From the Congressional Record Online through GPO
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
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
The most remarkable proposal came from the President recently in his
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
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
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
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
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
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
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
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 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
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
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
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
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
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,
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
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
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.
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
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 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
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
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
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
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
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 when this President and his supporters here in Congress will set
aside budget gimmicks and put Americans, our health and our well-being,
Mr. GARAMENDI. Mr. Speaker, the gentlewoman from New Jersey pointed
out a very important thing here, and that is: When will we get real
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
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
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.
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
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
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
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.
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.
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
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
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
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
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
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.
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
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.
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.