before, if we are able to do this increased research over 
the next 3, 4, 5 years, working on those series of drugs that now seem 
to have an effect, we will be able in the years 2025 to 2030 to save 
you, the taxpayers, and us, the appropriators of your tax money, over 
$120 billion in the years 2025 to the year 2030. In 5 years beyond 
that, that 10-year period, a half trillion dollars.
  So if you are worried about the deficit--and we all are--if you are 
worried about how we are going to put together a 5-year budget, which 
is what we do, then look at this investment. If you are worried about 
the effect of Alzheimer's in your family or on yourself, there are 435 
of us in this House and another 100 over in the Senate. Listen, one-
third of us are likely to die of Alzheimer's in the years ahead. So if 
you don't care about the family, you don't care about Americans, care 
about yourself. One-third of us are destined. If you happen to be a 
female, the odds are even greater.

  So what is this all about?
  Well, we are somehow grappling with the budget, the 5-year budget. We 
can't seem to get it together. Enormous chaos on the side of my 
Republican colleagues about how to do it. The appropriation process is 
underway and totally stalled out until at least May 15.
  There is a solution. A small investment, a very small investment, and 
then we can look at the long-term deficit. Then we can be in a position 
to improve the lives of Americans.
  Oh, by the way, the money is available. The money is available. In 
the budget and in the appropriations we are putting together, we are 
ramping up so that over the next 20 years, 25 years, we are going to 
spend a trillion dollars--a trillion dollars--on a brand-new nuclear 
arms race. We are going to rebuild all of our nuclear bombs. We are 
going to develop new airplanes to deliver those bombs, new satellites, 
new rockets, new cruise missiles, new submarines. A trillion dollars.
  Well, I have got a better place to spend some of that money. I have 
got a better place to spend it, where the lives of Americans will be 
significantly improved, where the stress on families throughout this 
nation will be less, where the budgets of this country will not be 
busted, where this curve, where this curve will be flattened, where we 
will not in the year 2050 spend over a trillion dollars a year, a 
trillion dollars a year caring for people who have Alzheimer's. Three-
quarters of that money is your tax money.
  You can go back here, 2020, and start spending a couple of hundred 
million dollars, a couple of hundred million dollars on research, on 
promising treatments for Alzheimer's, and then beginning in 2025, watch 
this curve begin to flatten out.
  Now, for me and for many of us in this room, we are not going to be 
out here in 2025, but our children and grandchildren will be, and they 
will be caring for us unless we begin to make these investments now in 
research.
  So in the next couple of weeks, the men and women in purple will be 
here in Washington, D.C., as they do every spring, advocating for 
Alzheimer's research, for the caregivers, and for the families, and we 
ought to be paying attention.
  The money is in the budget somewhere. All we need to do is to find 
it, move it from a few nuclear weapons over to research, delay the 
expenditure of a new ballistic missile or intercontinental ballistic 
missile, and spend it on something that affects every American every 
day of this year and every day of the years in the future, and that is 
Alzheimer's.
  It is a good investment. It is an investment in the quality of life. 
It is an investment in our effort to reduce the deficit, and it is an 
investment in America's future.
  Mr. Speaker, I yield back the balance of my time.

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