I thank my friend for yielding. Mr. Speaker, first of all, I want to thank Mr. Wolf for raising this. I didn't know he was going to be doing it; I just saw him on the television. So I appreciate the gentleman yielding. Let me just say, to…
I thank my friend for yielding.
Mr. Speaker, first of all, I want to thank Mr. Wolf for raising this. I didn't know he was going to be doing it; I just saw him on the television.
So I appreciate the gentleman yielding.
Let me just say, to clarify the record, this legislation, which would seek to lay bare the science about Lyme disease, the fact that I believe we do have an epidemic, the fact that Lyme often go misdiagnosed, underdiagnosed. It is called ``the great pretender'' because so many people have it and don't know it. It often masquerades as other kinds of anomalies manifesting in a person's body. And it is not until it gets to a chronic state--very often causing severe disability, including neurological damage--that people finally realize that they have Lyme disease.
There has been, unfortunately, a significant, I believe, cover up of the fact that chronic Lyme exists. The gentleman knows, we have asked him repeatedly, the gentleman from New Jersey, my good friend, Mr. Pallone, this legislation has been pending in his subcommittee. He told Pat Smith--no relation to me--who runs a Lyme disease association, that this would get a hearing and would be marked up. It has not been marked up. And meanwhile, this epidemic is growing--it is exploding.
Now, let me just say for the enlightenment of my colleagues; the Infectious Disease Society of America,
which creates--and often does a very laudable job--the definitions, the parameters of what constitutes a certain disease, has looked at Lyme and said that chronic Lyme does not exist. Many of us have raised serious concerns about that because of what we believe to be conflicts of interest on the part of the panel members that made up the Lyme panel.
I would note parenthetically that Chris Dodd is the prime sponsor of the comparison legislation that I've introduced on the House side. We have worked cooperatively on the legislation, so we have a companion bill on the Senate side. The legislation has over 110--I think it's 112--cosponsors, totally bipartisan, Democrats and Republicans alike rallying around this legislation.
The problem with the Infectious Disease Society of America is that these conflicts of interest, we believe, resulted in the conclusion that chronic Lyme doesn't exist. We don't know absolutely if that's the truth, but Attorney General Richard Blumenthal from Connecticut finally took a look at this and came back with a scathing insightful report that there were conflicts of interest. The red flag should go up everywhere.
What does my legislation do? As Mr. Pallone knows, the legislation does not prescribe a protocol, as he has suggested. It simply calls for an advisory committee that would take a good, long look at Lyme disease and determine what is fact and fiction, and finally, for the sake of all of those who are suffering immensely from this disease and their families, say what we need to be doing to mitigate and hopefully stop the spread of Lyme, whether it be long-term and very heavy antibiotic treatment--which I believe probably is the case based on clinical practitioners who have suggested that to be the case--but we want an honest look.
As Mr. Pallone knows, we did not get an honest look from the Infectious Disease Society of America. And I find that appalling. Conflict of interest with insurance companies has no place in modern medicine. And regrettably, and it has been--again, the full weight of the Attorney General's report clearly suggests, Richard Blumenthal of Connecticut, that there were significant conflicts of interest on the part of the panel members.
Our legislation says let's go where the science takes us. If the science says chronic Lyme exists, then all those patients and the insurance companies which need to be providing the coverage, to get the medicines and the like, like antibiotics--because what has happened, as my friend knows, because of this exclusion of chronic Lyme due to a problem in definition, the insurance companies say we don't have to pay. So when a patient presents with a bill of $100,000 or some excessive amount of money, the insurance companies say, not us, tough luck, we're not going to pay for it. And they go right back to what I believe to be a false definition that precludes chronic Lyme as a condition.
Now, you might think that chronic Lyme doesn't exist, I say to my friend, the chairman, but let's go where the science takes us. We need this advisory committee and we need it now. All points of view, as our legislation clearly suggests, has to be a part of this group. We want a robust debate, not something that is engineered by insurance companies.
Finally, the legislation would authorize $100 million over 5 years, $20 million each year. Frankly, if that drops off due to opposition to new authorization, and is only an authorization, I would like to see it go forward nevertheless, know this however, we're not spending enough on Lyme.
And Lyme is, as Mr. Wolf said so aptly, growing exponentially. CDC admits we are missing most of the cases. As many as 90 percent of the cases go unreported. Our state, Mr. Pallone, as you know, is number three in prevalence according to CDC numbers, and even that is probably very much understated in terms of the actual prevalence of Lyme disease.
So I would make the appeal again, as I have made to my friend from New Jersey, as I have made to Mr. Dingell, as I have made to Mr. Barton and everyone else, this legislation ought to be on this floor and it ought to be on the floor today. It is truly bipartisan. There ought to be a consensus to go where the science takes us. And again, an advisory committee, a Blue Ribbon panel that would be configured under this legislation would finally end, hopefully, this contentious debate and tell us what it is and what it is not.
I have known dozens of people who have had chronic Lyme. Now, you might say it doesn't exist, the Infectious Disease Society says it doesn't exist. These victims suffer from the spirochete, and have suffered neurological damage, severe joint damage, and many, many other problems.
There is a new book called ``Cure Unknown'' that I would recommend to the House. I read it in one sitting because it is so incisive in finally breaking through the fog on this disease. People are walking around with Lyme and they don't even know it.
We need to bring the forces to bear of the U.S. Government that an advisory committee of this kind would do a Blue Ribbon panel, a 9/11- type panel of scientists, of the best people we can put together to say, put aside the egregiously flawed Infectious Diseases Society of America's finding, which Blumenthal said was riddled with conflict of interest--and I urge Members to read Blumenthal's opinion, I will put it in the Record so Members can read it--his findings were, ``atrocious, conflict of interest everywhere.''
This legislation ought to be on the floor and it ought to be on the floor today.
Office of the Attorney General,
Hartford, Connecticut, May 1, 2008.
Attorney General's Investigation Reveals Flawed Lyme Disease Guideline
Process, IDSA Agrees To Reassess Guidelines, Install Independent
Arbiter
Attorney General Richard Blumenthal today announced that
his antitrust investigation has uncovered serious flaws in
the Infectious Diseases Society of America's (IDSA) process
for writing its 2006 Lyme disease guidelines and the IDSA has
agreed to reassess them with the assistance of an outside
arbiter.
The IDSA guidelines have sweeping and significant impacts
on Lyme disease medical care. They are commonly applied by
nsurance companies in restricting coverage for long-term
antibiotic treatment or other medical care and also strongly
influence physician treatment decisions.
Insurance companies have denied coverage for long-term
antibiotic treatment relying on these guidelines as
justification. The guidelines are also widely cited for
conclusions that chronic Lyme disease is nonexistent.
``This agreement vindicates my investigation--finding
undisclosed financial interests and forcing a reassessment of
IDSA guidelines,'' Blumenthal said. ``My office uncovered
undisclosed financial interests held by several of the most
powerful IDSA panelists. The IDSA's guideline panel
improperly ignored or minimized consideration of alternative
medical opinion and evidence regarding chronic Lyme disease,
potentially raising serious questions about whether the
recommendations reflected all relevant science.
``The IDSA's Lyme guideline process lacked important
procedural safeguards requiring complete reevaluation of the
2006 Lyme disease guidelines--in effect a comprehensive
reassessment through a new panel. The new panel will accept
and analyze all evidence, including divergent opinion. An
independent neutral ombudsman--expert in medical ethics and
conflicts of interest, selected by both the IDSA and my
office--will assess the new panel for conflicts of interests
and ensure its integrity.''
Blumenthal's findings include the following: The IDSA
failed to conduct a conflicts of interest review for any of
the panelists prior to their appointment to the 2006 Lyme
disease guideline panel;
Subsequent disclosures demonstrate that several of the 2006
Lyme disease panelists had conflicts of interest;
The IDSA failed to follow its own procedures for appointing
the 2006 panel chairman and members, enabling the chairman,
who held a bias regarding the existence of chronic Lyme, to
handpick a likeminded panel without scrutiny by or formal
approval of the IDSA's oversight committee;
The IDSA's 2000 and 2006 Lyme disease panels refused to
accept or meaningfully consider information regarding the
existence of chronic Lyme disease, once removing a panelist
from the 2000 panel who dissented from the group's position
on chronic Lyme disease to achieve ``consensus'';
The IDSA blocked appointment of scientists and physicians
with divergent views on chronic Lyme who sought to serve on
the 2006 guidelines panel by informing them that the panel
was fully staffed, even though it was later expanded;
The IDSA portrayed another medical association's Lyme
disease guidelines as corroborating its own when it knew that
the two panels shared several authors, including the chairmen
of both groups, and were working on guidelines at the same
time. In allowing its panelists to serve on both groups at
the same time, IDSA violated its own conflicts of interest
policy.
IDSA has reached an agreement with Blumenthal's office
calling for creation of a review panel to thoroughly
scrutinize the 2006 Lyme disease guidelines and update or
revise them if necessary. The panel--comprised of individuals
without conflicts of interest--will comprehensively review
medical and scientific evidence and hold a scientific hearing
to provide a forum for additional evidence. It will then
determine whether each recommendation in 2006 Lyme disease
guidelines is justified by the evidence or needs revision or
updating.
Blumenthal added, ``The IDSA's 2006 Lyme disease guideline
panel undercut its credibility by allowing individuals with
financial interests--in drug companies, Lyme disease
diagnostic tests, patents and consulting arrangements with
insurance companies--to exclude divergent medical evidence
and opinion. In today's healthcare system, clinical practice
guidelines have tremendous influence on the marketing of
medical services and products, insurance reimbursements and
treatment decisions. As a result, medical societies that
publish such guidelines have a legal and moral duty to use
exacting safeguards and scientific standards.
``Our investigation was always about the IDSA's guidelines
process--not the science. IDSA should be recognized for its
cooperation and agreement to address the serious concerns
raised by my office. Our agreement with IDSA ensures that a
new, conflicts-free panel will collect and review all
pertinent information, reassess each recommendation and make
necessary changes.
``This Action Plan--incorporating a conflicts screen by an
independent neutral expert and a public hearing to receive
additional evidence--can serve as a model for all medical
organizations and societies that publish medical guidelines.
This review should strengthen the public's confidence in such
critical standards.''
Will the gentleman yield?