[Congressional Record (Bound Edition), Volume 149 (2003), Part 11]
[House]
[Page 15191]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           EXPANDING MEDICARE

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentleman from Illinois (Mr. Rush) is recognized for 5 minutes.
  Mr. RUSH. Mr. Speaker, today in the Committee on Energy and Commerce 
we are marking up the most critical expansion of Medicare since its 
inception 37 years ago.
  As you might have expected, Mr. Speaker, in my opinion, the bill is 
not perfect. It needs work. There are two amendments that I will 
introduce to strengthen the Medicare Prescription Drug and 
Modernization Act of 2003.
  My first amendment will ensure that diseases that disproportionately 
affect the African American community will be highlighted in the 
disease management component of the bill. The diseases that need to be 
highlighted include prostate and colon cancer, hypertension, and 
obesity.
  The current language in the chairman's mark does not include enough 
diseases that should be highlighted in the preventive care management 
portion of the bill. There is disease management capacity in the bill, 
and it requires preventive care in Medicare. So, in my opinion, 
Medicare must address the diseases that proportionately affect minority 
populations.
  We have to address a population who has been told that their life 
expectancy is 15 years lower than that of their white counterparts. 
African American men have a 34 percent greater chance of being 
diagnosed with prostate cancer and a 123 percent greater chance of 
dying from prostate cancer than white men.
  African Americans' overall cancer rate is 33 percent higher than for 
whites overall. The incidence of this disease among African American 
men is among the highest in the world. From 1973 to 1992, the rates of 
death from prostate cancer among African American men increased by 41 
percent. Blacks are more likely to get cancer and to die from this 
dreaded disease than other racial or ethnic groups.
  It should not be difficult to understand my insistence at this 
opportune time in the Committee on Energy and Commerce that we address 
this particular matter. It is my hope that seniors will become educated 
about what they can do to lower their risk for cancer.
  Medicare should serve as an educational vehicle. Seniors will learn 
how to eliminate stress, how to eat properly, and how to incorporate 
exercise in their lives. They must learn how they can lower their own 
risk and improve health care through their own behavior.
  My amendment also addresses preventive care for hypertension. 
Hypertension, Mr. Speaker, is a leading cause of stroke. I am sure that 
we all know people, loved ones, who live dramatically different lives 
following a massive stroke. I am sure that we know people who have lost 
their lives prematurely following a massive stroke.
  Whether the stroke impedes speech, or it requires that an amputation 
must take place, or just general paralysis is the prognosis, we must do 
what we can to curb the indicators for stroke.

                              {time}  1830

  Preventative care and hypertension is so critical to minorities in 
the Medicare population. In 2001, 2,500 African Americans died from 
stroke, the third leading cause of death for all racial and ethnic 
groups. African Americans were 40 percent more likely to die of strokes 
than whites in 2001, when differences in age distribution were taken 
into account.
  Mr. Speaker, the prevalence of high blood pressure in African 
Americans is among the highest in the world. That is why my amendment 
is so critical to ensure the longevity of African American lives.
  The final component of my amendment addresses the overarching 
impediment to good health, and that is obesity. Obesity is a trigger 
for both hypertension and cancer. We would be remiss not to address 
cancer and hypertension and neglect to draw the connection to a healthy 
diet and exercise. Therefore, we must examine the how and the why 
obesity is a trend in minority communities and among many minority 
populations.
  I can answer the how and the why partially from my own experience. As 
I drive around my own communities in my own district, I see a scarcity, 
Mr. Speaker, of places that have grocery stores that have fresh fruits 
and vegetables. In my community, in my district, there is an abundance 
of fast food restaurants, and the proliferation of these establishments 
and the lack of healthy food choices spell disaster for a healthy 
population and for healthy relationships with food and exercise.
  The bottom line, Mr. Speaker, is a serious Medicare program must 
provide a comprehensive preventative care program. This care must be 
multi-layered. It must address all diseases and, in the case of my 
amendment, must address diseases that are disproportionately killing 
people of color.
  My amendment would ensure that diseases that disproportionately 
affect the African American community will be highlighted in the 
disease management component of the Medicare modernization bill.

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