[Congressional Record (Bound Edition), Volume 155 (2009), Part 19]
[House]
[Pages 25549-25550]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           ASTHMA IN AMERICA

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentleman from Wisconsin (Mr. Kagen) is recognized for 5 minutes.
  Mr. KAGEN. Mr. Speaker, I appreciate having the opportunity to review 
with the Members of the House, and also with other people watching, one 
of the most important ailments of the country, and that is there is 
today an asthma epidemic all across these United States. The rate of 
asthma in terms of its incidence of morbidity and mortality has been 
increasing each and every year.
  What we find here today is asthma in America has some numbers we all 
need to be aware of: 22 million people here in these United States 
suffer from symptoms of asthma. There are 4,000 deaths every year from 
people who have asthma that's totally out of control, undermedicated 
and undercared for. Too often today, patients will suffer from allergic 
reactions not just in the nose and the sinuses, which we call hay fever 
or allergic rhinitis, but also in the lungs, where we call it asthma, 
for asthma is nothing more than an allergic reaction within the lungs.
  $20 billion is what we spend every year treating and diagnosing this 
condition. We can and must do better. In terms of lost days of work, 
over 10 million days are lost because people are ill with their asthma 
symptoms, and 13 million school days are lost each and every year 
because children are underdiagnosed and undertreated with this 
important condition. We can and we must do better, and one way to do 
that is to guarantee that patients receive an accurate diagnosis.
  Recently, in the health care debate here in the House, much attention 
has been paid to primary care or to the medical home model where every 
citizen in the country would have a primary care physician to go to to 
receive their medical care, not just for themselves, but for members of 
their family as well.
  So how well are the primary care doctors doing when taking care of 
these asthma patients? In a number of double-blind crossover control 
studies, we find that asthma specialists have been delivering higher 
quality and lower costs to the care of these asthmatic patients. There 
has been a documented 95 percent reduction in hospitalization when 
taking patients once hospitalized with asthma and then following the 
patients, whether they are referred to primary care or to an asthma 
specialist. There has been a 95 percent reduction in hospitalization, a 
77 percent reduction in visits to an emergency room, and a 77 percent 
reduction in days missed from work.
  Clearly, the evidence reveals that specialty care for the diagnosis, 
treatment and management of this chronic and often fatal disease is 
best handled

[[Page 25550]]

by those who are specialists in the area. These facts have to be 
considered as we consider legislation that would compress people and, 
not force people, but guide them into primary care versus specialty 
care.
  Throughout the country, specialists and primary care physicians have 
been working hand in hand and need to collaborate and cooperate when 
caring for patients, not just with asthma, but with all sorts of 
medical ailments.
  And now that we are on the subject of health care reform, there are 
three essential elements that must be in a piece of legislation to pass 
this House and the Senate and to be signed by the President. They 
include not only no discrimination against any citizen due to 
preexisting conditions, but also transparency in the medical 
marketplace where every entity, every individual or business entity, 
that offers medical products or services for sale to the public should 
at all times openly disclose all of their prices and guarantee that 
everyone has an opportunity to know the price of a pill before they 
swallow it and to guarantee that everybody knows the price of a chest x 
ray or any other medical procedure before they actually have that 
procedure done.
  Transparency, that sunshine that's needed to help create a medical 
marketplace, is critically important. No discrimination against any 
citizen and complete transparency will help create that medical 
marketplace.
  But we also need to develop a standard health benefit plan, one that 
will guarantee that if you are sick and covered by that standard 
benefit plan, you'll be in your house, not the poorhouse, a standard 
plan that each and every insurance company must offer to every citizen 
within regional markets to guarantee that a marketplace creates that 
competition to drive down prices immediately, not in 2013, but in early 
2010.
  Asthma is an important condition. It's a very common condition, best 
managed by specialists who cooperate collaboratively with primary care 
physicians.
  As we go forward to reform our health care system, I hope that the 
House leadership will understand how important it is to collaborate 
between primary care and specialty care and to guarantee that no 
discrimination, complete transparency in medical pricing, and the 
standard health benefit plan will exist in our legislation.

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