Alzheimer's Accountability Act of 2014

Mr. Speaker, tonight, I want to spend some time with my colleagues discussing something that we actually can do for every American family, something that the Congress of the United States can take action on soon, like this week, when we pass our appropriations bill or, perhaps, next week if we fail to get the job done this week.

We can help every American family tomorrow, the next day, and on into the years out ahead if we take action. The subject matter of tonight is about an issue that affects every American family wherever you are out there--my own family, your family, the families of my staff, perhaps even the families of those who are working with us tonight.

This is an illness. This is an illness that has become the most expensive and will soon become the most pervasive illness in America. It is Alzheimer's. It is dementia associated with Alzheimer's. It is a devastating illness.

It is one that robs individuals of their mental abilities. It robs them of their memories of their families, of their work, of their lives. It confuses and muddles their thoughts, and eventually, it will destroy that individual, so tonight, we talk about Alzheimer's.

Is there anyone out there, any family, any individual, who hasn't seen this illness? I think we all have.

Let's get into it in some detail. A little later, as my colleagues join us, we will continue the discussion and talk about what we can do--your Representatives. There are 535 of us--435 here in the House of Representatives from every part of this Nation and from every walk of life and from every community, and there are the 100 Senators from every State. Let's use some of these charts to see if we can get a better fix on what we are actually facing here in America.

Let's see. Alzheimer's is the most expensive disease in America. One in five Medicare dollars is currently spent on people with Alzheimer's, 20 percent of every Medicare dollar. In fact, the total cost of Alzheimer's today--this year, 2014--is over $215 billion--a quarter of a trillion dollars. More and more of that money will come from Medicare as the baby boom population begins to move into its more senior years.

This illness is not just found in seniors. We are also learning about the early onset of Alzheimer's, men and women in their thirties and forties--early Alzheimer's. Of course, it extends on, mostly in the more senior population, 60-65 and above.

This is an illness that is also associated with genetics. If you have Alzheimer's in your family, there is a higher probability that you will have Alzheimer's yourself, but it is also an illness that is associated with brain damage that can occur from concussions.

I think we have all heard about the National Football League players who have suffered with one form of dementia or another and who have died early because of it. We also know that traumatic brain injuries are the most common injuries found among our troops who have returned from Afghanistan and Iraq.

Alzheimer's, it is there. It is very expensive.

What can we look forward to in the future? Let's see. This is Medicare and Medicaid--the Federal Government expenditures--not the family expenditures, not the expenditures by health insurance companies. This is just the Federal Government.

Today, it is about $122 billion. By the end of this decade, it will be $195 billion. As this wave of baby boomers passes through our demography and through our society, we expect, by the year 2050, that the Federal Government will be spending over $880 billion--$120 billion short of $1 trillion--on this illness, and this may be just two-thirds of the total cost. Well over $1.2 trillion will be spent in about 35 years on this illness.

Do you want to bust the budget? Do you want to see the deficits of America soar almost uncontrollably? Then look to Alzheimer's and dementia and the effect that they will have on the Federal budget deficit. Pay attention to these numbers because these numbers are the story of the American Federal budget and of the personal budgets of families across this Nation--Alzheimer's and dementia, $880 billion of Medicare and Medicaid money by 2050.

There is another way of looking at it. It is a different graph but the same story. The already high cost of Alzheimer's will skyrocket as the baby boom moves through the population. There it is: the same numbers, the same graph, the same extraordinary challenge facing America.

I should also mention that this is not just an American issue; this is an issue for every advanced economy in the world. If you are able to avoid the childhood illnesses--the illnesses that kill so many in the developing world--then those economies that have advanced to the more developed economies face the exact same population surge and costs associated with Alzheimer's and dementia.

What can we do about it? We can actually do a lot. I suspect, if you are looking at this on your TV screens or are here in the audience, you really only see the green line. This speaks of the treatment for Alzheimer's: today, $250 billion by Federal and local and private.

On this one over here is research, treatment versus research. It is the old adage: You spend it now or spend a lot more later. A penny saved is a penny earned.

What does research amount to? I have to pull this up close--oh, here it is. We are spending $122 billion to $150 billion or so of Federal and State money. What are we spending on research? $566 million. Billions? Millions? What does research amount to? It actually works. Research actually will solve problems, medical research.

How long have we been at polio? I remember growing up around the issues of polio. It was very common in our communities, then some money was spent on research and a polio vaccine. You don't see polio in our communities anymore.

The research worked with the development of the Salk vaccine, followed by other vaccines to treat polio. It is essentially wiped out in America. It only exists in a few very isolated places in the world. If we were to spend the money on a vaccination in those areas, we would see polio disappear from our world. The same thing happened with smallpox.

I want to show you something more of today. Let's look at the research budgets for those programs that are active today: investments in health research at the National Institutes of Health, $2,014; cancer research, $5.4 billion on cancer research.

Enough? Probably not. We probably could and should spend more on cancer research. Should we do so, I would suspect that we would see even more success in treating cancer in its earliest stages.

HIV/AIDS, nearly $3 billion on HIV/AIDS--have we solved the problem? No, but we have certainly figured out how people can live with HIV/ AIDS, and we are probably going to see a vaccine sometime in the near future. This is what we are currently spending--nearly $3 billion--on

Well, I get to represent the University of California- Davis, and it is in my district, although the hospital and the research center are not. So I guess we share the same sadness.

Thank you very much, Ms. Speier. I really appreciate you bringing the women's issue to this.

The last 3 years of my mother-in-law's life were spent in our home as she went through the process of Alzheimer's. And it is, indeed, a women's issue. Two-thirds, as you say, are women. And we experienced that. Fortunately, for us, it worked out very well for us and our family.

But we are not unique, and while our experience was sad but good in some

ways, that is not always the case. This is a huge, huge burden. Not only are the women the ones who suffer, but the women are often the ones who care for those who have it.

So I thank you so much.

I notice my friends from the east coast have joined us. We often do an east-west thing here. My two friends are debating who is going to go first.

Mr. Fattah, why don't you go first, and we will go from there.

Thank you so very much, Mr. Fattah, and thank you for your role on the Appropriations Committee trying to move the money into this research so that we can address this. You mentioned the Staglins out in California and their project, which is the One Mind project, our former colleague Mr. Kennedy involved in that project, trying to pull together the research from around the world and here in the United States specifically, so that there is a sharing of knowledge back and forth from these various research centers, so that the synergy would come from the knowledge that may exist at Cal Tech or New York, which we will undoubtedly hear about in a few moments, or in your country out in Pennsylvania.

Sure.

Well, thank you so very, very much. I am going to turn to my colleague from our normal East-West dialogue here that we have done so many days, so many times over the last few years.

Mr. Tonko, thank you so very much for joining us once again as we talk this time about--we usually talk about jobs and the economy and how we can build it, but this time we are talking about Alzheimer's, so please.

Mr. Tonko, thank you so very much for your bringing to us the information about actions that have already been taken. The Alzheimer's plan that you discussed lays out a process by which the National Institutes of Health will develop a program of research, bring it directly to Congress so that we can then analyze it and hopefully fund that research. It is the pragmatic way of dealing with it. As you said, it is based upon a studied step-by-step process to get to the solution of Alzheimer's.

There is also other legislation. Our former colleague, now Senator Markey, put together a bill that is called the HOPE Act, and that is one that would require that Medicare take specific account of Alzheimer's, and that in the Medicare program, there be a method for Medicare to fund early diagnosis of Alzheimer's and then the early treatment. As was said by one of our colleagues earlier, a delay of a couple of years or 3 or 4 years in the onset of serious Alzheimer's is extraordinarily beneficial to the individual and to the family, and, in a larger context, to the budget of the individual family, their insurance company, as well as the Federal government through Medicare and Medicaid.

So that program also speaks to the caregiving that is necessary and Medicare picking this up. It is clearly going to be the illness that will bust the bank unless we can get ahead of it, and that is where the research comes into focus and into play. We can do this.

There is another angle to this. I was going to take this up with Mr. Fattah when he was here. He was talking about other agencies and other governments that are involved in dealing with this. About a month ago I had the opportunity to spend about an hour with the new Secretary of Veterans Affairs, Mr. McDonald, and we were talking about the various challenges that the Department of Veterans Affairs has dealing with all of the veterans, and it wasn't long before the conversation turned to traumatic brain injury and PTSD, post-traumatic stress syndrome, both of which are illnesses or problems of the human brain.

We were discussing how the Department of Veterans Affairs is dealing with this. It turns out that they also have a research budget, and we know that he was unaware of some of the research that was going on both at the NIH and what Mr. Fattah talked about, the One Mind program that our former colleague Mr. Kennedy is involved in in pulling together the research that is available around the world, bringing that research together so that the synthesis of it could be a much more rapid solution to the problems that Mr. McDonald faces in the Veterans Administration dealing with post-traumatic stress illnesses as well as traumatic brain injury.

So all of these things come together, and in dealing with it, ultimately we carry a heavy burden of responsibility here in Congress.

Thank you, Mr. Tonko, for joining us in this Special Order hour. Working with you has always been a pleasure. I think this subject is one that you and I and our colleagues will want to take up as the days go forward.

In the spring, the 2015 Alzheimer's Day will occur once again here in Washington, DC. There will be thousands of people coming to Congress, knocking on our doors, grabbing our lapels, and asking us to pay attention to this illness.

I want to review some of the costs, and then basically wrap this up. You talked about home care. There are articles that appeared recently in The Sacramento Bee about elderly people taking care of each other, a wife taking care of her husband in their 50th year of marriage with severe Alzheimer's, the love that is so apparent, but also the difficulty of an elderly person taking care of another elderly person.

We can address that. That is what the HOPE legislation is all about, bringing Medicare into this.

The research thing that we talked about earlier, I am going to put up very, very quickly a couple of charts. This one, what is going to happen to the Federal budget if we do not address Alzheimer's, it is $122 billion today; in 35 years or 40 years, we are going to look at over $800 billion, and that doesn't include the private sector. It is going to be $1.2 trillion spent on this, so we are going to bust the budget. If you are a deficit hawk, you should be paying attention to this.

What do we need to address it? Well, we certainly need care for the caregivers. We have talked about that. We also need research. The plan that was in the earlier legislation laying out the Alzheimer's plan called for an additional $200 million this year on top of the $566 million that we are currently spending.

Keep in mind that, for cancer, it is nearly $5.5 billion; for HIV/ AIDS, nearly $3 billion; and cardiovascular illnesses, just about $2 billion annually spent in research at the National Institutes of Health.

They are very good, it is very important, and not a nickel should be taken away from that, but we should add $200 million this year as we complete the appropriation process right now.

People ask, ``Where can we find the money?'' Well, let's see. We just said we are going to spend $5.6 billion in Syria and Iraq--new money. I know that my work on the Armed Services Committee--I am on the Strategic Forces Subcommittee. We are talking about more than $12 billion over the next 6-7 years rebuilding a nuclear bomb that nobody knows what to do with.

Maybe there are choices that we can make. Would America be better off with a new nuclear weapon or rebuilt nuclear weapon, spending $12 billion or so on that, or maybe spending it on Alzheimer's research?

Our work is about choices, Mr. Tonko. How are we going to allocate the resources of this Nation? My suggestion is we go where every family in America will be affected, every family, either directly as my family has been directly impacted by this. My mother-in-law lived with us the last 3 years of her life, dying at the age of 92; yes, we were affected.

We know the genetic issues. My grandchildren are looking out there and saying, ``This is a genetic thing, Papa. What about me?'' So that worry carries through our family, and I suspect it carries through every family in America, either directly or indirectly.

Let's make a choice. Let's make a choice to attack with research, with care, with funding the most expensive, most common, most deadly illness in America and in other developed countries: dementia and Alzheimer's.

We can do it. This is not an impossible task. This is simply a task of focusing like a laser on this issue, and when we do, we will find the same success that we have seen with heart, cancer, and HIV/AIDS-- not cured, not stopped, but a very significant drop in the deaths associated with those illnesses.

Mr. Tonko, I have completed my statements tonight. I think you have another comment.

I thank you very much, Mr. Tonko, for joining us tonight. I also thank my colleagues, Mr. Fattah from Pennsylvania and Ms. Speier from California, for joining us on this important subject.

Mr. Speaker, I yield back the balance of my time.

Well, thank you, Representative Garamendi, for leading us in a very important discussion during this Special Order. There is no denying that all of us, Members of the House and beyond, if you are to ask individuals out there across this country if Alzheimer's or dementia issues have impacted their family, the immediate response is absolutely.

I think all of us have been touched by those devastating impacts, those outcomes that befell our loved ones, and the ripple effect onto that circle of family and friends. It is devastating. You in a sense lose that individual, and it is a very painful process certainly for those individuals living with Alzheimer's and dementia, and for their immediate families and loved ones and caregivers who watch as they painfully travel the journey with those individuals. So I think for us to take that human element, that impact and that dynamic, and put it into working order, we would be well served to acknowledge that Alzheimer's is the most expensive disease in America. It is driving bankruptcy if it goes unaddressed. And when one in every five Medicare dollars is spent on a person with Alzheimer's or dementia, the warning signals should be out there for sounder budgeting, to put our focus on a cure, on research, on developing those opportunities that will bend the cost curve, so to speak, that will enable us to address with dignity and common sense and economic sustainability the issues of Alzheimer's and dementia.

The impact upon our culture is so much so the economic drain is at about $214 billion in 2014. That is an immense economic toll that is placed upon budgets, be they Medicare, Medicaid, local budgets, or not- for-profits that make it their goal to best serve individuals, especially in their elderly years, and to be able to assist in that effort by advancing the efforts of the study of the

brain that have been initiated by this President, by President Obama and his administration, is a very, very worthy investment.

It will tell us much about several diseases out there and allow us to again approach an issue with dignity and facts at our fingertips that will then provide for the best prioritization of how to respond to those issues.

Now, much has been said about research here tonight, and rightfully so. It is very critical that we, you know, grow the investment on research. I have participated in our annual town halls that are called for in the National Alzheimer's Project Act, and that National Alzheimer's Project Act requires that we gather together to understand how well the services are coming together, what the needs are, and how we plan appropriately for ongoing budgets.

There you receive, all of us, the very disturbing testimony that reaches us, impacts our thinking, and certainly speaks to our hearts and souls about what we need to do, painful journeys that individuals have made. I can vividly recall a high school friend mentioning that her husband no longer knew her name but knew her voice. These are painful bits of testimony to absorb, and they motivate us. They ought to motivate us and challenge us to move more quickly in this effort to fund research and find a cure and find better treatments.

The efforts that I think are important here that follow the National Alzheimer's Project Act is to put together a more clinical response, and I think the Alzheimer's Accountability Act, which I have cosponsored, allows for H.R. 4351 to respond to the Alzheimer's planning in a way that clinicians and those directly involved in the service delivery system to the Alzheimer's community, they will advise what those budgeted amounts should look like in an annual effort from here to the threshold year of 2025. That is an absolute essential.

I applaud our efforts here in the House with Representative Guthrie and others--as I said, I am a cosponsor--looking to make certain that we have a much more accountable, logistic, well-planned, and professional-driven estimate that will move us forward with each and every budget year to respond to this crisis in America, and it indeed is at crisis proportion.

So Representative Garamendi, these are efforts that I think need to be made. The commitment that starts with the human element, the compassion that needs to be expressed on behalf of the people of this country via this House, via Congress, both Houses speaking to a legitimate request that authorizes the investment in research, that puts together a plan that is run by clinicians that advise the United States Government as to how to best respond, what those levels, those thresholds should be from now to the benchmark year of 2025, and to make certain that we do it all within our professional capacity in harnessing the resources that are required.

We grow, we cultivate an intellectual capacity in this country of which we are very proud, and one that should serve us abundantly well, and it is important to have our hearts and souls measure that opportunity, to put together the best blueprint for addressing this crisis. Let's move forward with a sound, resounding commitment of support to these individuals and their caregivers.

You know, when we look at the statistics out there, one in nine over the age of 65 is impacted by Alzheimer's, one in three in age category 85-plus. And guess what? That is the fastest-growing age demographic in our country. So in order to plan and plan well for the onslaught of baby boomers who will enter into these given demographics, we need to make commitments, and we need to again bend that cost curve by investing now in research, preventative therapies, and certainly study of the brain, efforts that are promoted by the President and the administration to make certain that we can move forward effectively and compassionately and allow for the best choices to be made.

So I thank you for leading us in this very important discussion, Representative Garamendi, and I am convinced that with the facts at our fingertips and with the elements of compassion and dignity that should respond to the Alzheimer's community, we can get these important measures achieved.

Absolutely. You talked too about the caregivers, and it is theorized that nearly 60 percent of those caregivers who respond to Alzheimer's patients and those living with dementia are impacted with tremendous emotional stress, and they rate that as high or very high. And then of that 60 percent of caregivers, literally one-third is suffering from some order of depression. So the impacts here continue to sprawl and cause greater expenditure for those who are doing their good deed, responding to the needs of loved ones or friends or the patient population out there, and then they are impacted by this order of depression.

It is assumed that has added additional cost to the system of our health care drain, and that is at $9.3 billion. That estimate goes over the year of 2013, so it is very easy to begin to do the calculus here on the cost of status quo, of not responding in deep measure or in wise capacity, so as to put together the sort of research that we require and the respite relief programs that are essential.

Having talked to a number of caregivers during my tenure here, now closing out my third term, but before that in the State Assembly of New York, I would routinely hear from folks who would deal with these situations, these family issues in ways that they never imagined would be possible.

I know of some spouses that indicated to me that, while they stayed home full time being the caregiver, they eventually sought employment and used every bit of that salary that came from that new employment to go toward the cost of caregivers. Now, they did that in order to save a relationship.

It was a tremendous emotional drain on their relationship because it is not easy serving as a caregiver. Individuals have told me, as spouses, that they have gone out and sought full-time employment and again passed over that salary to the respite person.

That is the sort of painful pressure under which individuals and couples--families--are living. It is a very difficult assignment many have chosen to keep their loved one at home.

There are issues of safety, economic duress, and certainly our system has to respond to that, so the sooner we set our sights on a cure, on funding that is adequate and effective for research purposes and for developing the responsiveness of the medical teams out there, via perhaps pharmaceutical assistance and development there, the better our economic situation will be in regard to these struggles.

Here is a chance for Congress to respond in very magnanimous terms that will allow us to state cumulatively that we get it, that we are there in order of compassion, that we understand it is about a dignity factor, it is about quality of life, and it is about providing hope to situations that may be rendered hopeless.

Isn't that the best element of work that we can do here to bridge that order of hope to those who have been so stressed and who have been given a walk in life, a journey that is powerfully painful?

I just appreciate the fact that we are utilizing these opportunities, such as this Special Order, to bring to the attention of those concerned with these issues to a laser-sharp focus and to allow for people to speak out there as the general public in support of measures that can be taken, of budget appropriations that can be secured, of opportunities that come in securing the resources essential to go forward and offer the fullest response that we can.

Again, health care situations are driven by this. There are huge costs if we don't respond to the needs of individuals living with Alzheimer's, and then there is that ripple effect that is happening all too frequently for the caregiver community that is also worn thin because of this assignment, because of this mission that they embrace.

It is honorable that they do these things, but we also have to work the system here on the Hill in Washington, to respond to them with a degree of reverence and common sense and fully acknowledge that there are efforts that can be made here that bend that cost curve and speak to the situations at hand in the most effective manner.

Representative Garamendi, I thank you for bringing us together on this evening of thoughtfulness here concerning dementia and Alzheimer's as a particular stress.

I would just like to attach my comments to those you have just closed your statement by.

This bankruptcy that is driven by certain catastrophic situations with health care costs are impacting far too many families, and this order of work here in the Congress is about prioritizations. We have spent trillions on war, and we have really diminished the investment in domestic programming, including health care.

We come up with all sorts of efforts called sequestration, which is a hidden attack on investments in our domestic agenda. We have to be cautious about how we are guiding those priorities that we are establishing in our budgeting here in Washington, but if we were to prioritize based on where the public demands are, let me suggest, in closing, that I have gone to the Alzheimer's walk in my district for the past several years, and every year, the same statement is made: ``This is the largest crowd ever assembled.''

It keeps growing. It tells me the consciousness of this country, that we want something done for this dreadful disease, doing something that will cure individuals who are walking and living with Alzheimer's and dementia.

The people have asked for this by their participation in local fundraising events. Is that the way that we respond to a crisis, by hoping we have good weather on the walk day, that we reach our intended goal that given year, as people are strapped with expenses of caregiving and medications?

There is a better way to complement that, to lead the effort here in Washington with the research, with the cure that can be found, with the advancements in the pharmaceutical industry to be able to extend life and enhance life and the quality of life. That is what I think is so powerful about the opportunity we have here.

I believe we can be those agents of hope. I do believe firmly that the priority here is to address this crisis that is devastating our American families and our economy. Let's go forward and be those agents of hope. Let's provide for a better tomorrow, and let's show people that there is a compassion that accompanies the efforts here in Washington.

Representative Garamendi, thank you for bringing us together on an important discussion that needs to be followed up with resources and public policy and certainly prioritization that brings us to the threshold of responsiveness that is so needed and so deserved and is so correct.

Mr. Speaker, recently, The Sacramento Bee wrote a three-page article on Alzheimer's and the effect that it has.

I would like to quote from that newspaper:

Gasps were audible as the images flashed before the

gathering scientists at a recent U.C. Davis Alzheimer's

Disease Center pathology conference. On the screen before

them were photos of a brain, severely wasted with age, with

what looked like silver rivers of atrophy cutting deeply

through the tissues. Even for the experts, it can be shocking

to see the damage that Alzheimer's disease inflicts on the

aging brain.

What can stop the devastation of Alzheimer's?

Without better answers from researchers, the degenerative

brain disease--already the Nation's sixth leading cause of

death--will be diagnosed in as many as 16 million aging baby

boomers by 2050. Unchecked, it will rob millions of their

memories and lives, of their pasts and futures, even as it

threatens to overwhelm the health care system.

Tonight, in a bipartisan 1-hour session, we are going to talk about Alzheimer's. Unfortunately, our time is being cut short, but we will take this up again in the weeks ahead as we deal with one of the most profound and expensive and damaging issues Americans face.

I have here a diagram that explains what is going to happen with Alzheimer's cost to Medicare and Medicaid in the years ahead. Right now, it is $122 billion, and it will rise in 2020 to $195 billion, to $346 billion in 2030, and by 2050, it will be approaching $1 trillion.

We have a problem. Americans--every family is facing this issue. My family has, and I suspect every other family in this Nation at one time or another already has faced this issue, and they will in the years ahead.

This is not a new issue for the Congress. It is an issue that has been dealt with. There has been legislation introduced, and in a few moments, I will talk about some of the bills that have been introduced by my colleagues here in the Congress, both on the Democratic and on the Republican sides of the aisle.

This issue has to be addressed, and the principal thing we need to do is to provide research and care and support for the families that have this issue in their midsts.

I want to take up a couple of other charts and then turn to my colleague from Kentucky.

This chart deals with the issue of what is going to happen with the funding. If we are going to solve this problem, we are going to have to increase the funding. We are, fortunately, spending around $5.5 billion a year on cancer through the National Institutes of Health.

HIV/AIDS is close to $3 billion a year. Cardiovascular issues are around $2 billion. Alzheimer's is down here at just over $566 million. We are not yet at $1 billion on this. As we can see here, this is going to be the most expensive illness facing the Medicare and Medicaid populations in the future years.

We also know of the deaths from the illnesses that have the greatest funding--breast cancer down 2 percent, prostate cancer down 8 percent, heart disease down 16 percent, stroke down 23 percent, and HIV--a remarkable success--with deaths now declining by 42 percent.

On the other hand, deaths from Alzheimer's are increasing at a rate of 68 percent.

So we are seeing this extraordinary shift occurring in the illnesses that are facing Americans and their families. We are seeing this extraordinary increase in Alzheimer's deaths as we see, thankfully, success. Often, that success is a direct result of what is happening with the research that is going on.

I would like now to turn to Mr. Guthrie, my colleague from Kentucky, as he discusses this issue from his perspective. And then we will spend the next 15 minutes in a dialog about this problem.

Thank you so very, very much. Thank you for being part of what, to my knowledge, is the first bipartisan hour. We ought to do this more.

This issue isn't a Democratic or Republican issue, a left or right issue. This is a true American tragedy--and one that is also going to be a true American financial as well as a family problem.

One of the gentlemen that has been involved in this from the very early days is my friend from New York (Mr. Tonko).

Thank you for joining us, Mr. Tonko. I know you have had a very difficult evening with one of our colleagues who lost her spouse this evening. Thank you for caring for her and joining us this evening.

Thank you very much, Mr. Tonko.

I know Mr. Guthrie may have some additional remarks. We have got about 7 minutes. I am going to take maybe 3 minutes and talk about some of the legislation that is here. I am going to go through this very quickly.

Mr. Markey, who is now a senator, introduced H.R. 1507 when he was here

in the House. This deals with the Social Security and Medicare diagnosis.

Of course, we have the Accountability Act you have introduced, Mr. Guthrie.

There is H.R. 489, the Global Alzheimer's Resolution. Next month is Global Alzheimer's Month. This will be part of that effort to talk about this issue around the world.

We have H.R. 4543, the PACE Pilot Act, to keep elderly people in their homes, which was introduced by Chris Smith, who will join us the next time we come out on this issue.

And also, H.R. 2975, the Alzheimer's Caregiver Support Act, was introduced by Representative Maxine Waters and, again, deals with the kind of support that you and Mr. Guthrie were talking about.

One more. We have H.R. 2976, the Missing Alzheimer's Disease Patient Alert Program, dealing with the issue both of you have talked about with elderly or people with Alzheimer's that wander off.

All of these are bipartisan pieces of legislation. All of them in one way or another deal with this problem.

The one thing that is not among these is specific money for research, which I would hope comes from our efforts to talk about this and make this a major issue.

Mr. Guthrie, I know you have some additional comments.

I would like to close with a statement of hope and a statement of opportunity. Here is what happens when you spend money on research and on treatment. Breast cancer is down 2 percent, as well as deaths from these other cancers. Prostate cancer is down, heart disease is down, stroke is down, and HIV has a 42 percent decline. That is what research and treatment will do.

Alzheimer's is up 68 percent. That is what happens when you spend this kind of money.

Cancer, over $5 billion a year. The result, a decline in cancer. HIV/ AIDS, almost $3 billion a year. You see the extraordinary success of that. Cardiovascular illnesses, $2 billion.

Again, a decline in each and every one of these causes of death. With Alzheimer's, right around half a billion dollars. The result is this: increased deaths.

So we have a way of answering this question of what to do with this, and that is turn our focus on the research and the care and the support for the families. That should be our watch word.

I think that is a bipartisan way of going at this. That is something that we can focus on as 435 Members of this House and our colleagues over in the Senate. This is a bipartisan issue, a bicameral issue, with a known path to a solution.

With that, we are out of time this evening. I want to thank my two colleagues in a bipartisan hour, my Republican colleague from Kentucky and my friend who is often on the floor with me, Mr. Tonko.

We are going to come back and do this for another hour in the last half of the month of June. I know that there are several of our Republican colleagues that wanted to be here tonight. And I know the Democrats do, also. We will see if we can go move forward with a solution.

Mr. Speaker, I yield back the balance of my time.

Mr. Speaker, I thank my colleague from California, Congressman John Garamendi, for the time, and I congratulate him for organizing this evening's Special Order Hour on Alzheimer's Disease.

As the Co-Chair of the Congressional Task Force on Alzheimer's Disease, I know how devastating this disease can be on patients, families, and caregivers. The Task Force works on a bipartisan basis to increase awareness of Alzheimer's, strengthen the federal commitment to improving the lives of those affected by the disease, and assist the caregivers who provide their needed support.

Alzheimer's disease in the U.S. is at crisis proportions. As our population ages, the number of persons affected by this brain disorder are expected to triple by 2050. The costs associated with Alzheimer's disease and other forms of dementia are also growing at an unsustainable rate. A recent RAND study of adults ages 70 and older found that the total economic cost of dementia in 2010 was estimated to be $109 billion for direct care alone. That is higher than the cost of both heart disease and cancer. Furthermore, the economic cost of dementia rises to $159 billion to $215 billion when the cost of informal care is included.

In the U.S., someone develops Alzheimer's every 67 seconds. According to recent data, women have a 1 in 6 estimated lifetime risk of developing the disease at age 65, while the risk for men is nearly 1 in 11. The Alzheimer's Association estimates as many as 16 million Americans over age 65 could suffer from Alzheimer's by 2050. It is now the fifth leading cause of death in my home state of California.

Alzheimer's has a devastating impact upon families. Right now nearly 15 million people, mostly family members, provide unpaid care for individuals with Alzheimer's or dementia, a market value of more than $220.2 billion. In California alone, about 1.5 million unpaid caregivers grapple with the tremendous challenges of Alzheimer's disease or dementia every day. Caregivers include spouses, children, and even grandchildren. As compared to caregivers for other diseases, Alzheimer's caregivers disproportionately report being forced to miss work, reduce work hours, quit their jobs, or change jobs due to caregiving demands. They are more likely to experience financial hardship, report health difficulties, experience emotional stress and suffer from sleep disturbance.

The bipartisan supported National Plan to Address Alzheimer's Disease calls for a cure or an effective treatment for Alzheimer's by 2025. In an effort to meet this goal, the Senate Appropriations Subcommittee on Labor, Health and Human Services, and Education approved a budget for fiscal year 2015 that calls for an additional $100 million in funding for the National Institute on Aging (NIA) to expand Alzheimer's disease research. NIA, along with other institutes at the National Institutes of Health (NIH), are supporting a number of promising Alzheimer's disease research projects, including cutting-edge ``prevention'' trials that are studying whether or not the disease can be prevented or slowed substantially by administering treatments earlier in the disease process.

I am urging the leaders of the House Appropriations Committee to include at least the additional $100 million for the NIA in the final budget package for FY 2015. This modest increase in Alzheimer's research funding will provide vital resources to support meritorious Alzheimer's disease research projects. This action will also demonstrate further resolve in support of our national priority of eradicating this insidious brain disorder.

The Senate Appropriations Subcommittee on Labor, Health and Human Services, and Education also included language directing NIH to submit a professional judgment budget for Alzheimer's disease research. As a cosponsor of the Alzheimer's Accountability Act (H.R. 4351), I believe that unfiltered information specifying the resources necessary to meet the goals and objectives laid out in the National Plan would provide Congress with a valuable tool for setting research and service priorities.

I also plan to urge the President to include robust funding for Alzheimer's research and caregiver support services in his fiscal year 2016 budget, which the President will be submitting to Congress early next year. Increased funding for Alzheimer's programs will allow us to meet these challenges head on and enhance our chances of meeting the goals articulated in the National Plan.

As we continue to search for a cure, our nation is at a critical crossroads that requires decisive action to assure the safety and welfare of the millions of Americans with Alzheimer's disease and dementia. Together, let us commit to take every possible action to improve treatments for Alzheimer's patients, support caregivers, and invest in research to find a cure for this disease.

Once again, I thank my colleague from California for organizing tonight's Special Order.

I want to thank my friend from California for yielding.

I rise today, Mr. Speaker, to talk about this devastating disease that impacts nearly every family in America: Alzheimer's disease.

According to the Alzheimer's Association, Alzheimer's is the costliest disease in America, with a direct cost of roughly $200 billion--most of which is paid by Medicare and Medicaid, and accounts for 20 percent of Medicare spending. These numbers will only continue to increase, making the discovery of a cure, or a way to delay onset, critical to our health care economy.

Across the United States, more than 5 million Americans are living with Alzheimer's today. In addition, the Alzheimer's Association estimates that someone will develop this disease every 67 seconds. Eleven percent of Kentucky's seniors are currently living with Alzheimer's. It is the sixth-leading cause of death in the United States.

But it is not the financial drain that is the most devastating.

My family has been personally touched by Alzheimer's. My great uncle suffered from the disease. I will never forget as a little boy hearing my grandmother talk to my mother about my uncle getting lost and trying to find his way home from the grocery store. Nobody really understood it. I remember as a young boy being confused about how this uncle I knew could be so confused and lose his way.

I also experienced it in my family with my wife's grandfather. I will never forget when my wife and I went to visit him the first time he didn't recognize her. The devastation on her face that someone she loved so much didn't know who she was has still stuck with me today.

This disease is emotionally wrenching for families who are impacted.

Beyond the direct emotional and physical impact, family members serving as primary caregivers are stretched to their limits. Many spouses and grown children work full time-jobs and then come home to care for their family member.

Finding a cure or treatment for Alzheimer's is of the utmost importance. I was pleased to introduce H.R. 4351 with my colleague, Representative Paul Tonko of New York.

H.R. 4351, the Alzheimer's Accountability Act, seeks to ensure that the research and resources needed to find a cure for Alzheimer's are properly conveyed to Congress. By receiving a professional judgment budget directly, Congress will be in a better position to see the needs and promise of researchers and use that information to make critical decisions, especially during difficult budgetary situations.

Today, H.R. 4351 is bipartisan. My friend Paul Tonko and myself filed this legislation. We have 80 cosponsors. There is also a Senate companion bill, and it is gaining momentum.

Again, I want to thank my colleague for organizing this evening and for allowing me to be part of this effort to shine a light on Alzheimer's disease. I would also like to encourage all of my colleagues to cosponsor H.R. 4351, and help make fighting Alzheimer's a top priority.

I will just take a couple of minutes. Thank you for yielding.

I thank Representative Tonko for cosponsoring and working on this legislation together.

I will have to give also my sympathies to Ms. Slaughter. She took me in when I first got here. I know she is from upstate New York, but if you listen to her accent, it has got a little bit of Kentucky mountain in it.

She is from our beloved mountains. We had that connection. She has been special to me. So my prayers are with her.

The one thing I want to share, because we are short of time, is we are doing research into this. The Alzheimer's Association said by 2050, Alzheimer's disease will cost the Federal treasury a trillion dollars.

So I remember thinking, Well, by 2050 my great grandkids would have to take care of that. Then I did the math. I am going to be 86 in 2050. So the generation that will be in that category is me. It is not some long-off issue. So my children will be dealing with it, as well as me and people my age.

I am the end of the Baby Boom. I was born in 1964. So by the time I am 86, the entire Baby Boom will be older than me. At least my age, or older. And that will be not just a stress on the Federal budget, but as I said, the dignity of the person with the disease and the stress on the family dealing with the disease and the emotion of it is why it is so important.

I saw it with my great uncle, with the early onset of Alzheimer's when I was a young boy and didn't quite understand what was going on. And later on in life, we figured out what was happening. Our whole family didn't really understand what was going on in the 1970s. But we do now. And I think it is something we need to put the efforts of both parties together on--as you see, we are standing here together--the effort to move forward. It is when my generation is retired, our children aren't going to be able to sustain it financially or emotionally. Therefore, it is something we need to do today.