[Congressional Record (Bound Edition), Volume 163 (2017), Part 4]
[House]
[Pages 4987-4992]
[From the U.S. Government Publishing Office, www.gpo.gov]




                         ALZHEIMER'S IN AMERICA

  The SPEAKER pro tempore (Mr. Smucker). Under the Speaker's announced 
policy of January 3, 2017, the gentleman from California (Mr. 
Garamendi) is recognized for 60 minutes as the designee of the minority 
leader.
  Mr. GARAMENDI. Mr. Speaker, we are going to talk about our health, 
not about last week's legislation and the effort to change the 
Affordable Care Act but rather about another part of the health of the 
American public.
  The most remarkable proposal came from the President recently in his 
budget proposals.

                              {time}  1815

  I know that when I saw what he was proposing, I am thinking: You have 
got to be kidding. He is proposing a $5.6 billion reduction in the 
National Institutes of Health's research programs.
  I want to just take a second here and draw your attention to what 
research really means.
  The National Institutes of Health is the principal research arm for 
healthcare issues throughout the United States. Over the years, we have 
spent very large amounts of taxpayer dollars dealing with health issues 
in the United States. The result of those research efforts, together 
with the implementation, has resulted in breast cancer deaths dropping, 
between 2000 and 2013, by 2 percent, prostate cancer deaths down 11 
percent, heart disease down 14 percent, stroke down 23 percent, HIV/
AIDS down 52 percent.
  Research pays in better lives, in people living longer and the 
quality of their life. And yet this 18 percent reduction that has been 
proposed by the President in the basic funding for medical research 
here in the United States goes directly against these very important 
and very impressive changes in the statistics about mortality--HIV/
AIDS, 52 percent.
  Now, it is not all research, but it begins with research. It is 
unconscionable that such a proposal would be brought to the House of 
Representatives.
  We are going to go beyond these success stories, and we are going to 
talk about this purple line here. The deaths from Alzheimer's have 
actually increased by 71 percent in the same 13-year period, in part 
due to the fact that the population, the baby boomers and those that 
preceded them, grow old; and that is where Alzheimer's occurs, in the 
older age groups.
  So what is the research funding here on Alzheimer's? Well, not so 
good.
  But before I go to that, I just want to take one moment and draw your 
attention to this little chart. This is the funding level for the 
National Institutes of Health's projected budget: $31.7 billion. The 
scientists, the researchers out there said that that is underfunding 
not from their wish list, but from viable, credible research programs 
that can't be paid for because they have run out of money. So they have 
suggested that the budget should be somewhere around $35 billion.
  So what does the President propose? Well, he proposes, instead of 
going up, going down to $25 billion or just close to $26 billion, $5.6 
billion less.
  The result is that this is not going to come down. We are going to 
talk about this for the next hour, about research, about the National 
Institutes of Health, about what it means to your life, to my life, to 
my colleagues' lives, to be able to extend our lives, whether it might 
be prostate cancer, heart disease, stroke, HIV, or Alzheimer's. It is a 
fact that, if we are to increase the research in this area, which, 
until just last year, was just over $500 million, we can see this begin 
to change.
  Joining me today are my colleagues from around the United States. I 
was looking for a more senior Member from California, Maxine Waters, 
who is the co-chair of the Alzheimer's Caucus. She is not here, so I am 
going to go to our next more senior Member, Mr. Cohen from the great 
State of Tennessee.
  I yield to the gentleman from Tennessee.
  Mr. COHEN. Mr. Speaker, I am pleased to join you today in this 1-hour 
session.
  I am the co-chair of the Medical Research Caucus. As the co-chair, I 
am most aware of the need for research and how much it has helped our 
country and how much it has helped many cities and universities in 
their efforts to save us.
  For a long time, I have realized that my enemy--and I am not 
suggesting to anybody, or I don't want anybody to get the wrong 
impression that I don't think that we need a military, and a strong 
military, but I have known that the odds of me dying from something 
that happens initiated by North Korea or Iran or ISIS is about nil. But 
I also know that the odds of my dying from heart disease, stroke, 
diabetes, Alzheimer's, cancer is likely. So my enemy is disease.
  And who is working to protect me and be my defense department? The 
National Institutes of Health. That is my defense department. That is 
all of America's defense department, for we all have, as an enemy, 
disease. Cures and treatments will be found through grants and research 
coordinated through the National Institutes of Health.
  Francis Collins, the genius who is the Director of the NIH, is really 
our secretary of defense because he is fighting to find cures and 
treatments not just for us, but more so for the next generation and the 
next generation.
  So it is a perfect situation for us to act to protect our 
constituents against their most serious enemy, and that is disease, and 
to protect them no matter how we fund it. For the deficit hawks who 
might suggest that some of the expenses be paid for by future 
generations, that is who is going to get the treatments and the cures, 
and people not even born yet.
  In 1954, my father was a pediatrician, and he gave the Salk vaccine 
to second grade children for polio. He didn't give it to me in the fall 
of 1954 or the spring of 1954 because that wasn't his charge; it was to 
give it to second graders in a test of the Salk vaccine.
  I came down with polio in September of 1954. And but for medical 
research not being a year earlier when the Salk vaccine became 
available to everyone in the spring of 1955, I would not have had 
polio.
  It affected me as a young person. I spent 3 months in a hospital, 
lots of time with physical therapists, had surgeries, and today wear a 
brace because, without it, I wouldn't be standing here.
  My future, I am not sure what it will be, but it would have been a 
lot better if we had the Salk vaccine a year earlier. For every cure 
and treatment that comes a little later and a little later are that 
many more people that will suffer from it.
  So this nearly $6 billion cut is going to affect people's lives in a 
meaningful way. For that reason, I am proud to join Mr. Garamendi and 
my other colleagues here to oppose this $6 billion cut and also to 
advocate for increases

[[Page 4988]]

in funding to the National Institutes of Health, our real defense 
department fighting for all Americans against the number one enemy we 
all have, which is catastrophic illnesses and diseases.
  Mr. GARAMENDI. Thank you so very much, Mr. Cohen, for your personal 
story and the effect of research not being available to you in your 
early childhood and the result of that. We know that all across the 
United States there are issues that are out there. Certainly 
Alzheimer's, which is our principal subject matter today, together with 
the cuts in the National Institutes of Health budget, but also there is 
this thing called Zika. That is out there, and the research for that, 
is that going to be forthcoming or is that also going to be cut?
  I noticed that our co-chair of the Alzheimer's Caucus is here. Ms. 
Waters, if you would like to join us, the gentlewoman from the State of 
California with whom I have been able to work now for, well, just a few 
years, dating back to our time in the California Legislature. I yield 
to the gentlewoman.
  Ms. MAXINE WATERS of California. I would like very much to thank my 
friend and colleague from California, Congressman John Garamendi, for 
the time, and I commend him for organizing this Special Order on 
Alzheimer's disease. It is fitting and appropriate that we would be 
holding this Special Order hour this evening prior to the National 
Alzheimer's Dinner, which will take place tonight.
  The National Alzheimer's Dinner is an annual event, organized by the 
Alzheimer's Association, that brings together staff, policymakers, 
advocates, and families impacted by Alzheimer's disease from across the 
country.
  As the co-chair of the bipartisan Congressional Task Force on 
Alzheimer's Disease, I know how devastating this disease can be for 
patients, families, and caregivers. I am proud to lead the task force 
along with my co-chair, Congressman Chris Smith.
  Alzheimer's is a tragic disease affecting millions of Americans and 
has reached crisis proportions. There is no effective treatment, no 
means of prevention, and no method for slowing the progression of the 
disease.
  According to the Centers for Disease Control and Prevention, that is 
the CDC, 5 million Americans were living with Alzheimer's disease in 
the year 2013. This number is expected to almost triple to 14 million 
by the year 2050.
  Alzheimer's is the sixth leading cause of death in the United States. 
In 2017, the direct cost of care for Alzheimer's disease and other 
dementias is expected to hit $259 billion, with 67 percent of those 
costs paid for by Medicare or Medicaid.
  Alzheimer's disease and related dementias will increase exponentially 
as the baby boom generation ages. At the current rate, the cost of 
Alzheimer's will reach $1.1 trillion in 2050. We must act now to change 
the trajectory of this disease.
  The 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.
  Fortunately, Alzheimer's research did receive a substantial increase 
in Federal funding in fiscal year 2016. Congress allocated $936 million 
for Alzheimer's research at NIH in funding year 2016, an increase of 
$350 million over the 2015 level. But that is still far less than what 
is needed to confront the challenges we face.
  In March of last year, I wrote a letter to the House Appropriations 
Committee requesting an additional $500 million increase in funding for 
Alzheimer's research, for a total appropriation of almost $1.5 billion 
in funding year 2017. The letter was signed by a bipartisan group of 74 
Members of Congress, including myself, co-chair Chris Smith, and one of 
the greatest advocates on behalf of Alzheimer's patients not only in 
the Congress of the United States, but even before he came here, 
Congressman Garamendi.
  Last summer, the Senate Appropriations Committee passed its version 
of the funding year 2017 Labor, Health and Human Services, Education 
Appropriations bill and provided a $400 million increase in funding for 
Alzheimer's research at NIH, for a total appropriation of $1.39 billion 
in funding year 2017.
  Meanwhile, the House Labor, HHS, Education Appropriations 
Subcommittee passed this bill for funding year 2017 on June 17. The 
House bill provided a $300 million increase in Alzheimer's research.
  Unfortunately, Congress still has not finished its work on funding 
the year 2017 budget, so we don't know how much funding Alzheimer's 
research or any other program, for that matter, will receive this year.
  At the same time, Congress has already begun consideration of year 
2018 funding levels. I am once again circulating a letter to the House 
Appropriations Committee leaders requesting robust funding for 
Alzheimer's research.
  This year my letter requests a $414 million increase in funding for 
Alzheimer's research in fiscal year 2018 above the level included in 
the funding year 2017 Senate bill. That would be a total appropriation 
of more than $1.8 billion for Alzheimer's research in funding year 
2018.
  Although this letter just started circulating, more than 25 Members 
of Congress have already signed this letter, of course led by Co-Chairs 
Chris Smith and Congressman Garamendi and myself.

                              {time}  1830

  I am also circulating a letter to House Committee on Appropriations 
leaders in support of a program to address the problem of wandering 
among Alzheimer's patients. This program helps local communities and 
law enforcement officials quickly find persons with Alzheimer's disease 
who wander away from their homes and reunite them with their families.
  The majority of American Alzheimer's patients live at home under the 
care of family and friends. According to the Alzheimer's Association, 
more than 60 percent of Alzheimer's patients are likely to wander away 
from home. Wanderers are vulnerable to dehydration, weather conditions, 
traffic hazards, and individuals who prey on seniors.
  Let me just continue my remarks by thanking all of the Members of 
Congress who are signing letters, who are focused on this, who 
understand what is going on. I would like to thank the gentleman from 
New Jersey (Mr. Smith) and the gentleman from California (Mr. 
Garamendi) for their leadership and all the work that they have done 
educating the Members and helping to give exposure to what we need to 
do.
  Mr. GARAMENDI. Mr. Speaker, I appreciate the leadership of Ms. 
Waters. It goes on for many years in this particular area and beyond.
  Progress can be made. I am just going to take 2 seconds here to show 
the funding levels for cancer, almost $5\1/2\ billion; HIV/AIDS, almost 
$3 billion; cardiovascular, $2 billion. This is 1 year out of date.
  Because of the work of Congress and the leadership of Chris Smith 
from the Republican side and Ms. Waters from the Democratic side, plus 
many Members, this number is not 560; it is just under a billion 
dollars now. We need more, and we need to get at it soon.
  Mr. Speaker, I yield to the gentleman from the southern part of 
California (Mr. Peters).
  Mr. PETERS. Mr. Speaker, I thank Mr. Garamendi so much for organizing 
this discussion of a really important topic.
  In San Diego, we are a center of genomics, a center of life sciences, 
and a center of collaborative scientific research that makes 
groundbreaking discoveries and improves people's lives. In 2015, our 
research institutions received $768 million in NIH research funding, 
the most of any metro area in the United States. We are home to places 
like the Salk Institute for Biological Studies, Sanford Burnham Prebys 
Medical Discovery Institute, the J. Craig Venter Institute, and the 
Scripps Research Institute, where world-class scientists are making 
discoveries that save and improve millions of lives.
  At the University of California San Diego, UCSD, the Shiley-Marcos 
Alzheimer's Disease Research Center is part of a collaborative national 
effort to better diagnose, prevent, treat, and

[[Page 4989]]

ultimately to cure Alzheimer's. More than 5 million Americans are 
living with that disease. Alzheimer's kills more Americans every year 
than breast cancer and prostate cancer combined. It puts a tremendous 
burden on the family and the loved ones of those battling the disease 
because for every Alzheimer's patient, there are three people providing 
unpaid care.
  Thanks to organizations like Alzheimer's San Diego, there are 
services to support families that are providing care for their loved 
ones. We are grateful for that, but we need to do more.
  Alzheimer's also puts a tremendous burden on our healthcare system, 
as some of the speakers have mentioned. This year, Alzheimer's and 
other dementias will cost the Nation $259 billion. As our population 
ages, those numbers will only go up. It costs on average $1,150 more 
per month for a senior with Alzheimer's to reside in assisted living. 
That puts a financial strain on Medicaid, Medicare, and millions of 
families.
  The research being done at UCSD and around the country is fueled by 
the National Institutes of Health and the National Institute on Aging. 
The investments we make in basic scientific research to better 
understand the disease are our best chance at developing new therapies 
and ultimately a cure.
  One of the most bipartisan victories we have had in Congress since I 
have been here--this is my third term--was to increase NIH funding and 
to make a $6.3 billion investment in scientific research, which we did 
last year. Members of both parties came together with the understanding 
that NIH funding creates high-paying jobs, grows our economy, and 
unlocks discovery that changes lives. In his joint address to Congress 
this year, right here in this room, President Trump said he wanted to 
find cures to ``free the Earth from the miseries of disease.''
  Unfortunately, then he turned around and sent a budget to Congress 
that slashed funding for NIH, clawing back the progress that we made 
last year. Our efforts to find cures to diseases like Alzheimer's would 
be completely undermined by the President's budget. We just can't allow 
that to happen.
  I really, again, appreciate Mr. Garamendi for hosting this 
conversation. I want to let him know that I would be happy to sign on 
to Ms. Waters and Mr. Smith's letter, which he is also a leader of. I 
look forward to working with Mr. Garamendi and all of our other 
colleagues to defend the investment we have made in scientific research 
last year and to push for even more so that we can begin to win the 
battle against Alzheimer's and other diseases. That is what it is 
about, it is about winning. That is what I have been hearing. We want 
to win this battle.
  I am very conscious that the United States has written the playbook 
for how to lead the world in science, and it is by funding basic 
scientific research, by letting the best scientists in the world 
compete for those grants that are peer-reviewed--not decided by 
politicians, but by scientists. That system has worked marvelously 
well. Let's not kill it. Let's feed it.
  Mr. GARAMENDI. Mr. Speaker, I thank Mr. Peters for his comments. His 
knowledge and expertise in this field is appreciated and, I am sure 
when shared with the other Members of this House, will have a positive 
result.
  Mr. Peters said something toward the end of his conversation that I 
think we need to drive home. I said earlier that the scientists 
suggested that instead of a $31.7 billion budget for the NIH, they 
needed an additional $3.3 billion. It is for those projects that Mr. 
Peters described as peer-reviewed by peers in the area of science--
whether it is heart disease, cancer, or HIV or Alzheimer's--that are 
worthy projects for which there is no money.
  If we could fund those--not reduce the level of funding, as suggested 
by the President, but, rather, increase it--what would be the result?
  I am going to toss this up one more time. This is what happens when 
research is applied to diseases. Breast cancer down, prostate cancer 
down, heart disease deaths, strokes, and HIV, all down as a result of 
research, and then the application of that research through the medical 
community. This is progress. This is what can happen. This is what we 
want to get to.
  Mr. PETERS. Will the gentleman yield?
  Mr. GARAMENDI. Mr. Speaker, I yield to the gentleman from California.
  Mr. PETERS. I want to leave time for Mr. Raskin, but we talk about 
this peer-review concept. Maybe people don't understand what that is. 
What happens is these top scientists from around the world file these 
grants. They are reviewed not by government employees, not by 
bureaucrats, not by politicians, but by real scientists, the best in 
their field, to determine which would win. In the good times, about 25 
percent of those grants will be funded by NIH when there is robust 
funding. Seventy-five percent of them are turned down. That is how 
selective it is.
  Unfortunately, now we are looking at 7 to 10 percent funding. That 
means we are not discovering a lot. We are also turning a lot of our 
young people off of science. We can't let that happen.
  Again, we could talk about this all day, but I want to turn to my 
colleagues. Again, I thank Mr. Garamendi for setting up this 
discussion.
  Mr. GARAMENDI. Mr. Speaker, let's move to the other side of the 
continent. Let's talk about the view from New Jersey. I yield to the 
gentlewoman from New Jersey (Mrs. Watson Coleman).
  Mrs. WATSON COLEMAN. Mr. Speaker, I thank Mr. Garamendi for 
sponsoring this moment that we can speak about such important issues.
  In a budget proposal purported to ``make America great again,'' 
President Trump has put forth a request to cut $5.8 billion from the 
National Institutes of Health for fiscal year 2018. Mr. Speaker, there 
is absolutely nothing great about that. These cuts would reverse growth 
for the agency that President Obama boosted its budget by $2 billion in 
2016 and 2017. These cuts would forfeit American dominance in a sector 
where we are global leaders.
  In New Jersey's 12th District, Princeton University received close to 
$46 million in NIH grants, and the College of New Jersey received 
around $400,000 to continue our Nation's stature at the forefront of 
medical breakthroughs. The cuts proposed would, in effect, stunt good 
and essential medical research, lifesaving research.
  Unlike what we have seen from this administration, the NIH has 
produced results that improve the health and livelihood of the American 
people. For example, there is no widely available cure for sickle cell 
anemia. While some children have been successfully treated with blood 
stem cell and/or bone marrow transplants, this approach was thought to 
be too toxic for adults. However, NIH researchers successfully treated 
adults with severe sickle cell disease using a modified stem cell 
transplant approach that does not require extensive immune-suppressing 
drugs.
  After receiving an experimental spinal stimulation therapy from a 
team of NIH-funded researchers, four young men paralyzed due to spinal 
cord injuries were able to regain control of some movement, promising 
results for treating these devastating injuries.
  NIH-supported researchers designed a protocol to transform human stem 
cells into beta cells that produce insulin and respond to glucose. That 
finding could lead to new stem cell-based therapies to treat diabetes 
in patients of all ages, a disease that is so prevalent in our society.
  The specific damage that occurs in affected brain tissue after a 
concussion has not been widely well understood. A study by NIH 
researchers provided insight into the damage caused by mild traumatic 
brain injuries and suggested approaches for reducing its harmful 
effects.
  It has even been reported that these draconian cuts will slow 
research that could lead to new ways to prevent and treat cancer, the 
Nation's number two killer, which claimed the lives of almost 600,000 
Americans just last year and which, incidentally, claimed the lives of 
both of my parents.
  The evidence is overwhelming, and these are the facts. I just want to 
know

[[Page 4990]]

when this President and his supporters here in Congress will set aside 
budget gimmicks and put Americans, our health and our well-being, 
first.
  Mr. GARAMENDI. Mr. Speaker, the gentlewoman from New Jersey pointed 
out a very important thing here, and that is: When will we get real 
about this?
  It is my understanding that many of these budget cuts, the National 
Institutes of Health and others, were made so that a wall on the 
Mexican border could be funded.
  Ponder that for a few moments. Is that really a priority? Do we cut 
the funding for this basic research--whether it is for cancer, 
diabetes, even people that are suffering from post-traumatic stress 
disorder--so that we can fund a wall on the border?
  That may be what this is all about, in which case it is a terrible, 
terrible choice. I don't think we are going to make that.
  I thank the gentlewoman from New Jersey (Mrs. Watson Coleman) for her 
views. I really appreciate her understanding of this and her 
participation today.
  I see next to you our colleague from the great State of Maryland (Mr. 
Raskin) listening very intently to you and now prepared to jump into 
the fray here.
  Mr. Speaker, I yield to the gentleman from Maryland (Mr. Raskin).
  Mr. RASKIN. Mr. Speaker, nobody takes the speech and debate clause 
more seriously in this body than Mr. Garamendi. He speaks in debate 
pretty much every day, and that is what the Founders wanted us to do, 
not to just come here in a kind of naked exercise of power politics and 
see who can get more votes, but really try to learn from each other and 
engage in a dialogue so we are advancing public policy.
  It was a pleasure to receive the gentleman's invitation to join this 
Special Order on Alzheimer's disease. I am delighted to join him. I am 
also delighted to see at the dais this evening the Speaker pro tempore, 
my friend Congressman Smucker from Lancaster County, Pennsylvania. He 
is just a freshman, but he is already wielding the gavel. I would say 
that seat suits Congressman Smucker just fine. It is good to see him up 
there tonight.
  Congressman Garamendi, I am the Congressperson from Montgomery 
County, Frederick County, and Carroll County, Maryland, the 8th 
Congressional District, which includes the NIH, the National Institutes 
of Health; so I have the great fortune and honor and responsibility of 
representing thousands of people who work at NIH and who live in 
Rockville and in the neighborhood. So I see this as not just a national 
treasure and resource, but also a vibrant and vital part of my 
community that I represent.
  I speak tonight not just as a politician, but I speak also as someone 
who has--I guess what we call around here--a preexisting condition 
because when I was in the Maryland State senate and as a professor of 
constitutional law at American University, I was given a diagnosis in 
the year 2010 of colon cancer.

                              {time}  1845

  I learned something very interesting going through the experience 
about the difference between misfortune and injustice. Because if you 
have a job that you love and a family that you love and constituents 
that you love and it is a beautiful day and you are told that you have 
got stage III colon cancer, that is a misfortune. It can happen to 
anybody--liberal, conservative, Democrat, Republican, Independent, old, 
young, every race, every ethnicity. It can happen to anybody. It is a 
misfortune.
  At the time, I was the floor leader in Maryland on marriage equality 
legislation, and it struck me that the misfortune can happen to 
anybody. But if you can't get health insurance because you love the 
wrong person or because you are unemployed or because you are too poor, 
that is not just a misfortune. That is an injustice because we, as a 
society, can do something about that.
  So when we think about Alzheimer's disease or cystic fibrosis or lung 
cancer or diabetes 1 or 2, in a democratic society, our obligation is 
not to compound the misfortunes of life with governmental injustice; 
our job is to try to reduce misfortune because we are all citizens 
together.
  So that is why I am so proud to represent NIH because, as has been 
said very eloquently by a number of speakers tonight, the NIH is in the 
forefront of defending our population against disease and serious 
illness.
  So let's talk about Alzheimer's for a little bit.
  More than 5 million Americans are living today with Alzheimer's 
disease. That is about the population of my State--everybody in 
Maryland, from Baltimore to Rockville, to Silver Spring, to Bethesda, 
to Chevy Chase, to Middletown and Frederick County, to Sykesville, all 
over Carroll County, from the eastern shore to western Maryland, 
millions of people. That is how many people across the land are 
suffering from Alzheimer's disease. And it is a number that is rapidly 
increasing. It could be as high as 16 million people by 2050 is what 
the experts at NIH are telling us.
  Since 2000, deaths from Alzheimer's have increased a startling 89 
percent. You have shown us what the graphs are, Mr. Garamendi. One in 
three senior citizens today dies from Alzheimer's or another form of 
dementia. For victims of this disease, it is demoralizing, devastating, 
debilitating, and draining for the whole family.
  In Maryland, Alzheimer's affects 100,000 people, and it costs us 
around $1 billion in Medicaid dollars every year.
  In 2017, it is estimated that, across the country, we will spend $259 
billion caring for people with Alzheimer's and other kinds of dementia, 
with $175 billion being borne by Medicare and Medicaid, alone. This 
means nearly one out of every five Medicare dollars is spent on 
Alzheimer's.
  So we have got to move quickly and effectively to address the crisis 
and to solve the puzzle of Alzheimer's disease; otherwise, these costs 
are going to continue to grow even more sharply, and Alzheimer's could 
overwhelm our healthcare system.
  We need a cure, which is why the good people at the Alzheimer's 
Association are asking Congress to support a $414 million increase in 
the research budget at NIH for Alzheimer's in FY 2018. But President 
Trump has proposed a $5.8 billion cut to the NIH, which is a 19 percent 
reduction in the NIH budget.
  Why?
  Well, it is very hard to know. It is part of a proposal to slash $60 
billion in science research, environmental protection, housing, the 
human needs budget, and to shift it into the Pentagon. Now, that is at 
a time, Mr. Garamendi, when a committee I serve on, Oversight and 
Government Reform, just had hearings where Democrats and Republicans, 
alike, were outraged to learn that $125 billion in waste, fraud, abuse, 
and contractor overruns is happening right now in the Pentagon.
  We could save $125 billion just by taking seriously the problems in 
contracting and fraud and abuse that is taking place with the beltway 
bandits. But instead of going after that corruption and waste, they 
want to take $60 billion out of the human needs budget and shift it 
over to the Pentagon.
  Well, that is going to have a disastrous effect on our ability to 
make progress. That is the point I think you are making tonight, 
Congressman Garamendi. You are saying that, when we invest in basic 
research on the diseases, we make progress.
  Look what we have done with AIDS. It is amazing. Look what is 
happening with cystic fibrosis. We are making real progress because we 
are investing. We have got to not cut back on any of the research that 
is taking place. We have got to double down and invest, and we really 
need to do that with Alzheimer's.
  So this move to slash the human needs budget, the medical research 
budget, and put it in the Pentagon is an assault on science, on 
medicine, and on the health care of our people. These are our people 
whose lives are at stake that we are talking about. These are our 
families that are suffering the savage repercussions of Alzheimer's 
disease. It is a terrible infliction on the land.

[[Page 4991]]

  So I think that the idea of slashing $6 billion from research for 
serious diseases like Alzheimer's, like the doomed repeal-and-replace 
legislation that crashed and burned on Friday of last week, is totally 
counterproductive and destructive of the true needs and priorities of 
our people.
  We spend more money on the military than the next five or six 
countries combined, and the Pentagon is swimming in a deep pool of 
waste, fraud, abuse, and contractor overruns today.
  Let's focus on helping our own people right now, the way mature 
democracies do, not enriching beltway bandits and plutocrats and 
insiders the way that authoritarian governments do. The question of 
Alzheimer's is an urgent question for our time, just like the research 
into all of the other killer diseases that are afflicting our people.
  Mr. Speaker, I thank Mr. Garamendi for making me part of this Special 
Order hour.
  Mr. GARAMENDI. Mr. Speaker, I thank Mr. Raskin so very much. And, 
indeed, the National Institutes of Health has a stellar representative, 
as do the American people, and certainly the people of Maryland.
  As he told his own personal story of one of the dreaded diseases, I 
am delighted to see him stand here in such good health. Apparently, he 
has recovered completely from that.
  I suspect that recovery was, at least in part, due to, first, his 
good health at the outset, but also to the research that was done in 
the preceding years through the National Institutes of Health on cancer 
research. We have seen the decline in cancer deaths as a result of that 
research. What we would like to do is to deal with this Alzheimer's.
  I want to take a moment just to talk about where we are. We had a 
huge debate last week on repealing the Affordable Care Act and what it 
would mean to Americans, and a lot of that debate centered around the 
cost of medical services. Tragically, one of the ways that the 
proponents of repealing the Affordable Care Act would save money is to 
reduce the Medicaid program in different ways, but the end result was 
to reduce the Medicaid program.
  Sixty percent of the Medicaid program is for people in long-term care 
facilities. A good percentage of those, probably the majority of those, 
with some sort of dementia or Alzheimer's. What we need to do is to 
address this issue straightforward.
  I will tell my own story.
  My mother-in-law lived the last 3 years of her life in our home. We 
were in a position where we were able to take care of her, so she 
didn't go to a long-term care facility. Nonetheless, it was one of the 
obligations that we felt we had, and many, many other Americans share 
that obligation.
  This is 2015. The number $2.026 billion came up during the discussion 
that we had. That is what we spent in 2016. Some of that was spent by 
other payors. That would be insurance companies. Some was spent by 
family. Medicare and Medicaid spent the great majority.
  As we go through the years, in 2020, we expect to spend $267 billion. 
And again, Medicare and Medicaid make up the great majority of it. As 
we move through time, we will see that there will be greater and 
greater expenses, rising year by year, so that in the year 2050, which 
is not that far away--that is one generation away--we will be spending 
over $1 trillion, and Medicare and Medicaid will, throughout this 
entire period, be the single largest source of money to pay for 
Alzheimer's.
  So, if we want to reduce the cost of premiums, if we want to reduce 
the cost of government, if we want to deal with the quality of life of 
Americans, then we have to get to this research because there is hope. 
Alzheimer's is not a hopeless disease. It is not a disease for which 
there is no cure. It is a disease for which we have not spent money on 
finding the cure.
  If we can delay by a year, we will save tens of billions of dollars 
of taxpayer money in care that has been pushed off into the future. And 
the quality of life for the individual that has one more year of 
quality of life ahead of them is enormous and invaluable.
  Here is just a way of depicting the backward nature of how we are 
dealing with the research for Alzheimer's. This was originally the 
2015. We have been at this a couple of years, and we have seen 
progress.
  In 2016, we spent $941 million, just under $1 billion, on Alzheimer's 
research. At the same time, we spent $153 billion in the care of 
Alzheimer's in Medicare and Medicaid. It is Federal taxpayer money.
  Look, $1 billion, less than $1 billion in research, $153 billion in 
out-of-pocket expense caring for these individuals that have come down 
with Alzheimer's. A pretty neat equation here, isn't it?
  If we were to ramp that up, as we would like to see, from $941 
million to $1.4 billion, the researchers all across this country--some 
in San Diego, as we heard from Mr. Scott Peters; others in New Jersey, 
as we heard from Mrs. Watson Coleman; or in other parts of California, 
Boston, wherever. If we were to ramp that up by an additional $500 
million, the researchers believe that they will untangle the tangles in 
the brain that lead to Alzheimer's and understand what is going on and, 
from that point, be able to find a path towards a solution.
  It is not hopeless. We have seen progress. We have seen research that 
was done a decade ago. The analysis indicated that it really didn't 
work too well when they came up with a solution. Another researcher, 7 
or 8 years later, went back to that very research, looked at the 
statistical analysis, and noticed that, for those who had early onset, 
that particular treatment modality had an enormous effect, not on those 
that were in later Alzheimer's but those who were in early onset.
  Whoa. What does that mean?
  That means that there is a path. That means that there is an avenue 
towards a solution. However, this Congress, the 435 of us who will be 
here voting on the appropriations to fund the Federal Government, to 
fund the military, to fund the highways, to fund the National 
Institutes of Health, will be given a choice. We will have a choice. Do 
we increase the funding for the National Institutes of Health and 
Alzheimer's research, or do we fund a wall on the Mexican border to the 
tune of $20 billion?
  We just received that supplemental appropriation request from the 
administration today to spend $20 billion on a wall.
  I can talk to you about a wall. I represent 180,000 people just 
downstream from the Oroville Dam, and I have got a 30-foot wall that 
needs to be repaired. We are talking about imminent danger, and the 
rainy season is not over in California.
  Or, another $5.6 billion for the military for programs that nobody 
has told us yet should be funded.

                              {time}  1900

  We are going to make choices here. The President has made his choice. 
He has shown what is of value in his mind.
  I challenge that value. I challenge that value statement. I will tell 
you what is important. What is important are those millions of 
Americans who face Alzheimer's in the days, the months, and the years 
ahead. I am looking to the generations that are 40 and 50 years of age 
today who know, like my wife and I, they will be caring for their 
parents who are suffering from dementia and Alzheimer's. That is a 
value that I think is important.
  Mr. Cohen spoke to the real enemy. Is the real enemy somewhere out 
there around the world, or is the real enemy the disease that will take 
us down--in his case, childhood polio?
  We are going to make choices here, very important choices to the 
everyday lives of Americans. My choice is to increase, to increase the 
budget, the appropriation for the National Institutes of Health so that 
the $35 billion that the scientists--who have already done the peer 
review on all types of diseases, ranging from Zika, to cancer, and HIV, 
and Alzheimer's--say are worthy research projects that should be 
funded.
  I reject the value that the President has said to strip $5.6 billion 
out of the National Institutes of Health and transfer it for a wall on 
the Mexican border or for some spending in the military--some 
unspecified spending. These are choices.

[[Page 4992]]

  I know where, in my mind, the choice should be, and I reject the 
choice that has been made by our President.
  And with that, Mr. Speaker, I yield back the balance of my time.

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