The wealthiest nation in the world ought to be the healthiest nation in the world. But we're not. In fact, the U.S. ranks a dismal 24th in life expectancy, and we lag on many other health measures, as well.
The problem is that, while the U.S. spends far more on health care per capita than any other country, we spend it unwisely. More than 75 percent of all U.S. medical expenditures are accounted for by chronic conditions such as heart disease, cancer, diabetes, stress, and depression - many of which are preventable by changes in diet and lifestyle. Meanwhile, we spend peanuts on prevention -- less than five percent of health care spending in the U.S. goes toward the prevention of chronic disease. In short, we don't have a health care system in America; we have a sick care system. And this misplaced emphasis on "sick care" is a major reason why there has been a shocking 78 percent increase in family health care premiums since 2001.
Another big problem is that some 47 million Americans do not have health insurance - that's nine million more than when President Bush took office in 2001. These people are far less likely to get proper health care, allowing small health problems to become chronic and often catastrophic health conditions. Instead of paying for an ounce of prevention, we're paying for a pound of cure when these uninsured Americans show up in emergency rooms, on disability rolls, or call in sick to work.
My aim is to recreate America as a "wellness society" focused on fitness, good nutrition, and disease prevention - keeping people out of the hospital in the first place. At the same time, I am working to maintain America's standing as the world leader in biomedical research. This means generously funding the search for cures at the National Institutes of Health, and removing arbitrary restrictions on embryonic stem cell research at the federal level.
Creating a Wellness Society
The Healthier Lifestyles and Prevention (HeLP) America Act
The journey to a wellness society begins with a giant step forward, and that is why I have introduced the Healthier Lifestyles and Prevention America Act, also known as the HeLP America Act. This legislation takes a truly comprehensive approach to wellness and disease prevention. It provides tools and incentives to schools, employers, and communities. It aims to create better nutrition, physical activity and mental health opportunities for kids in schools. It gives the Federal Trade Commission authority to regulate unfair marketing to children. It provides incentives to build bike paths and safe sidewalks. And it requires nutrition labeling on menus in chain restaurants.
Bringing Wellness into America's Workplaces
Encouraging employee wellness is a matter of enlightened corporate self-interest, as a healthy workforce means reduced health care costs, better productivity, and less absenteeism. Annual health care costs are 49 percent lower for individuals who are non-smokers, non-obese, and who participate in physical activity three days per week. A recent study found that workplace wellness programs return, within 12 to 18 months, $2 to $10 for each dollar invested. To help businesses to reap these savings, I have introduced the Healthy Workforce Act, which provides a 50 percent tax credit for companies that offer a comprehensive wellness program to their employees. The bill is supported by public health advocates, the United States Chamber of Commerce and the National Retail Federation, among others.
Improving Our Children's Nutrition, and Increasing Their Physical Activity
Since the 1970s, obesity among preschool children has doubled, and among children ages 6 to 11 it has tripled. We are currently in the midst of what the Centers for Disease Control and Prevention calls an "epidemic" of childhood obesity and juvenile diabetes. This is an epidemic that we can and must reverse.
There are two keys to combating childhood obesity:
- Making sure our kids get plenty of exercise in and out of school
- Improving childhood nutrition
I have introduced two bills designed get children more physically active. The Fitness Integrated with Teaching Kids Act, or FIT Kids Act, amends the No Child Left Behind Act to support physical education for all public school children through grade 12, and to ensure that they are taught essential health and nutritional information. The Promoting Lifelong Active Youth Every Day Act, or PLAY Every Day Act, seeks to measure the barriers in communities to youth participating in physical activity.
In addition, I am working on multiple fronts to promote better childhood nutrition. In the 2002 Farm Bill, I created the Fresh Fruit and Vegetable Program, which allows elementary school children to receive free fresh fruit and vegetable snacks at school, and I have steadily expanded the program over the years. I am also working to modernize the school lunch program and to get junk food out of our public schools.
Discovering New Therapies and Cures
Having lost four of my five siblings to cancer, I am passionately committed to the search for new therapies, and one day a cure, for cancer and other diseases. America is blessed with the world's premier biomedical research organization, the National Institutes of Health (NIH). As chairman of the Appropriations subcommittee that funds this remarkable institution, I have no higher priority than to ensure that NIH gets the resources it needs. On that score, one of my proudest legislative accomplishments was joining with Senator Arlen Specter (R-PA) to double funding for NIH over a five-year period (1998-2003). NIH Director, Dr. Elias Zerhouni, has testified before my committee that, thanks to the human genome project, stem cell research, and other advances, we are in a "transformational stage" in the biomedical sciences. In recent years, I have fought repeated attempts by the Administration to cut funding for NIH, including budget reductions that would eliminate hundreds of research grants that could lead to cures or treatments for cancer, diabetes, Alzheimer's and other diseases.
Pursuing the Promise of Stem Cell Research
Embryonic stem cell research offers hope to millions of people suffering from cancer, ALS, juvenile diabetes, Parkinson's, spinal cord injuries, and other devastating diseases and conditions. Regrettably, seven years ago, President Bush imposed arbitrary restrictions on the number of embryonic stem cell lines that can be used for research at the federal level, severely limiting the most promising new field of biomedical research in our day.
Recently, scientists have determined that skin cells may also yield new therapies and cures. But this new technique is an exciting complement to, not a substitute for, existing mechanisms for generating embryonic stem cells. That is why I am continuing to champion the Stem Cell Research Enhancement Act, which would lift the President's restrictions and tighten ethical guidelines for this research.
This bill (including a similar version I sponsored in 2005) has been passed twice by Congress, and vetoed twice by President Bush. It would not allow federal funding to be used to create or destroy human embryos. However, instead of discarding the estimated 400,000 embryos that are currently sitting frozen in storage, destined for destruction, I believe it is important to use some of them - as long as the mothers and fathers provide informed, written consent - to help people who are suffering from life-threatening diseases. It is this choice that is truly respectful of human life.
Combating the Scourge of Breast Cancer
Nearly 185,000 Americans will be diagnosed with breast cancer this year, and almost 40,000 will die from the disease. I know this all too well, having lost both of my sisters to breast cancer. They contracted breast cancer at a time when regular mammograms and improved treatments were not regularly available.
Fifteen years ago, I was shocked to discover that barely $90 million in federal funding was directed to breast cancer research. So, in 1992, I offered an amendment to dedicate $210 million in the Defense Department budget to begin the Breast Cancer Research Program, a partnership between the military, medical, and breast cancer survivor communities to develop and implement innovative research towards the goal of curing and eliminating breast cancer. Overnight, this program more than tripled federal funding for breast cancer. I've also fought to increase the National Cancer Institute Breast Cancer Research budget to more than $550 million annually. These research dollars have helped to increase the number of breast cancer patients still living five years after diagnosis from 78 percent in 1985 to 88 percent in 2000. Large clinical trials, widespread and early screening, a focus on preventing tumor recurrences after initial treatment, and carefully matching up the proper patients with the proper treatment have all paid off in treating breast cancer, and are now being applied to treating other types of cancer.
Improving Women's Health
Improving access to women's health services has been one of my top health care priorities for many years. Largely thanks to federal resources and public awareness efforts, 70 percent of women over age 40 have had a mammogram, and 78 percent of women over age 18 have a had a PAP smear within the past three years. Early detection and intervention are critical to fighting many of the diseases that uniquely affect women, and we need to make even more progress.
I am also committed to preventing unintended pregnancies and making abortion as rare and unnecessary as possible. To this end, I am a cosponsor of the Prevention First Act, which would provide increased funding for pregnancy prevention efforts. It would also improve treatment for sexual assault victims, require medically accurate and comprehensive sex education, and improve access to contraception and family planning services.
Fighting Tobacco Use, America's No. 1 Killer
Smoking is the No. 1 cause of preventable death in the United States. Tobacco kills more than 400,000 Americans every year, and accounts for more than $96 billion in health care expenditures. Yet, every day, an average of 4,000 young Americans try smoking for the first time, and 1,000 become regular smokers. The 2004 Surgeon General's Report is unequivocal: smoking harms nearly every organ of the body, causing many diseases and reducing the health of smokers; however, quitting smoking has immediate as well as long-term benefits.
Yet despite the overwhelming evidence, Congress has still failed in our efforts to give the Food and Drug Administration the authority it needs to regulate the marketing and manufacture of tobacco products in an effort to curb youth smoking. I am a strong supporter of this legislation - the Family Smoking Prevention and Public Health Protection Act - which passed the Senate Health, Education, Labor and Pensions (HELP) Committee again last year. I will continue to push for the full Senate to consider this legislation this year. The time has long since passed for us to give FDA the tools it needs help reduce smoking rates and disclose more factual information about the dangers of smoking.
Access to Quality Healthcare
Affordable, continuous health care coverage is essential to preventing and managing chronic diseases, and to making the best use of our health care dollars. Yet, today, some 47 million Americans do not have health insurance, and more and more employers are dropping health care coverage of their employees. In a humane, decent society, no citizens should have to forego needed medical treatment because they are priced out of the market. Improving access to quality healthcare must include:
Expanding Health Insurance for Children in Low-Income and Working Families
The federal Children's Health Insurance Program was created in 1997 to provide health insurance to children of working families who do not qualify for Medicaid but who cannot afford private insurance. By every measure, the program, known in Iowa as the Healthy and Well Kids (HAWK-I), is cost-effective, and has been shown to work well in meeting children's basic health care needs. But even with this program in place, some 55,000 Iowa children, and more than 8.5 million children nationwide, continue to go without insurance, and the number of children in families making $40,000 or less who are not eligible for or cannot afford private health insurance is increasing. That is why Congress, on a bipartisan basis, twice passed an expansion of this program, fully paid for by increasing the tax on cigarettes and other tobacco products. Both times, the legislation was vetoed by President. But these vetoes are not the final word. We need to ensure that all children in Iowa and across the U.S. are eligible for basic health care, including regular checkups, preventive care, and prompt treatment of injuries and illness.
Expanding Community Health Centers
Because of the increasing cost and declining availability of health insurance, Community Health Centers -- clinics that serve everyone, regardless of ability to pay - have assumed a major role within the U.S. health care system. As chair of the Appropriations subcommittee that funds health care initiatives, I have made expansion of the Community Health Center network a major priority. Since 2000, I have worked to double funding for the program, and to construct new clinics all across the country. In Iowa, I have helped to add five new Community Health Centers, in Cedar Rapids, Dubuque, Fort Dodge, Storm Lake, and Decatur County, while expanding the services already available in Des Moines, Waterloo, Sioux City, Council Bluffs, Davenport, Burlington, and Ottumwa. At the same time, I have secured federal funding to expand facilities and enhance equipment at clinics across Iowa. I am currently working to gain federal status and funding for a clinic in Sioux County.
Improving Rural Health Care Services
Iowa has a disproportionately large population of senior citizens, and many of them live in rural communities. As co-chair of the Senate's Rural Health Caucus, I am acutely aware of the challenges that the Medicare program faces in largely rural states such as Iowa. Currently, Medicare reimburses doctors and hospitals in rural areas at a much lower rate than in urban areas, and this is making it increasingly difficult for rural hospitals to stay open and for doctors to practice in rural communities. I am currently cosponsoring sponsoring The Craig Thomas Rural Hospital and Provider Equity Act of 2007, also known as the R-HoPE Act, to address the urban-rural disparity in reimbursements, and to increase the amount of money Medicare pays to rural hospitals, doctors and ambulance services.
Helping Small Businesses to Provide Health Care Coverage
Small businesses that want to provide employees with health coverage are often charged higher premiums than large employers, and are less able to offer their employees a choice of health plans. That is why I am cosponsoring the Small Employers Health Benefits Program Act. This bill would create a new program modeled after the Federal Employees Health Benefits Program, which successfully provides affordable health coverage to more than eight million federal employees and retirees and their families, including members of Congress. The bill would allow small businesses to pool their purchasing clout to negotiate lower rates, and give small-business employees the same kinds of health plan choices that members of Congress have. The bill would also set reasonable limits on what insurers can charge.
