National Alzheimer's Project Act

Thank you, Chairman Pallone, for yielding.

Madam Speaker, I, too, rise in strong support of S. 3036, the National Alzheimer's Project Act.

Today, the effects of Alzheimer's disease are devastating-- devastating to the estimated 5.3 million Americans with the disease to their more than 11 million caregivers and to the Nation as a whole, because we all share the tremendous cost of contending with Alzheimer's. By the middle of the century, as many as 60 million Americans could have Alzheimer's disease, putting it on the course of being our country's leading public health crisis and the defining disease of the baby boomer generation.

Building on the recommendations of the Alzheimer's Study Group, the National Alzheimer's Project Act would create a national strategic plan and establish an interagency council to work with the Secretary of HHS to comprehensively assess and address Alzheimer's research, care, institutional services, and home- and community-based programs. It would ensure strategic planning and coordination across the Federal Government as a whole.

Currently, without a coordinated effort, we have no way of evaluating outcomes or developing more effective ways to improve those outcomes. The National Alzheimer's Project Act addresses this critical gap by establishing a national plan which would assess current Federal initiatives, evaluate outcomes from these programs, prioritize future actions, and set national goals.

In addition, this legislation will work to reduce the tremendous costs associated with Alzheimer's disease. The baby boomers are beginning to turn 65. Without the discovery and delivery of effective interventions, 10 million of us will develop Alzheimer's, and the lives of many millions more will be upended by the emotionally, physically, and financially draining toll of caring for us.

According to the Alzheimer's Association's report, we are currently spending $172 billion annually on Alzheimer's and other dementia care in America. $88 billion of that is for Medicare alone, which is 17 percent of the total Medicare budget. Medicare beneficiaries with Alzheimer's or another dementia cost the system three times as much as a person who does not have dementia. For Medicaid, the cost multiplier for someone with dementia is nine times more. The report estimates that in the next 40 years, the cost of Alzheimer's and other dementias will be in the trillions.

The National Alzheimer's Project Act will help to address these costs by establishing an advisory council in which Federal and private representatives will work to reduce costs for Federal programs, as well as for families, while working to improve national health outcomes.

The National Alzheimer's Project Act also aims to decrease health disparities in Alzheimer's. Sixteen percent of women over the age of 70 have

Alzheimer's compared to 11 percent of men, and although under- diagnosed, African Americans are two times more likely and Hispanic Americans 1\1/2\ times more likely to have Alzheimer's or other dementias. The National Alzheimer's Project Act will ensure the inclusion of those at-risk populations in clinical, research, and service efforts.

S. 3036 makes significant strides in addressing one of America's most feared, costly, and deadly diseases.

I congratulate Mr. Markey for his work on this bill and I urge its passage.

I rise in strong support of S. 3036--the National Alzheimer's Project Act, which will provide critical federal support and coordination to overcome the growing Alzheimer's crisis.

Today, the effects of Alzheimer's disease are devastating--to the estimated 5.3 million Americans with the disease, to their more than 11 million caregivers, and to the nation as a whole as we all share the tremendous costs of contending with the Alzheimer crisis. Tomorrow, the devastation of Alzheimer's disease will grow far worse. In fact, it is on course to be our country's leading public health crisis of the 21st century, and the defining disease of the Baby Boom generation. If we don't succeed in changing the trajectory of this disease, by the middle of the century as many as 16 million Americans could have Alzheimer's.

Building on the recommendations of the Alzheimer's Study Group, the National Alzheimer's Project Act, NAPA, would create a national strategic plan for the Alzheimer's disease crisis. It would also establish an inter-agency council to work with the Secretary of Health and Human Services to comprehensively assess and address Alzheimer research, care, institutional services, and home and community based programs. NAPA would ensure strategic planning and coordination of the fight against Alzheimer's across the federal government as a whole.

Currently, without a coordinated effort, it is impossible to determine if it has been a good year in the fight against Alzheimer's. There are no benchmarks--we have no way of evaluating outcomes, let alone a way to improve them.

The National Alzheimer's Project Act addresses this critical gap by establishing a national plan. This national plan would assess current federal initiatives, evaluate outcomes from these programs, prioritize future actions, and assert national goals. With an integrated national plan, the government can improve the quality of life and outcomes for the millions of Americans--and their families living with Alzheimer's disease and other dementias.

In addition, this legislation will work to reduce the tremendous costs associated with Alzheimer's disease. In a few weeks, the first Baby Boomer turns 65--Alzheimer cases will begin to mount at an ever- increasing pace. Without the discovery and delivery of effective interventions, 10 million American Baby Boomers will develop Alzheimer's disease. And the lives of many millions more will be upended by the emotionally, physically and financially draining toll of caring for them.

The economic factors of Alzheimer's rival the human devastation of the disease. According to the Alzheimer's Association's report, ``Changing the Trajectory of Alzheimer's Disease: A National Imperative,'' we are currently spending $172 billion annually on Alzheimer's and other dementia care in America; $88 billion of that is for Medicare alone, which is 17 percent of the total Medicare budget. Medicare beneficiaries with Alzheimer's or another dementia cost the system three times as much as a person who does not have a dementia. For Medicaid, the cost multiplier for someone with dementia is nine times more. The Trajectory report estimates that during the next 40 years, the cost of Alzheimer's and other dementias will exceed $20 trillion.

Our country is engaged in a collective and very appropriate conversation about what should be done to address our current fiscal situation. When we look at how we can take costs out of the system while improving outcomes, we quickly see that Alzheimer's should be a core part of these discussions.

Fortunately, the National Alzheimer's Project Act will help to address these costs. The legislation establishes an Advisory Council comprised of federal and private representatives; the Council will work to reduce costs for federal programs, as well as families, while working to improve national health outcomes.

The National Alzheimer's Project Act also aims to decrease health disparities within Alzheimer's. Studies have shown certain populations are at greater risk of suffering from this devastating disease. Sixteen percent of women over the age of 70 have Alzheimer's compared to 11 percent of men. African Americans are about two times more likely to have Alzheimer's disease and other dementias; however, they are less likely to have a diagnosis. The legislation will ensure the inclusion of those at risk populations in clinical, research, and service efforts which will play a vital role in changing the future of disease.

The National Alzheimer's Project Act makes significant strides in addressing one of America's most feared, costly, and deadly diseases. I am pleased to support such a critical piece of legislation which will improve the quality of life for the millions of Americans affected by Alzheimer's disease.

Mr. President, I rise today to commend members of the Senate Committee on Health, Education, Labor, and Pensions and Members of the Senate for their support of the National Alzheimer's Project Act, S. 3036. In particular, the committee was helpful in strengthening the National Alzheimer's Plan and the annual reporting requirements to Congress that include the articulation of goals, benchmarks, priorities, recommendations, and tracking outcomes.

This legislation is focused on changing the devastating trajectory of Alzheimer's disease for our families and our economy. Alzheimer's disease is a debilitating illness that affects more than 5 million Americans and their families every day. The growing number of Americans expected to be affected by this disease, which is estimated to reach up to 16 million people by 2050, will continue to place an enormous burden on families and loved ones, not to mention the serious fiscal consequences to consider if we do not act now to address this disease. If nothing is done, studies report that Alzheimer's disease will cost the United States $20 trillion over the next 40 years.

With no current plan to address Alzheimer's, this important piece of legislation would lay the foundation to coordinate all Federal Alzheimer's programs and initiatives, including research, clinical care, institutional cared home- and community-based programs. The bill also ensures that a national Alzheimer's plan will be implemented by the agencies and Congress.

This bill will leverage existing leadership to offer real solutions to the Alzheimer's crisis. The National Alzheimer's plan called for in this bill will, for the first time, articulate what outcomes the Federal Government is seeking to reduce the impact of this crisis. It would allow Congress to assess whether the Nation is meeting the challenges of the disease for families, communities, and the economy. It

would give all stakeholders an answer the fundamental question, ``Was this a good or a bad year in the fight against Alzheimer's?''

The National Alzheimer's Plan will include appropriate performance measures and benchmarks to allow legislators to evaluate progress in the fight against Alzheimer's. The assessment and priority recommendations will likely address issues such as the underinvestment in Alzheimer's research. By addressing Alzheimer's disease and dementia directly, the National Alzheimer's Plan will also call attention to the many steps that can be taken to improve recognition, diagnosis and care for people with these conditions, reduce symptom severity, support family caregivers, and encourage ``healthy brain'' behaviors that may reduce risk for these conditions.

With the leadership of the Federal Government and input from all stakeholders, including Alzheimer's patient advocates, health cafe prodders, State health departments, voluntary health associations, and researchers, this bill would allow an opportunity for all worthy entities addressing Alzheimer's, including organizations at the State and at the national level, to come together on advisory council to make recommendations and implement a national strategic plan to overcome this dreadful disease. The advisory council will also ensure buy-in, leadership, and coordination of all related Federal agencies conducting Alzheimer-related care, services, and research.

One of the principal objectives of the advisory council is to represent a broad range of expert stakeholders within the Alzheimer's community to provide input and recommendations to the Federal Government on a national strategic direction for combating Alzheimer's disease. When crafting this legislation, the sponsors were careful to include patient advocates, caregivers, and providers who serve at the front lines of Alzheimer's care and who understand on a personal level the toll of this disease on patients and their families. Additionally, sponsors of S. 3036 included representatives of State health departments and Alzheimer's researchers who have expertise regarding the impact of this disease on public health as well as the state of the science in discovering prevention methods, treatments, and cures. Lastly, sponsors sought to include national voluntary health associations on the council, who provide invaluable research, care, support services, and advocacy tools for patients, caregivers, and local organizations throughout the country. It is our intent that two national organizations have representation on the council.

The threat that Alzheimer's disease poses to the health and wellbeing of our Nation demands an aggressive and well-coordinated response. This bill creates the first-ever national plan to combat Alzheimer's and ensures that every dollar spent on the disease will be used to get the best possible care for patients. At a time when medical research funds are too scarce and we are struggling to provide quality health care for all Americans, for the first time we will be able to assess all Federal efforts related to Alzheimer's disease, ensure existing resources are maximized, enhance the delivery of quality care, and support the kind of research that will one day result in a cure for this devastating disease.

Madam Speaker, Thank you, Chairman Waxman, Chairman Pallone, Representative Burgess, and Ranking Member Barton.

I'd like to thank Senators Bayh and Collins for their leadership on this bill, the Senate companion to H.R. 4689 which I introduced with my friend and cochair of the Task Force on Alzheimer's Disease, Representative Chris Smith from New Jersey.

The poet Robert Browning once wrote, ``Grow old with me, the best is yet to be.''

Unfortunately, the ``Golden Years'' can be the worst years for Americans afflicted with Alzheimer's and their families.

We've worked with the Senate to engage in a bipartisan, constructive process with stakeholders to reach legislative language and move this bill forward.

After all, Alzheimer's is an equal-opportunity disease. My father was a milkman, my mother the valedictorian. My father always said it was an honor that my mother married him and that if Alzheimer's was determined by the strength of your brain, ``Your mother would be taking care of me instead.'' He took care of her in our living room in Malden, Massachusetts for 10 years as she suffered from Alzheimer's. I'm thinking of them both today.

Alois Alzheimer first discovered the plaques and tangles in the brain that cause Alzheimer's in 1906--within the very same year that my mother was born.

At the time, doctors believed that dementia in the elderly was a normal part of the aging process that was caused by the hardening of the arteries.

However, Alzheimer's groundbreaking work was done on a patient who was only 51 years old. So Alzheimer reached the conclusion that the condition he had discovered was a kind of ``pre-senile dementia,'' and that the pattern of plaques and tangles he had identified was a rare condition that afflicted only the young.

Years passed, my mother grew up, and researchers did little to study and learn about the plaques and tangles that were forming in her brain.

It wasn't until the mid-1970s that it became clear that the most common form of dementia in older people was caused by the same plaques and tangles that Alzheimer had identified decades earlier.

Unfortunately, the search for the cure had begun too late for my mother who was diagnosed in 1981--75 years after Alzheimer had discovered the disease that lead to her death.

Alzheimer's patients are the mothers and fathers, and sisters and brothers who we recognize even if they don't recognize us; who we remember even if they don't remember us, and who we continue to love and cherish even as their condition worsens.

A few stats: 5.3 million Americans have Alzheimer's; it is the 7th leading cause of death; $172 billion is spent annually for Alzheimer's.

Our challenge is to ensure that we increase not only the lifespan, but also the health span of Americans, so that the 30 bonus years of life we gained in the 20th century--and hopefully will continue to gain in the 21st--are truly better years of life.

The Alzheimer's community has been waiting for help, and trying to maintain hope.

Today the House can take action to help and give hope to Alzheimer's families.

The bill we are considering today will help coordinate Alzheimer's research, care, and services across all Federal agencies.

The United States is one of the only developed nations without a national plan to combat Alzheimer's. For too long, we've been unarmed against this disease.

Through this plan, will be developed: An assessment of all Alzheimer- related Federal efforts; recommendations; annual updates; and a strong advisory committee.

This bill will: Help coordinate the health care and treatment of citizens with Alzheimer's; it will accelerate the development of treatments that would prevent, halt or reverse the course of Alzheimer's by coordinating existing government resources; and it will ensure the inclusion of ethnic and racial populations at higher risk for Alzheimer's and reduce health disparities among people with Alzheimer's.

Thank yous: The Alzheimer's Association--Harry Johns, Rob Egge, Mary Richards, Katie Maslow, Matthew Baumgart; Maria Shriver for all of her great work; The Alzheimer's Foundation of America--Eric Hall, Sue Peschin; Cure Alzheimer's Fund--Tim Armour, Dr. Rudy Tanzi; The National Institute on Aging--Dr. Richard Hodes, Tamara Jones; Keep Memory Alive--Maureen Peckman, George and Trish Vradenburg, Patience O'Connor, Meryl Comer, Jillian Oberfield, Mark Bayer, Kate Bazinsky, Josh Lumbley, Amit Mistry, and Binta Beard from my office; Tim Lynagh from Representative Chris Smith's office; Emily Gibbons, Sarah Despres from the Energy and Commerce Committee Majority Staff; Ryan Long and Clay Alspach from Mr. Barton's staff; J.P. Paluskiewicz from Dr. Burgess's Office; Sarah Kyle and Kevin Kaiser from Senator Bayh's Office.

Thank you to the many hard-working advocates for this disease, and those who are caretakers, bearing many burdens day in and day out.

I once again thank my colleagues for their support--Waxman, Pallone, Burgess, and Barton.

Mr. President, I have sought recognition today in order to reintroduce a resolution I first put forward in the 110th Congress that would prohibit the use of the procedural tactic of filling the tree. I feel strongly that this practice contributed greatly

to inefficiencies and ineffectiveness that the United State Senate experienced in the 110th Congress. Commonly known as the ``world's greatest deliberative body,'' the Senate has prided itself on free and fair debate on each and every issue that comes before it. Traditionally, members have had the right to offer virtually any amendment on any bill at any point in the legislative process. This all inclusive practice of legislating has earned the United States a unique place among modern democracies because of the open arena for ideas and sufficient debate.

However, in the past 15 years both sides of the aisle have increasingly seen the majority leaders use their authority to seek first recognition and fill the amendment tree. Republicans and Democrats alike have been equally as guilty of this practice for history has shown, when there is a problem with this institution, bipartisan blame is easily applicable. Beginning in 1993, ``filling the tree'' became increasingly prevalent as Senator George Mitchell used it 9 times in the 103rd Congress, Senator Trent Lott used it nine times in the 106th, and Senator Frist used it 9 times in the 109th. In the recently concluded 110th Congress, Majority Leader Senator Reid filled the tree on 16 different occasions, bypassing the previous record amount by a significant margin.

Regular order in this chamber was sacrificed in this past Congress, and in its place was a procedural tactic that prevented passage of legislation that would have been extremely beneficial for this country. Bills such as FAA Reauthorization--H.R. 2881, Climate Change Legislation--S. 3036, and the Energy Speculation Bill--S. 3268 were all derailed by this practice. Cloture on each piece of legislation was not achieved and caused any further movement on them to be stymied. Blame was placed on Republicans for engaging in obstruction through the use of the filibuster to prevent movement to debate. The fact of the matter was our side was completely blocked from participating in the legislative process, forcing our hand to oppose moving to the bill.

My proposed resolution would disallow the majority leader or any other member from offering a first-degree amendment, followed by a second-degree amendment. It amends Rule 15, Standing Rules of the Senate and it is my hope the Senate can adopt this and operate under this rule in the 111th Congress and beyond. It is time for this chamber to conduct business in a logical, factual way; that is, for Senators to come to the floor and address the substance of the bill and offer amendments if they choose.

Congress currently has an approval rating at a level that is unacceptable. As we enter a new Congress, efforts must be made to allow regular procedure to return to the United States Senate. It is my hope that the grueling hours members and staff put into legislation will be honored by giving it due consideration on the Senate floor. With a few changes in procedure, this Senate can ensure a more productive environment in the 111th Congress and beyond.

Madam Speaker, I thank my distinguished friend for yielding.

Madam Speaker, as cochairman along with my good friend and colleague Congressman Ed Markey of the Congressional Task Force on Alzheimer's, which we founded back in 1999, and as lead Republican sponsor on the companion legislation--this is a Senate bill, of course--I rise in strong support and ask for our colleagues to pass the National Alzheimer's Project Act.

This legislation is an important step forward in our battle against the crisis of Alzheimer's disease. Unfortunately, we know that the trajectory of Alzheimer's disease over the next few decades threatens unparalleled tragedy and threatens to overwhelm society's ability to cope if something is not done to change that trajectory.

Alzheimer's disease is both a current and future health crisis of our Nation. About 78 million baby boomers were born between 1946 and 1964, which has been termed the single greatest demographic event in United States history. In a couple of weeks on January 1, the first of those boomers will turn 65 years of age.

Today, 5.3 million people have Alzheimer's, and another American develops the disease every 70 seconds. 200,000 Americans under the age of 65 have early onset Alzheimer's. Alzheimer's costs Medicare and Medicaid alone approximately $122 billion. The average annual Medicare payment for an individual with Alzheimer's, as the previous speaker pointed out, is three times higher than for those without the condition. Additionally, 11 million unpaid caregivers provide 12.5 billion hours of care, valued at an estimated $144 billion. This unpaid care obviously is a huge drain on family resources.

Without effective intervention to change the trajectory, by mid- century, the number of individuals with Alzheimer's will increase to an estimated 13 million to 16 million people, and the cost to Medicare and Medicaid will be staggering, over $800 billion in today's dollars. Given these realities, it is astounding that there is no national plan to address the crisis of Alzheimer's disease and the looming crisis.

The National Alzheimer's Project Act is designed to help turn the tide by creating a national strategic plan to address it. NAPA establishes an interagency advisory council to advise the Secretary of Health and Human Services on how to comprehensively address the government's efforts on Alzheimer's research, care, and service, including both institutional and at-home care.

As a percentage of the population, more women than men have Alzheimer's, and African Americans are about two times more likely to have Alzheimer's or other dementias, yet they are less likely to be diagnosed. NAPA aims to address these disparities as well.

NAPA will provide the framework to accelerate the development of an efficacious care and comprehensive treatment in an effort to mitigate the unspeakable agony and suffering of millions of patients and their families. And if we are successful, we will also save the country billions of dollars every year and trillions over the coming decades.

This is an outstanding bill, and I hope the membership of this body will overwhelmingly support it.