Patrick Kennedy

Mr. KENNEDY

Mr. KENNEDY. I want to thank my good friend and colleague Ed Markey for organizing this Special Order and all of my colleagues for the wonderful tribute that they've given my dad tonight. I will just say that he loved people in public life because they were willing to go out and face the elements and weather the scorn of public opinion in order to stand up for what they believed in. That's why he really admired political figures, and especially in a time where political figures aren't very revered. They're pretty much down at the bottom of the public opinion polls in terms of most professions. But he knew what a difference it meant to have people of good faith and conviction be involved in the political process because he knew what a difference it made in terms of getting good policy done for the American people. He knew how easy it would be for most people to sit back and make criticisms from the sidelines, but it took a really special person to put themselves out and really sacrifice a big part of their lives because it takes enormous sacrifice of their private lives to be in the public life, especially today. So he always really got so much energy out of the people that he served with. They were the ones that sustained him so much because he felt like he was part of a team effort. There is nothing that he loved more than being part of a team, whether it was playing sports or whether it was just being part of a family team, being part of a family. That was his politics. His politics was simple. It was being part of a group and making sure that nobody in the group was left behind. I think it's a great kind of a spirit that he brought to his politics. It was a family spirit that I saw over and over again in every issue that he faced. He wanted to treat everybody else the way he expected to be treated if he were a member of a family, and I was included. He was brought up to believe that everybody had dignity and everybody had a place. You know, when I was growing up in my family, we all had a place. A lot has been said about his belief in everybody having an opportunity in society. Well, in an anecdotal way, I can tell you, in my life, he always made sure that I had an opportunity to participate.

Mr. KENNEDY

Mr. KENNEDY. Mr. Chair, on rollcall No. 711 I was detained. Had I been present, I would have voted ``no.'' Amendment No. 7 Offered by Ms. Foxx

Mr. KENNEDY

Mr. KENNEDY. I appreciate the gentlelady, and thank the gentleman from Tennessee for yielding me this time. I won't go on any further than I have already explained except to say that obviously there are good green jobs. We talk about good green jobs in this bill. This is about good green jobs. These vehicles are already being sold to police departments as public safety vehicles all across America. These Vectrix vehicles that are made in my State are electrical vehicles that have enormous capacity in the metropolitan areas. And, frankly, they are obviously great for the environment, but they are also fuel efficient, and they provide a great alternative to vehicles that we have since relied on that create such pollution in our air. So I think this is good. It's creating good jobs here domestically. And if we provide the loans, then we can keep these manufacturing jobs here at home. Roughly, 16,000 jobs are anticipated, conservatively, within the next 5 years as a result of just loans that can be made through the Department of Energy as a result of this amendment. So I would ask that my colleagues favorably support this amendment. Mr. Chair, I rise in support of my amendment, offered by Mr. Gordon, an amendment to ensure that this valuable legislation includes all manufacturers of qualified plug-in electric vehicles. Right now, there are a dozen companies in our country that are designing and manufacturing 2- and 3-wheeled electric vehicles. They have not been able to participate in Department of Energy funding opportunities, not because they lack merit, but because they simply don't have 4 wheels. If these companies had access to Department of Energy loans on the same basis as the rest of their industry, they could create 900 green jobs in the next year and 16,000 jobs in the next 5 years. With our current unemployment, we cannot afford to leave one job on the table. My amendment is simple. It ensures that all manufacturers producing qualified plug-in electric vehicles are eligible under this legislation. In the past, innovative vehicles like electric motorcycles were left out simply because they did not conform to outdated definitions. My amendment clarifies that these ground-breaking vehicles and their manufacturers are eligible under the program using a definition from existing law. The electric vehicle industry has an opportunity to profoundly influence our nation's future. It can help to preserve our environment, revitalize our manufacturing base and help free us from our dependence on fossil fuels. I urge my colleagues in the House to join me in support of all plug- in electric vehicles and adopt this amendment.

Mr. KENNEDY. We have found already that these vehicles have not been able to garner the loan assistance that has been already available in other pieces of legislation and in the stimulus bill and previous legislation because they don't come under the strict definition of a 4- wheel vehicle. We have tried to make the regulations flexible enough to say that they are two and can be retrofitted to become four, but, of course, that's kind of a stretch in the fact that the manufacturing process can be expanded to make 4-wheel vehicles out of these 2-wheel kinds of systems, but it's not the intended purpose of these manufacturing facilities. That's why we want to put it in specifically to mention 2- or 3-wheel vehicles.

Mr. KENNEDY. Yes. To answer the gentlewoman's question, obviously, with advanced technology and energy-efficient vehicles, we're looking at all sorts of modes of transportation. Of course, in Europe, these modes of transportation, for the most part, are these small motor scooters. In fact, if we're looking to become energy independent and efficient and if we're trying to incentivize in this country the production and manufacturing of vehicles that are going to reduce our dependence on foreign oil and are going to promote energy efficiency, we cannot do this and miss a large part of the market that the rest of the world is utilizing in order for them to become more energy independent and more energy efficient. That's why it is important that we actually put this in the language of the bill, because, otherwise, they will not be eligible for the incentives that we make available for 4-wheel vehicles. In fact, if the idea is to promote all of these kinds of vehicles, we ought to make sure that it says that distinctly in the language.

Mr. KENNEDY

Mr. KENNEDY. Madam Chair, as we know from legislation that this committee worked on many years ago called the Foundations for Learning program as part of the Elementary and Secondary Education Act, social and emotional development are as important as anything in the early part of a child's life. Importantly, in this piece of legislation, we recognize these same important facts, and in this legislation we reflect these findings by acknowledging the importance of intervening early in a child's life who has had domestic violence exposure, has had homelessness exposure, has had their parents exposed to mental illness. Intervention in these children's lives makes an enormous difference in their social/emotional development and in their educational abilities later on in life. For these reasons, I think this is an important piece of legislation that needs to be adopted. I appreciate the chairman for acknowledging these facts and incorporating this legislation into the body of his bill.

Mr. KENNEDY

Mr. KENNEDY. Mr. Speaker, on rollcall No. 697, I was unavoidably detained. Had I been present, I would have voted ``yea.''

Mr. KENNEDY

Mr. KENNEDY. Mr. Chair, I want to commend your hard work on this bill which shows our strong commitment to America's children, seniors, families, and others in most need. In particular, I want to thank the Chairman for increasing funding for the NIH, CDC and SAMHSA. When it comes to medical research the bill moves our nation forward. It provides $500 million over the President's Budget for the National Institutes of Health so that NIH can get us closer to the cures that we all wait for. When it comes to addressing our national security from the H1N1 virus it moves our nation forward. The bill gives $545 million total for critical pandemic flu activities at NIH, CDC and the Office of the Secretary. When it comes to public and preventative health the bill moves our nation forward. It provides increases to health professions and nursing education, which have been starved in recent years. This year instead, we will be able to train the doctors, nurses, and other health professionals the country needs to ensure that more people get quality health care. When it comes to mental health and substance abuse services the bill moves us forward. In particular, I want to commend the new initiative funded by the Chairman in SAMHSA regarding the effects of the economic downturn on mental health. There is $5 million provided for a Community Resilience Initiative. Nowhere are our economic hard times felt more than in Rhode Island, where we have over twelve percent (12%) unemployment and a state in budget crisis. This new initiative will help workers across the nation and in my state, to better cope with the stress this economy is placing on them. I also would like to commend the Chairman for his commitment to funding the Senator Edward M. Kennedy Serve America Act. Named after my father, the senior Senator from Massachusetts, this bill provides the public and volunteer service roadmap for the Twenty-first Century, much like my uncle's call to service over 40 years ago. Named after a steadfast leader of so many of the programs that are funded in this bill, from vocational education to AmeriCorps, from NIH research to the Corporation for National and Community Service, it is only fitting that funding for the Senator Edward M. Kennedy Institute for the Senate be included in this Labor, HHS, Education and Related Agencies Appropriations bill. I thank the Chairman for his support for what will be a part of a tremendous legacy. Again, I want to thank the Gentleman from Wisconsin and his staff, for their unwavering commitment to the vital programs in this bill.

Mr. KENNEDY

Mr. KENNEDY. Mr. Speaker, the health care bill that we are now considering contains a very important item, and that is mental health parity, requiring all health insurance plans to treat mental illness and addiction on the same grounds as other physical illnesses. If we are to do this and also to include prevention, it's important that we have the appropriate education and medical education for all doctors so that they may be able to properly screen and treat all patients. Irrespective of their specialties in some other areas, doctors ought to be able to identify and to treat, at least in the primary care setting, mental health challenges before referring them to specialists. This has been an issue within the Institute of Medicine report, and I encourage my colleagues to support this in a section for medical education and training within the base of the bill.

Mr. KENNEDY

Mr. KENNEDY. Madam Speaker, this legislation, America's Affordable Health Choices Act of 2009, otherwise known as our health bill this year, will guarantee all Americans access to affordable health care without preexisting condition discrimination. Imagine that, getting health care insurance without being told that your preexisting condition is going to result in higher premiums, higher deductibles or higher copays. Imagine being able to change your job at will without having to worry that you're going to lose your health insurance. Imagine having no worry that you're going to have to exceed a lifetime cap. Imagine being able to know that you're going to have catastrophic health care coverage. Imagine knowing that we're going to now move in our health care system from a sick care system that just is the most expensive that we know to actually a health care system where we actually pay for preventive care so that we actually get health care in this country, not sick care; where we pay for prevention, not sick care. We don't have to wait until an asthmatic gets an asthma attack before we get a doctor to that asthma patient. We don't have to wait until a diabetic gets an amputation before we get that critical care. We get prevention and chronic care management. And what is so great about this legislation is that it includes full parity for mental health coverage. I was proud last year to author the Mental Health and Addiction Equity Act of 2008. What it required is that we finally recognize that mental health and addiction equity is part of our health insurance system, meaning insurance companies can no longer discriminate if you had alcoholism or addiction or depression. Imagine that, we finally acknowledge that the brain is part of the body. Mental illness is a big part of our country's health care system. It accounts for over 50 percent of the trauma admissions in our trauma one centers and emergency rooms every single weekend. Suicides in our country exceed homicides by two to one, suicides do. And you know what, we don't have a mental health system in this country to speak of because, you know why, there's a stigma out there against mental illness. We still believe in this country that it's your fault if you have a brain illness. If somehow you have a lower dopamine level or seratonin level, it's your fault. We think you ought to pick yourself up by your boot straps; it's your fault. It's a moral problem. We forget the fact that now, even to this day, we can take brain scans and tell whether someone has a differing brain or not from a normal functioning brain. But today, we are enforcing what we know to be scientifically true, what the AMA said in 1955, and that alcoholism is a disease, that there is such a thing as brain disorders, substance abuse disorders, eating disorders, depression, bipolar disorder, and things of that nature. In this legislation, in this health care bill, we require parity in health care coverage. We say that we ought to recognize these disorders for what they are, and furthermore, we say we ought to have prevention. And even more in this legislation, we're going to say we're going to require medical school education to have education teaching all doctors to recognize this. That is what is important in this legislation, and I am pleased to ask my colleagues that they ought to support this legislation so that we can finally have justice for all in health care in this country.

Mr. KENNEDY

Mr. KENNEDY. Madam Speaker, the America's Affordable Health Choices Act of 2009 vitally enhances the provision of mental health care in our nation. Perhaps most importantly, the legislation includes mental health and substance-use disorders benefits in the essential benefits package. It is because of the precedent set by the mental health parity law, fortifying the civil rights of those with mental illnesses, which lead to the clear recognition by the bill that optimal health cannot be achieved without the inclusion of mental health and substance-use disorder services. I am pleased to have worked with the Committees to have accomplished this victory. This bill also bolsters the provision of primary care in our country, and in particular prevention. However, if mental health and substance- use disorders are to be included as an essential benefit, we need to be sure that our Nation's physicians, both primary care doctors and specialists, have the behavioral health training and education necessary for them to meet these new provisions. Current medical education, and in particular continuing medical education, does not include enough behavioral health components for physicians to adequately meet the mental health needs of their patients. Substance- use disorder education in particular is rarely offered as a separate component of education, leading medical school graduates with a lack of confidence in their skills to screen, assess, or provide the needed interventions to their patients, according to the 2005 National Academy of Sciences' Institute of Medicine (IOM) Improving the Quality of Health Care for Mental and Substance-Use Conditions report. This report also found that even in preventative medicine, most substance-use education focused solely on tobacco. The recommendations from this report were so essential for the health of our Nation that I developed legislation based on them--the Improving the Quality of Mental and Substance Use Health Care Act. These issues are now more pertinent than ever as we craft a reform of the current system which will greatly increase the access to mental health care for Americans. Sadly, a recent study showed that barely a third of Americans with mental illness get proper treatment, and that most people who do get care obtain it through their care from primary care physicians. Yet about two-thirds of U.S. primary care physicians reported in 2004-05 that they could not get outpatient mental health services for their patients--a rate that was at least twice as high as for other services, according to the Commonwealth Fund. It is more crucial now than ever that physicians receive the proper behavioral health training--we cannot increase access without arming our workforce with the tools needed to meet this challenge. I therefore respectfully ask the Committees' and my colleagues to ensure that this essential education and training is included in the workforce and education enhancements sections of this bill.

Mr. KENNEDY

Mr. KENNEDY. Chairman Obey, I want to commend you for the very hard work that you put into this bill, which shows a strong commitment to America's children, seniors, families, and others most in need. In particular, I want to thank you for increasing funding for the NIH, CDC and SAMHSA. When it comes to medical research, this bill moves our Nation forward. It provides $500 million over the President's budget for the National Institutes of Health so the NIH can move us closer to the cures that we all wait for. When it comes to public and preventative health, this bill moves our Nation forward. It provides increases to health professionals and to nursing education and to the very serious public health and national security crises posed by the H1A1, avian flu. This bill prepares us for that uncommon threat. When it comes to mental health and substance abuse services, this bill moves us forward. In particular, Mr. Chairman, I want to thank you for funding a new initiative regarding the effects of the economic downturn on mental health, called the Community Resilience initiative. Through this funding, we are going to be able to design a health program that meets our public's mental health resilience needs at a time of economic downturn and of very strong public stress. In my State of Rhode Island, with 12 percent unemployment and in a state of budget crisis, my people and our country's needs are much greater because of this pressure, not only on our economy but on the public at large in their personal lives. For that, I want to thank you, Mr. Chairman, for these increases in funding.

Mr. KENNEDY

Mr. KENNEDY. Mr. Speaker, today I rise in favor of the health care bill this Congress is considering. It would cap out-of-pocket expenses. It would eliminate preexisting condition discrimination. It would give patients a choice between our own physician and a government plan. It would eliminate lifetime caps for health care. It would eliminate the ability for people to no longer have the choice of having to choose a job and not be able to leave that job because of health care discrimination, no more denial because of a preexisting condition, and mental health parity for all insurance plans, irrespective of mental health preexisting condition. Mr. Speaker, we need to have mental health screening annually covered, and that is what this bill does so that we treat it as a preventive item. For the 130 million Americans with mental health conditions, this will act as a preventive measure, saving us millions and millions of lives and dollars from suicide and the like.

Mr. KENNEDY

Mr. KENNEDY. Mr. Speaker, I want to commend my good friend and colleague, Chairman Ruben Hinojosa, for his work on this issue of adult illiteracy which he just spoke about. Just like Ruben Hinojosa and his district in Texas, in my State of Rhode Island where unemployment rates continue to rise, 23 percent of the adult population in my district alone lacks a high school diploma. Last June when the National Commission on Adult Literacy released its report, it served as a wake-up call for all those concerned with the quality of our adult workforce. The commission found that 80 to 90 million adults in this country have deficiencies in basic education and that our investments in adult education and training were reaching less than 3 percent of those who need it. That's why we need to ensure that our adult education and workforce training programs have the tools and resources they need to prepare our workers for the next generation of jobs in energy, in health care and in technology. We need to improve the way we deliver adult education and workforce training programs and the way we provide career paths to higher growth fields through greater involvement with business leaders, State agencies and adult education community and workforce leaders. We need to better leverage employers to provide educational programs to their employees. We need to enhance the use of technology to improve quality learning access and delivery of adult education, literacy and workplace skills services. The Adult Education and Economic Growth Act which Ruben Hinojosa and I are introducing will do all of these things in order to provide those employed and unemployed with the ability to attain the skills they need to compete in an ever-changing workplace. I urge my colleagues to support this important legislation. The Adult Education and Economic Growth (AEEG) Act of 2009

Mr. KENNEDY

Mr. KENNEDY. Madam Speaker, as we continue to craft a meaningful, necessary reform of our health care system, we must continue to embrace prevention, the provision of whole-body care, and the reversal of the current ``sick-care'' system. With this in mind, I respectfully ask you to ensure that screening for mental health and substance abuse is included as one of the preventative services proposed by the America's Affordable Health Choices Act of 2009. The pervasiveness of mental illness and substance abuse in our society continues to be disconcerting. In 2007, over 20 million individuals were diagnosed with substance dependence or abuse. However, less than 10 percent received treatment for their disorders. By some estimates, the societal health and economic costs of alcohol and drug abuse are estimated at $366 billion per year. Conversely, screening has an estimated net savings of $294 per person offered screening. Extensive data documents that drug and alcohol addiction treatment is as effective as treatment for other chronic medical conditions such as cancer, diabetes, and heart disease. Substance addiction, like cancer, diabetes, and heart disease, is a preventable and treatable chronic disease. Likewise, mental illnesses are among the most expensive and disabling chronic diseases. Severe mental illnesses are estimated to cost the U.S. $193 billion in lost wages in 2002. The World Health Organization has pronounced mental health disorders to be the leading cause of disability in the U.S. based on burden of disease. Moreover, mental illnesses often accompany and greatly increase the cost of treating other chronic conditions. Tragically, individuals with serious mental illness have a life expectancy of 25 years less than general population. Currently, mental health and substance abuse screening tools, such as Screening, Brief Intervention and Referral to Treatment (SBIRT or SBI), are being used effectively in many academic centers, hospitals, trauma centers and community health settings across the country. A cost assessment conducted of SBIRT in Washington State demonstrated a cost savings for the State of $2 million in Medicaid costs for just 1,000 patients. SBIRT is already effectively being used by the Federal Employees Health Benefits Program, and the Center for Medicare Services has also allocated approximately $300 million for states specifically for reimbursement of SBIRT. I look forward to continuing to work with my colleagues to ensure that this life-saving preventative strategy is included in the America's Affordable Health Choices Act of 2009.

Mr. KENNEDY

Mr. KENNEDY. Mr. Chair, on rollcall Nos. 556, 558, 559, 560 and 564, I was detained by a phone conversation with George Soros regarding the state/the U.S. economy and world economy and what would be done to rectify it. Had I been present, I would have voted ``no.'' Amendment No. 13 Offered by Mr. Flake

Mr. KENNEDY

Mr. KENNEDY. Madam Speaker, I would like to thank you, Speaker Pelosi, for bringing to the floor of this House a piece of sweeping health care legislation, the likes of which we haven't seen in over 60 years since the Congress passed the Medicare legislation. Madam Speaker, I want to thank you because it's about time the American people had an opportunity to have health care for all, irrespective of preexisting conditions. Madam Speaker, I want to thank you on behalf of the millions of Americans who suffer from mental illness because health insurance companies do not acknowledge that the brain is part of the body, that there is such a thing as alcoholism and addiction in this country. Madam Speaker, thanks to your leadership, we passed the Paul Wellstone-Pete Domenici Mental Health and Addiction Equity Act last session, and thanks to your leadership with this legislation, there is no discrimination against those with mental illness. And in each and every one of the health care plans, there is absolute parity in health care coverage for those with mental illness. Thank you, Madam Speaker, for this historic legislation.

Mr. KENNEDY

Mr. KENNEDY. Mr. Speaker, I did not mean to impugn the reputation of any individual Member. I was merely speaking about the party that was representing the insurance companies. I ask unanimous consent to withdraw the words.

Mr. KENNEDY. Mr. Speaker, anyone ever heard the expression, ``the proof is in the pudding''? Well, when the private health insurance companies found out that there may not be a government option, you know what happened to the health insurance stocks on Wall Street? They went through the roof. Profits skyrocketed because, you know why? The health insurance companies make money off of the consumers when they don't have competition, when they're able to cut your health care and make profits out of denying you health insurance. That's how the private marketplace makes money, by denying you health care. They only want to cover the healthy and well. We have the government option, the public option, to guarantee the American people that they get the health care that they paid for. * * * We're on the side of the American people. We want to protect the people so that they can get their health care, irrespective of a preexisting health care condition. I'm proud that this health care plan covers all preexisting conditions, including mental health parity as covered by the Mental Health Parity and Addiction Equity Act that was passed and signed by President Bush. MR. GOHMERT. Mr. Speaker, the words were just said that the Republicans, pointing over here, are bought and paid for. I would ask that those words be taken down.

Mr. KENNEDY

Mr. KENNEDY. I want to thank the chairman of the Appropriations Subcommittee on Veterans Affairs, Chairman Edwards, for his leadership on what has been an amazing increase in funding for veterans in this country. As chairman of the Appropriations Committee, we have seen in the last cycle the largest single increase in veterans funding in the 76-year history of the Veterans Administration in the last cycle. And, as such, that has carried over till this cycle and will in the succeeding years ahead as we continue to increase the veterans appropriations. And, again, this year, we are seeing another large, large increase in the veterans spending, including increases in veterans mental health. And that, my friends, is what I am so pleased to see, especially in the wake of the terrible tragedy at Camp Victory, where we saw a murder- suicide, once again highlighting the terrible tragedy that so many of our veterans are facing with the psychological wounds that they are facing and the combat that they are so readily seeing on a day-to-day basis. They are not only suffering the physical wounds of war but the psychological and mental wounds of war. I would like to acknowledge the ranking member, Zach Wamp, for the incredible support that he has given to our veterans in the area of mental health services. We have seen in this bill $4.6 billion for mental health services in this bill. We have seen an additional $3.2 billion for homeless veterans. It's a tragedy, as my friend Sam Farr said, that the single largest percentage of the homeless population in this country are veterans. That should not be the case. In this bill, we seek to try to end that situation. Madam Chairman, I am also pleased to see that this committee responds to the veterans of America in providing advance funding for veterans funding for the succeeding years, so that veterans do not have to wait on Congress to provide those funds, and that we provide an additional $48 billion in the 2011 budget. And that, my friends, is a result of General Shinseki, the VA Secretary's strong advocacy and this President's commitment to our veterans to make sure that they don't have to wait--they don't have to wait for a budget in order to know that they're going to get the funds they need to take care of our veterans. For these and all the reasons, I'm so proud to be part of this committee and to see that this country lives up to its promise to our Nation's veterans. And I thank the chairman for all the good work that he does, and I thank the ranking member for all the good work that he does. And I'm proud to be on this committee.

Mr. KENNEDY

Mr. KENNEDY. Mr. Chair, I regret that I was unable to participate in a vote on the floor of the House of Representatives today. Had I been present to vote on rollcall No. 305, a Chaffetz (UT)/Shea- Porter (NH) Amendment to H.R. 2200, the Transportation Security Administration Authorization Act of 2009, I would have voted ``aye'' on the question.

Mr. KENNEDY

Mr. KENNEDY. The average age of death of people from this flu is 19 years old. The average person in an ICU is 24 years old. So this is a whole new phenomenon in terms of your father's Chevrolet. This is a whole new issue we are dealing with. I would hope that Homeland Security would be working with public health and with everyone else to help address this.

Mr. KENNEDY. I thank the gentleman from Mississippi, and I thank all of those who have worked on this very important bill. I had the opportunity to serve on the committee on oversight. Last week, we had a hearing on H1N1, the flu. Most people have forgotten about the flu already. What was very startling to me was that, like many things, they come and they go in our public consciousness. This flu is coming back by all the scientists' projections, and when it comes back, it's going to have mutated into an even more deadly strain.

Mr. KENNEDY

Mr. KENNEDY. Mr. Speaker, I would like to thank the gentlelady from California (Mrs. Capps). Thank you for all your good work on health care. As a former nurse, you know full well of the challenges of making sure that we have adequate supply of providers and how important it is for us to address the needs of those with mental illness by making sure that there are enough providers out there who are adequately educated in the field of mental illness. And I appreciate your cosponsorship on the Child Work Force Reduction Act, which will address the need of bringing in more child and adolescent mental health workers into the workforce field to deal with children and adolescents who need mental health care, because right now we're at a critical stage in this country with respect to the need for our children to gain access to providers willing to take care of those special needs that children have in the area of mental health. And nurses and doctors are in great need for those reasons. And Lois Capps has been really one of the champions in the area of trying to provide greater numbers of nurses and professionals who can take on the enormous challenges ahead. In addition to that, Mrs. Capps, you've been very helpful in recognizing the enormous boom that's going to happen with our aging population. We're going to have a baby boom generation that's going to become a senior boom generation, where so many of our baby boomers are going to be elder boomers. They're going to be elderly, and the demand for new nurses is going to be extraordinary. And we don't have, right now, the necessary populations of nurses to deal with that. Many people write off senior citizens' dementia, if you will, as part of growing older. They say, Oh, Grandma. Well, that's Grandma. That's the way they are when they're nonresponsive. Well, frankly, I certainly don't want to be treated that way when I grow old, and I dare say anybody watching this doesn't want to be treated that way when they grow old. And the fact of the matter is, for most older people, it isn't dementia that leaves them isolated and with their heads down; it's depression. It's depression. And who wouldn't be depressed if you're a senior citizen and you've lost your life mate after over 40 years of marriage, if you've had to pick up and sell your house because you've no longer been able to afford it any longer, if your children and grandchildren are scattered all across the country and very rarely visit you any longer, if now you're confined to an elderly-only high rise. I would imagine that would be pretty depressing for a lot of elderly people, and for many of them, it is depressing. And so we are working on the Positive Aging Act, which will address the needs of our senior centers and the needs of our seniors with regards to that. But I also want to acknowledge my good friend and colleague, Grace Napolitano, who has been so wonderful in her efforts to lead the charge of the Mental Health Caucus. And Grace Napolitano has been a terrific champion for making sure that our young people are also included in on these issues of mental health because she has seen in her own neighborhoods, that we may talk about war overseas and the posttraumatic stress that our veterans suffer when they go into harm's way, and they come back and they're suffering from reconciling all this violence to the new world they're coming back to, and they have to readjust to the main life of everybody else, and they have to somehow come home, and a lot of them suffer from PTSD. Well, you can imagine, these are adults. These are fighting men and women, the men and women of our Armed Forces, and they have adult coping mechanisms. And even adults, with adult coping mechanisms, have posttraumatic stress disorder. So imagine what a child is facing in a barrio in East Los Angeles, or in a borough in Upper Manhattan, or a neighborhood in South Providence, or Pawtucket, Rhode Island, imagine the coping mechanisms that the children are going to need to have in those areas when they see violence in their own hometowns. In a very real way, they are suffering from posttraumatic stress, while not even having to go overseas to go see a war because the war that they are seeing is in their own backyard. They are seeing gunshots in their own backyard on a regular basis. We have 36,000 people killed by firearms in this country every year, a far cry from the number of people that have been killed in action over in Iraq. You know, this is a situation where it's not a small wonder that there are so many kids in this country who are acting out and who are having trouble with their own mental health needs and posttraumatic stress. So, Mr. Speaker, we have a lot to do with addressing the mental health needs of our people, both seniors and children and, of course, those who suffer from serious mental illnesses at the same time. So this is Mental Health Week. We need to raise awareness of mental health. And the most crucial part of destigmatizing mental health is for people to go online to any of the National Institutes of Health, National Institute on Drug Abuse, National Institute of Mental Health and so forth, National Institute on Alcoholism, and look up the studies, because you will see the biochemical makeup and breakdown of the brain and how it operates differently for those who are at high risk of being alcoholics, or at high risk of having a propensity to have a bipolar disorder or not, or having depression, or those people who may have other diagnosable mental disorders. It's quite striking that what you'll see in these videos that are a result of these MRIs, these new x-rays of the brain, that you cannot dismiss the notion that mental illnesses are physical illnesses. And we know that for a fact, because if you simply give people who were in total depression before certain medications, it's amazing how they blossom in their abilities to now live more functional lives after they've taken the medications. So why we would ever treat the brain unlike any other organ in the body is beyond me. The brain is an organ in the body just like every other organ of the body. But unfortunately, in this country, in our health care system it's treated as if it's something separate. What we need to do in health care reform is make sure the brain is treated holistically, as part of the body. And in any health care reform, it's got to be reimbursed holistically in terms of the rest of the health care package. I thank Representative Napolitano for introducing this resolution in support of the goals and ideals of Mental Health Month. I rise today to speak to those goals, and the need to integrate them into health care reform. According to the Institute of Medicine, together, mental and substance-use illnesses are the leading cause of combined death and disability for women of all ages and for men aged 15-44, and the second highest for all men. When appropriately treated, individuals with these conditions can recover and lead satisfying and productive lives. Conversely, when treatment is not provided or is of poor quality, these conditions can have serious consequences for individuals, their loved ones, their workplaces, and the nation as a whole. Tragically, individuals with serious mental illness have a life expectancy of 25 years less than the general population. The World Health Organization defines health as ``a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity.'' As we work to reform and reincentivize our health care system, we must ensure that it is a whole-body initiative, recognizing that mental health is integral to overall health, and that optimal overall health cannot be achieved without this. With this in mind, we must diligently work to ensure that when crafting health care reform, we create a health care system that treats the whole person. Health care reform policy should support and encourage practices that fully integrate mental health into primary care. All providers, and in particular primary care doctors, must be trained and adequately reimbursed, for providing comprehensive and coordinated care--care that approaches health as a whole body initiative. Primary care physicians must be given the resources needed to adequately address the mental health needs of their patients. Innovations, like medical homes, are working to improve quality and contain cost, but the primary care workforce is not sufficient to meet the country's needs. Over the last two decades, fewer medical students are choosing primary care for a number of reasons, including reimbursement issues. Payment policies do not adequately compensate doctors for the time it takes to coordinate care, provide case management, or address mental health and substance abuse issues in the primary care visit. Specialty providers and other physicians must likewise have training on mental health and substance abuse problems and be trained to provide collaborative care and case management, and be reimbursed accordingly. For the 45.7 million Americans without health insurance (a number which has grown due to the recent economic downturn), we must create an affordable, quality health care system in which all Americans are covered. Providing coverage alone, as it exists now, is not a solution onto itself however. The coverage we provide for all Americans must include the full spectrum of evidenced-based mental health care, including both treatment and prevention services. Mental health coverage should not be subject to restrictive or prohibitive limits when formulating coverage determinations on the frequency or duration of treatment, cost-sharing requirements, access to providers and specialists, range of covered services, life-time caps, and reimbursement practices. The expansion of insurance coverage is not the same as ensuring access. Lack of insurance is only one of the many barriers to care for those seeking mental health services. Those with coverage also face financial barriers to care due to prohibitive cost sharing requirements, limited access to providers, and denials of coverage for mental health conditions. Once all Americans have health insurance, coverage must provide for access to affordable, high quality care. Current barriers to care within the health insurance system must be eliminated, and mental health coverage must include access to the full spectrum of evidenced-based care for both prevention and treatment of mental health conditions. This includes, but is not limited to, access to and choice of doctors who approach health as a whole body initiative. Other reform measures necessary to create a system best posed to treat the health of the whole body include: instituting rules for standardized payments; ensuring that clinical necessity is the determinant of patient care; replacing underwriting with a ``community rating'' system that would set premiums based on age and location instead of health status of the individual; requiring that any denials of coverage be transparent and subject to a meaningful and independent review process; promoting and incentivizing mental health prevention programs; integrating mental health consumers and providers in emerging health information technology systems; requiring the regular use of standardized, objective and uniformly applied clinical outcome measures; and improving coordination among social service sectors. Further, in order to truly achieve the above stated principles, we need health care reform that addresses the underlying, systemic issues in our current system. We are the only industrialized country that treats health care like a market commodity instead of a social service. Thus, care is not distributed according to medical need but rather according to ability to pay. Cost savings cannot be discussed without acknowledging that 31 percent of all health care expenditures in the U.S. are administrative costs. The average overhead for private insurance in this country is 26 percent, compared to 3 percent for Medicare. The majority of doctors and Americans support a single-payer health care system, yet this option has been dismissed by many policymakers as unrealistic. As elected Representatives of this democratic system, we are responsible for representing the views of the public. Therefore, it is imperative that we keep this option in the discussion of health care reform. I hope to work together with my colleagues to institute these critical changes to our nation's health care system. The American people deserve nothing less.

Mr. KENNEDY

Mr. KENNEDY. Madam Speaker, on behalf of the constituents of the State of Rhode Island and those whose lives have been impacted by Special Olympics Rhode Island, I would like to pay tribute to Mike McGovern, a man who has dedicated his life to the fulfillment of dreams of many with intellectual disabilities. After a long and accomplished career serving in various leadership capacities for Special Olympics Rhode Island, Mike has decided to retire. He served as Assistant Executive Director from 1988 through 1998 before taking on the role of Executive Director in 1998. Over the last two decades, Special Olympics Rhode Island has benefited from his talents in fiscal management, fundraising, public relations, personnel management, and compliance with accreditation requirements established by Special Olympics, Inc. Without a doubt, Mike's greatest satisfaction has come from watching young children with intellectual disabilities defy stereotypes and low expectations. Witnessing the children develop into confident, productive members of society is one of the many motivations that have empowered Mike over the course of his career. Additionally, Mike has been the driving force behind the success that Special Olympics Rhode Island has enjoyed in its commitment to being an athlete-centered program. His enthusiasm and guidance has ensured that Special Olympics Rhode Island is one of the most innovative and dynamic sports organizations in the state. Mike McGovern remains a true friend to all those whose lives are touched by a person with developmental disabilities. Special Olympians across Rhode Island will miss his dedication and devotion as an individual who truly exemplifies the true meaning of Special Olympics, sport, spirit, and splendor.