Patrick Kennedy

Mr. KENNEDY of Rhode Island

Mr. KENNEDY of Rhode Island. Mr. Speaker, this weekend, on December 8 and 9 in Taiwan, there will be an important gathering of legislators from Pacific Rim nations to discuss the role of congresses or legislatures in the growing number of democracies developing across Asia. The meeting has been convened by the Pacific Congressional Caucus, an arm of the Democratic Pacific Union, DPU, a regional organization of Pacific Rim democracies. Legislative leaders from 20 nations, including Canada, Australia, New Zealand, Korea, Mexico, El Salvador, Honduras, Nicaragua, the Philippines, and the host Taiwan are expected to participate. It is unfortunate that, because of our legislative schedule, no member of this House or of the other body are able to attend. However, Mr. Speaker, I did want to take note of this important meeting that will focus on the role of Congress in the various democratic governing models, such as the parliamentary system and the presidential system. Another important set of discussions will focus on the issue of legislative elections in various democracies, how they are conducted, and how they are financed. I congratulate Taiwan's political leaders who were instrumental in creating the DPU and the Pacific Congressional Caucus. Taiwan's Vice President Annette Lu was the prime mover in bringing the DPU into existence and the Speaker of Taiwan's Legislative Yuan, Wang Jin-Pyng, was instrumental in establishing the Pacific Congressional Caucus and in organizing such meetings as the one this weekend. This effort in Taiwan has been truly bipartisan, with Vice President Lu a member of the ruling Democratic Progressive Party, and Speaker Wang a key leader of the Nationalist Party, known as the KMT. Because Taiwan is one of Asia's most dynamic democracies, it is fitting that Taiwan has been instrumental in forming the DPU and the Caucus and in organizing this symposium. I congratulate Taiwan and wish all the participants a rewarding series of meetings.

Mr. KENNEDY of Rhode Island

Mr. KENNEDY of Rhode Island. Mr. Speaker, I'm proud today to introduce the Personalized Health Information Act, which I hope will be a step in helping us redesign America's health care system. Our health care system today delivers some of the best care in the world, but can hardly be described as the best health care system. We spend more than 50% more on health care per capita than other industrialized nations, and yet our health outcomes are much worse. We all know the burden that health care costs are putting on America's families and businesses. Many of us have extolled the potential of information technology to begin transforming health care. I.T. can unlock data that is trapped in paper, catch human errors, help providers deliver the latest evidence- based medicine, improve public health, reduce duplication and administrative costs, and provide new research capabilities. I.T. is by no means a silver bullet, but it is a tool that can be used to reorient health care, so that--finally--the system delivers the right care to the right people at the right time, as efficiently as possible. I've introduce other bills on this subject, and House and Senate negotiators are currently trying to work out a compromise health I.T. bill, but this bill today is a new approach. Those other bills, mine and others', have generally focused on the challenges of putting technology in providers' hands and building the related infrastructure. That goal is critical, and we pursue it vigorously. But it also is long-term. I believe that there are other, parallel steps we can take that can begin harnessing the power of technology to improve health outcomes and efficiency right now. And I think we can do so in a way that will begin changing the dynamics around health I.T. in a way that makes the longer-term goals more attainable. Web-based, consumer-controlled patient health records, PHRs, have been recognized by many to have great potential. After all, a PHR that contains a person's basic demographics, insurance information, and a current medications list would be extremely valuable, even if it contained nothing else. That PHR would mean every provider would have important basic information at the point of care. It would cut down on medication errors, and streamline administration. The problem is that while many organizations offer PHRs, few people actually use them. The Personalized Health Information Act is designed to jump-start the use of PHRs. This bill seeks to use the doctor-patient relationship to make the PHRs of value to the patients. Right now, most individuals see PHRs as a lot of work with little benefit. If doctors begin using them with patients, however, the patients can get something out o them. So this bill will ask doctors to use PHRs to replace those dreaded clipboards when patients come to the office. If physicians do that, PHRs become more attractive. The patient can take ten minutes to put their information into a PHR, and use it with any doctor. If their doctors use them, the person will never have to fill out another clipboard again. Even better, the PHR can be a communications channel between doctor and patient. The physician, or other entities like the person's health plan or the Centers for Disease Control and Prevention or the American Heart Association, can send messages to the patient. For example, the patient can receive a reminder that she is due for a mammogram, or her prescription needs to be refilled. If physicians are willing, many PHRs can be used to allow e-consults and online scheduling as well. If we can bring a critical mass of consumers into PHRs, it could create a strong consumer demand for health I.T. that could dramatically accelerate adoption. And polls show that consumers do want the capabilities that PHRs provide. For example, a recent Wall Street Journal poll found that approximately three-quarters of respondents said in each case that they would like to be able to email their doctor, to schedule appointments online, to receive test results electronically, and to receive electronic reminders. Unfortunately, fewer than ten percent can do any of those things right now. Once physicians begin tapping into this pent-up demand by offering to use PHRs, I believe large numbers of patients will enroll. And conversely, as patients begin using PHRs, they will want their physicians to do so as well. Banks initially paid customers to use ATMs, but now they compete on how many ATMs they have and the functionality of their online banking offerings. Similarly, once health care consumers begin seeing the convenience and benefits of information technology, providers will want to be able to meet that demand. In this way, widespread use of PHRs could help give providers the incentive to make the investments in electronic medical records and other information technologies. PHRs carry the potential for significant health and efficiency gains by changing patient behavior. Research shows that when patients receive reminders and other messages, they better comply with prescriptions, preventive care, and other health care recommendations. When that happens, patient health improves, and it also brings financial benefits to health plans, purchasers, and pharmaceutical companies. Everyone wins. The Personalized Health Information Act would tap the value-added of PHRs by creating a public-private PHR Incentive Fund to pay physicians and other providers an incentive of at least $2 for every patient with whom they use a PHR. The doctor simply needs to use the PHR in lieu of the clipboard, ensure that the patient's medications list is updated after the appointment, and use the PHR for communicating with the patient in appropriate circumstances. These requirements would be carried out by office staff and put minimal burden on doctors. Medicare would contribute $2 to the Fund for each beneficiar enrolled, and private plans, drug and device manufacturers, and other private parties could do the same. To qualify physicians for the payment, PHRs will need to meet certain minimum standards. They need to be entirely in the control of the individual, and will have to guarantee the portability of the data, so that the individual can take the information at any time. They'll have to meet interoperability standards and privacy and security standards. The PHR will also need to be able to send patient-specific messages in appropriate situations. Partners in the Fund would be able to have messages sent to patients with whom they have relationships via the PHRs, with strong safeguards to ensure that the messages are independently verified to be objective, accurate, and relevant to the patient. Absolutely no marketing or solicitations would be permitted. The individual must have the right to opt out of these messages, either entirely or from particular sources, at any time. In addition, the bill creates a Consumer Protection Board to ensure that these standards are met. By paying incentives to physicians from a public-private fund, the Personalized Health Information Act captures the value that PHRs can create while tapping the strongest force in health care: the doctor- patient relationship. This bill is not a silver bullet, Mr. Speaker, and will not solve all of the challenges inherent in moving from a 20th century pen-and-paper system to a digital system for the 21st century. But it can inexpensively and quickly give millions of consumers and physicians a stake in that transition. Before I close, I want to acknowledge the efforts of Dr. Edward Fotsch, who has done much to develop the ideas underlying this bill and has helped pull together feedback and input from physicians, consumer groups, payers, pharmaceutical companies, and others. I also need to express a debt of gratitude--again--to former Speaker Newt Gingrich and David Merritt at the Center for Health Transformation, who have been unlikely but terrific allies in the quest for, as Speaker Gingrich would say, a 21st century intelligent health system. There are too many Americans who are being let down by a health care system that is unable to consistently and efficiently deliver the world-class care that it is capable of. I hope that this legislation will bring us one step closer to the health care system we need and deserve.

Mr. KENNEDY of Rhode Island

Mr. KENNEDY of Rhode Island. Mr. Speaker, I thank the gentleman for yielding me this time and for his leadership on sovereignty in this country on behalf of Native Americans, our very first Americans, the people who had America before Europeans settlers came here to take their land. When the European settlers took their land, they took it and made one promise: We will give you what little land you have left, we will let you stay on that land and we will let you be in charge of it. And we will incorporate that into our various systems of government where we have a State government, we have city government, we have county government, and we will have tribal governments. But for purposes of tribal governments, they will have sovereignty that will surpass States so that the only relationship that these tribal governments will have will be the relationship between them and the Federal Government superseding States. This was a part of the Constitution. It was decided by the Constitution and this legislation undermines that premise and forces tribes to negotiate with local counties, which is undermining 200 years of Federal policy for tribal sovereignty. I ask for a ``no'' vote on this because its substance is bad, and the fact that it is being rushed through is bad as well.

Mr. KENNEDY of Rhode Island

Mr. KENNEDY of Rhode Island. Mr. Speaker, will the gentleman yield?

Mr. KENNEDY of Rhode Island. Mr. Speaker, the gentleman has mentioned prescription drugs a number of times. I think it is analogous to this debate, because that was a debate that took place late at night, and you used the elderly and their need of prescription drugs to pass a trillion-dollar bill that benefited the pharmaceutical companies and the insurance companies in this country. The people of the United States know that, and they are going to see it again tonight. You are using people in order to pass your agenda for the very wealthy in this country and it is wrong.

Mr. KENNEDY of Rhode Island

Mr. KENNEDY of Rhode Island. Mr. Speaker, I thank the gentlewoman for yielding me this time. Mr. Speaker, I have been working on this issue for several years. I have met with countless groups across this country. I have forged bipartisan relationships to bring a solid piece of legislation before this House, and today I am disappointed to say that this legislation does not meet the mark. The Congressional Budget Office itself has said this legislation, quote, would not significantly affect either the rate at which the use of health technology will grow or how well that technology will be designed and implemented. So what is the point? If we cannot get this technology in the hands of the providers, what are we doing here? This legislation does not require us to adopt standards that are interoperability standards for all on a date certain. We need to do this within the next year and a half. We could do this within the next year. We should be taking this opportunity and passing real health care information technology legislation; but, instead, we are passing a shadow of a bill that misses the opportunity to pass real opportunities for savings, both in people's lives and in countless dollars across this country. Mr. Speaker, we spend twice what every other industrialized nation spends on health care. It is the worst system when it comes to employers paying incredible premiums. We see employees paying incredible premiums. We are seeing providers complain. Nobody is happy with the current health care system; and, yet, what are we doing about it? We are missing the opportunity today. We could provide technology today that would help us implement quality standards so that when you are being treated, whether it is in Iowa or Rhode Island or New York, you get the same standard of care. But are those quality provisions in this bill? No, they are not. We can make sure that we have provisions in this bill to have the privacy protections in place, as Mr. Markey just talked about. Are they in this bill? No, they are not. How can we have an IT bill that does not set a date certain for technology, that does not have quality provisions in place so that we can use technology to bring the best and evidence-based medicines to the bedside? How can we not have provisions to protect privacy in an age when we are going electronic in health care records? Mr. Speaker, this bill falls way short of our opportunities to make a fundamental change in our health care system. I am sorry I am going to have to oppose this rule. I am going to have to oppose this bill because I think it falls way short of the opportunities we have been given to make the most of this chance to get a better health care system today. We are squandering that chance. For that reason, I will oppose the rule and oppose the underlying bill.

Mr. KENNEDY of Rhode Island

Mr. KENNEDY of Rhode Island. Mr. Chairman, I thank Mr. Stark for his leadership on this issue. Mr. Chairman, we are talking today about the potential to revolutionize our health care system by means of technology that we are using in almost every other industry currently in our society except the industry that probably could benefit the most from it, and that is our health care system. We are after this for many different reasons, but one of the reasons I am after it for is because I want to reduce the cost of health care for my constituents. My constituents, whether they be businesses that are paying exorbitant premiums for their workers, or the workers who are paying high premiums themselves, or whether it is not only the consumer, but it is even the providers that are getting shortchanged on their reimbursement, no one is happy with the current health care system. So, Mr. Chairman, what we could do today is do what has been already outlined by the Rand report, which says we could save $162 billion in direct costs because we would now not have to duplicate care if we have care now that is tracked, so we don't have to go to four different doctors and not have each doctor repeat the same test. We can now make sure that the best in care gets to everybody, because now the evidence base will be available to all doctors, no matter where they live in this country, so people will get the same and the best of care. But, frankly, Mr. Chairman, this bill doesn't do it. This bill doesn't do it. Why? Because it doesn't implement the quality standards to ensure that people get that good care. It doesn't ensure that we move quickly to the adoption, because, one, it sets up the adoption date too far in the future. Why are we waiting? If we are acknowledging this is important, why are we putting this off? Next, when it comes to making sure that there is privacy, I don't frankly understand how we can go into an electronic age in medical records and not ensure that people's personal medical privacy is protected. For those reasons, I will be voting against this legislation.

Mr. KENNEDY of Rhode Island. Mr. Speaker, I want to ask a few questions to my colleagues about this privacy law. Do you think it should be a violation of Federal health privacy law to be able to hack into an electronic database for health information? I think it should be against the law. But it is not against the law. If a hospital employee accesses your health record, for example, for a famous movie star and sells it to a tabloid, do you think that is wrong? Well, that is not against the law now. If you can allow a hospital information to be accessible through an information network, this is now permissible. All of these things are permissible under the HIPAA law. And if you do not like that, you are going to hate what this bill does to HIPAA, which is going to magnify it 100 times. There is going to be no protection for privacy whatsoever. And that is why I ask all of you to join us in the motion to recommit. Your constituents will thank you for it if you vote for the motion to recommit.

Mr. KENNEDY of Rhode Island. Mr. Speaker, will the gentleman yield?

Mr. KENNEDY of Rhode Island. Companies that are in the business of storing patient health information online are not covered under HIPAA. Are not covered under HIPAA.

Mr. KENNEDY of Rhode Island

Mr. KENNEDY of Rhode Island. Mr. Speaker, I rise today to express my extreme disappointment with the President's decision to use his veto power to reject the Congress's will to see H.R. 810, the Stem Cell Research Enhancement Act, become public law, and I stand in support of millions of Americans who will benefit from the promises of embryonic stem cell research. Each year, I meet several hundred, perhaps thousands, of constituents who share with me how Federal support of embryonic stem cell research could vastly change their lives. There are a few constituents in particular who stand out on this issue. Late last year, Maddie and Tommy Poulin, just 4 and 5 years old, traveled from Rhode Island to Washington. These two young children talked with me about what their life is like with Type I Diabetes. In a journal they left with me, Maddie included an entry that said, ``I really hope you can help us find a cure, we're not asking for a lot, we just want to live without needles.'' Stem cell research also holds promise for those suffering from Parkinson's disease, like my good friend, and the distinguished Senator from Rhode Island, Claiborne Pell. Senator Pell's contributions to our country are too numerous to list, but I know his legacy is honored everyday when individuals are able to attend college with the assistance of a Pell Grant. He stood up for those without a voice for over 35 years, and now it is time for us to stand up for him. Sue Sgambato, a cancer survivor living in Rhode Island, visits my office regularly to advocate on behalf of patients in our State. Rhode Island has one of the highest rates of cancer in the Nation, and stem cell research may provide clues on how to beat this devastating disease. I cannot and will not stand by and let one more person be diagnosed with cancer, Alzheimer's, Lou Gehrig's disease, or multiple sclerosis without holding the President responsible for his action today. It is absolutely tragic that President Bush has used his very first and only veto on an issue of such importance to American families. Every family in America has a loved one who is suffering from a disease that could benefit from the advances of stem cell research. This veto is only the latest action that President Bush has taken against medical research. He has also level funded the National Institutes of Health, and cut programs at the Centers for Disease Control and Prevention (CDC), limiting our Nation's ability to find better treatments and cures for diseases. President Bush had a choice today, and he chose politics over people. I want to assure my friends in Congress, as well as the people of the First District of Rhode Island, that today's veto is not the end to this debate, it is only the beginning. Congress has voted overwhelmingly in support of stem cell research, and this bill remains a top priority for a majority of elected officials. I promise that I will continue to do everything within my power to get this legislation back to the President's desk, and to get this language into our public law. We will be back, and we will succeed.

Mr. KENNEDY of Rhode Island

Mr. KENNEDY of Rhode Island. Madam Speaker, if this issue were not so serious it would be a joke. The Republican majority today is talking about a Pledge of Allegiance where they are saying that we should include the words ``under God'' as they have been historically in our country. They preach God all the time. They even call themselves the Christian Coalition. But you look at their policies, and you would not see anything Christian about their policies. My Aunt Rosemary was mentally retarded. If she didn't come from my family and have all of the financial support to give her, all of the support she needed, under the Republican Medicaid budget, she would have to live in the right State in order to get the support of services she needed because this Republican Congress has cut funding for the developmentally disabled in this country. The very people who are treating the most vulnerable people in our society, the handicapped, the people who are living in group homes, in institutions, those people are being paid the least. They are being paid the minimum wage. They are taking care of God's children, God's children, and yet this majority says they want to make sure they stand up for God. Where is their religiosity when it comes to standing up for the children of God? Where is their sense of justice when it comes to making sure that we treat others with the dignity and respect that God would have us treat one another with? This is a joke, Madam Speaker, that this majority would talk about God and yet not even work to raise the wages of the very people that are taking care of the children of God.

Mr. KENNEDY of Rhode Island. Madam Speaker, in 1960 my uncle, President Kennedy, in one of his remarks in the inaugural address said, ultimately, our truest test here on Earth, we need to make sure we do God's will, because God's work is ultimately our own. I find it so interesting that when it comes to our implementing the kinds of things that this gentleman would say we are somehow being inconsistent; it is really my point that the gentleman is being inconsistent, saying that he is for making sure we have God in our Pledge of Allegiance, but that God does not exist anywhere else in the Republican majority positions.

Mr. KENNEDY of Rhode Island

Mr. KENNEDY of Rhode Island. Mr. Speaker, I rise in support of the effort to override this Presidential veto, of people's right to live a life where they can be free from the illness that they are suffering today, and of my colleague Jim Langevin's right to be able to get out of that wheelchair within his lifetime thanks to stem cell research.

Mr. KENNEDY of Rhode Island

Mr. KENNEDY of Rhode Island. Mr. Chairman, I thank the gentleman from North Carolina for his work on this issue. On June 13, Rhode Island and Providence lost Mike Day due to a heart attack just after he had returned from a fire to the fire station. He is the son of a firefighter, and he is one of four brothers who all became Providence firefighters. He was passionate about helping save people's lives and helping to serve people. Who has he left behind? He has left his wife of 22 years behind, Cynthia, as well as four children, Mike Jr., Amanda, Brianne and Stephanie. The Hometown Heroes Act was signed by the President 3 years ago. Where is the support for these families who put their lives on the line to save our lives and our communities? The delay out there from the Department of Justice means that these benefit applications of people like Mike Day are waiting, collecting dust in the Department of Justice. This is inexcusable. Mr. Chairman, I believe our public safety officers need to know that if they lay down their lives for us that we are going to be there to back their families up and make sure those families are supported. The hardship of these families shouldn't wait on the Department of Justice and neither should we in Congress wait for the Department of Justice. I urge passage of this amendment.

Mr. KENNEDY of Rhode Island

Mr. KENNEDY of Rhode Island. I thank the gentleman. Right now, everybody has access to your medical records. Obviously, I would like to support more privacy. But, frankly, your insurance company has a right to your medical records, all the data processing companies have a right to your medical records, and all the financial institutions that are collocated with the insurance companies have your financial records. The Health Care Information and Privacy Act in this country has no teeth. Some nurse or doctor can sell your medical records and not be liable civilly or criminally. Someone can sell your records to a tabloid, and you have no right to sue the tabloid. They can obtain it under illegal and false pretenses. No recourse whatsoever. This notion of privacy is really bunk. We have no privacy in terms of medical records. And I would ask the American people, please call your representative and demand medical privacy from our HIPAA laws. Announcement by the Chairman

Mr. KENNEDY of Rhode Island. Mr. Chairman, just one last point. We have no medical privacy in this country now. The health care and privacy act is nonexistent. It has no teeth in it. Your medical records can be found out from anybody anywhere. They pass through a million different institutions as they get processed through transaction companies, insurance companies, financial companies. It is absolutely bogus. We haven't even passed the genetic nondiscrimination act here in this place, which means, if you have genetic disposition to a particular illness, you are not protected. There is no privacy in our medical records. Let us just understand that from the get-go. The American people are outraged by not having privacy, they have to get to their Members of Congress and request that we do more to strengthen the HIPAA law, the healthcare information and privacy act.

Mr. KENNEDY of Rhode Island. Mr. Chairman, will the gentleman yield?

Mr. KENNEDY of Rhode Island. Mr. Chairman, I want to congratulate the gentleman for his passion in advocating on behalf of Native Americans. I salute him entirely in his efforts to represent his district but also all of Native American country. Growing up, I had a picture in my house of my Uncle Robert Kennedy out in Pine Ridge Reservation, and the pictures were of like a developing country that we would never think was here in our own country. And your description today of the conditions are no different than the descriptions that occurred 40 years ago when people were thinking what a tragedy it is, the way we are treating our Native Americans. And what is even more of a tragedy is that, over all of these years, we have done nothing to improve the conditions of Native Americans in this country who have absolutely been decimated in so many ways because the United States has failed to fulfill its very basic trust responsibility to our first Americans. I cannot thank the gentleman enough for his passion and his advocacy, and I think he has done an admirable job laying out the statistics for the American people. I think if the American people only knew how bad these situations were, their conscience would be raised and we would be about trying to solve the problems that the gentleman talked about in his speech.

Mr. KENNEDY of Rhode Island

Mr. KENNEDY of Rhode Island. Mr. Chairman, I move to strike the last word. Mr. Chairman, first let me commend the chairman and ranking member for their work on this bill. Today I rise to bring attention to a very critical issue, and that is how to provide evidence-based treatment for prisoners with mental illness and substance abuse disorders. Nearly 74 percent of those arrested test positive for drugs and alcohol at the time of arrest. The disease of alcoholism and addiction is obviously a very important one in our justice system, and hence if we are going to reduce recidivism rates and reduce the revolving door of people going in and out of prison, we must tackle this issue of both trying to reduce the stigma and the access to treatment of those with alcoholism and addiction. A study by the National Institute on Drug Abuse has said that prison- based substance abuse treatment programs combined with aftercare reduces recidivism. Those who have not received these programs have recidivism rates up to 75 percent of the time. Those who have had treatment have recidivism rates under 27 percent of the time. Seventy- five percent recidivism without treatment, 27 percent recidivism with treatment. So the fact of the matter is, we can make an enormous difference in helping to reduce not only the lives lost, but also the cost to our prison system. We are going to add $90 million in this bill for new prison construction. How many people out there as taxpayers want to pay for new prison construction, when over half the people in prison today are there for simple possession of drugs and alcohol. I would like to ask the chairman of the committee to engage in a colloquy, and first commend him for increasing the amount for the drug courts over 300 percent in this budget, recognizing the importance of reducing recidivism and keeping people out of the prison system, and ask him whether he would work with me to make sure that we tie in the National Institute on Drug Abuse, obviously the Substance Abuse and Mental Health Services Administration, and, of course, HHS, to help us address this overall issue that does not just lie in the justice system, but rather lies around an interagency approach to this subject.

Mr. KENNEDY of Rhode Island. I yield to the gentleman from Virginia.

Mr. KENNEDY of Rhode Island. I know the gentleman will. I thank him for all of his work in this area, and I thank him for his 6 years of service as chairman on the committee.

Mr. KENNEDY of Rhode Island

Mr. KENNEDY of Rhode Island. Will the gentleman yield?

Mr. KENNEDY of Rhode Island. Mr. Chairman, I want to thank the gentleman for all he has done in the area of providing more drug treatment, more work in terms of interdiction of drugs. This chairman has done more than anyone else in his position could ever do on the meth epidemic or anything else. All of us care about the census because we are not going to get back in our districts the entitlements for veterans, for those who are children, for education, if we don't have an accurate census. It is the process by which all substance goes through. If we don't have money for our districts that comes through a proper accounting, we are losing money in our districts. If you can't understand that the census is the key to making sure our districts' needs get met, then I don't think you have actually been looking at why we have a census. That is the reason we have it, so a portion in government, the money can go to where it ought to go to those who need it most. And, again, the chairman has done more than anyone else to try to make sure this meth epidemic has been tackled, and I support him wholeheartedly in opposing this amendment.

Mr. KENNEDY of Rhode Island

Mr. KENNEDY of Rhode Island. Mr. Speaker, I want to thank my colleague from Texas (Mr. Hinojosa) for his great leadership on this bill, and applaud Chairman McKeon for his leadership as well, and also Representative Miller from California. But I want to begin by paying special tribute to my colleague from Illinois (Mr. Davis) for his leadership on the issues of mental health in the committee and working to try to get more mental health provisions incorporated into this legislation. I also want to add a special word about my Fellow in my office, Berre Burch. Our Fellows do enormous work for all of us. They don't get paid for it, but they are very committed and spend long hours. Berre Burch has been instrumental in working on many of these provisions on mental health in this bill, as well as many others. Mr. Speaker, I know we are in a tight budget year, and often programs are not included in bills such as this because of the expense that they have. But, frankly, Mr. Speaker, I am pleased to see that the mental health needs of our seniors are included in this bill, principally because they do help save us money. Not only do they help save us money in long-term care costs, but they also help save lives as well. Yes, lives. According to the National Institutes of Health, senior citizens commit suicide at a higher rate than any other age group in our country. Now, understand this. Suicide is already twice the rate of homicide in this country. People don't recognize that. For every murder in this country, two people take their lives. Now you can see that having senior citizens have the highest suicide rate of all is pretty startling. It runs in the face of our notion of what the golden years of a senior citizen's life should be all about. We all have been guilty about understanding what it means to be a senior citizen. A lot of us confuse dementia. We say that is part of being old. It doesn't have to be part of what being old is all about. We have proven, effective treatments to intervene with seniors and make sure that the depression that they may be suffering is something that is treated so that their golden years can actually be golden years, where they can live productive, happy lives. But what does this country do to our seniors? They put them away. They put them in senior high-rises. They take them away from their families. They don't support them in their communities. They are detached from the social networks in their communities and from the community bonds that keep them uplifted. Many of them lose their spouse. Many of them lose their independence. They have physical challenges. And all of this leads, very obviously, to anything that we would all acknowledge is depression. Who wouldn't be depressed under these circumstances? The fact of the matter is, Mr. Speaker, they don't have to remain depressed. They can get treatment. We can intervene and help them out of these very same challenges. Mr. Speaker, this is an issue that has been looked at over and over and over again. Surgeon General Satcher acknowledges it, the New Freedom Commission on Mental Health by President Bush acknowledges it, the White House Commission on Aging, all of whom say that there are many impediments and obstacles to senior citizens getting the mental health care that they need, none the least of which is stigma and stereotype. In my generation, mental health is no longer the stigma that it used to be. But for many senior citizens, when they hear mental health, they think that it is something wrong with them. They think it is something morally wrong with them. We need to tell senior citizens this is part of your health care. The brain is part of your body. When the brain has chemical imbalances, we need to treat those. But, Mr. Speaker, in our country today, even in this great time of prosperity and advancement in science, we still don't acknowledge the brain as part of the body. When it comes to insurance coverage, we don't have parity for mental health or for Medicare parity, which basically means if you have depression or any other mental illness, you are paying a higher copay for your insurance for mental health treatment, you are paying a higher deductible for your health insurance, you are paying a higher premium, because somehow mental health care is treated as if it is cosmetic surgery. It is treated like it is elective surgery. It is not treated as if it is the real physical health challenge that so many millions of Americans face and, tragically, so many senior citizens face on a daily basis. But it doesn't have to be this way. I appreciate the fact that many portions of my bill called the Positive Aging Act were included in this legislation. But I will continue to fight for mental health parity so that we can give all Americans access to mental health services, and I will continue to fight for the Positive Aging Act so we get all of the necessary community support systems in place to help treat our seniors with the dignity and the respect that our senior citizens have earned and that we ought to give them.