[Congressional Record (Bound Edition), Volume 145 (1999), Part 11]
[House]
[Page 16331]
[From the U.S. Government Publishing Office, www.gpo.gov]



     CONGRATULATIONS TO THE PRESIDENT FOR MEDICARE PREVENTIVE CARE 
            PROPOSALS: CONGRESS SHOULD ENACT THEM THIS YEAR

                                 ______
                                 

                        HON. FORTNEY PETE STARK

                             of california

                    in the house of representatives

                        Thursday, July 15, 1999

  Mr. STARK. Mr. Speaker, I rise today in strong support of enhancing 
the preventive benefits available in the Medicare program. The 
President's Medicare reform plan has taken a step in the right 
direction by eliminating cost sharing on preventive services. This will 
encourage more beneficiaries to seek out mammography and other valuable 
screening tests. Let's continue this work by encouraging outreach 
efforts targeting preventive care.
  The number don't lie. Prevention saves lives. The Centers for Disease 
Control and Prevention has stated that ``our country cannot decrease 
its enormous healthcare costs, much less its priority health problems, 
without addressing in a fundamentally more aggressive manner, the 
prevention of chronic disease.'' (Unrealized Prevention Opportunities; 
Reducing the Health and Economic Burden of Chronic Disease, CDC 
Publication March, 1997)
  The most preventable cause of death in our society is tobacco use. 
Although we hope to target new initiatives for preventing tobacco use 
primarily to children and adolescents, a lot can be accomplished with 
smoking cessation efforts in the senior population. The President's 
decision to include such programs in his reform plan makes good sense. 
Studies have shown that health risks attributable to smoking decrease 
significantly within a few years after quitting, regardless of age. 
Tobacco use costs the nation $50 billion annually, in medical expenses 
alone. Smoking cessation efforts can help to reduce this immense burden 
on the health care system.
  With most chronic diseases, early detection is the key to successful 
treatment. Early detection also has the potential to save money. For 
example, treatment costs for breast cancer diagnosed in the localized 
stage are as much as 32 percent lower than treatment costs for later 
state diagnosis. Regular screening can detect cancers of the breast, 
colon, cervix, among others, at early stages. Currently, about 66 
percent of people with these cancers survive for more than 5 years. 
With improved early detection efforts, about 95 percent or an 
additional 115,000 people would survive for 5 years or more. You can't 
put a price tag on that.
  In the case of diabetes, the CDC has found that enhanced prevention 
could save the Medicare program nearly a billion dollars per year. For 
example, if all people with diabetes received recommended eye disease 
screening and followup, the annual savings to the federal budget could 
exceed $470 million. Second, over half of the 57,000 lower extremity 
amputations associated with diabetes could be prevented. These 
preventable amputations currently cost $285 million annually.
  Finally, at least half of the 19,000 new cases of diabetes related 
kidney disease could be prevented. These preventable cases cost over 
$350 million annually.
  Prevention makes good sense in terms of both human and monetary 
costs. To not support the prevention of chronic diseases is to turn our 
backs on addressing the major health issue of our time.

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