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American Recovery And Reinvestment Act Of 2009 - Continued

Floor Speech

Location: Washington, DC


Mr. SPECTER. The basic amendment calls for the addition of $6.5 billion to the National Institutes of Health, and the modification provides for an offset from the State Fiscal Stabilization Fund.

Before proceeding directly to the discussion on the amendment, a few observations about the bill generally: I believe an economic stimulus is necessary. We have seen the unemployment rate rise to 7.2 percent last month. Some 2.8 million people lost their jobs last year. Each day brings new reports of additional people losing their jobs. We know the safety net is failing. We know there is a need to liberalize bank credit, the foreclosure rate is very high, and there is a need to provide Government intervention to stop the foreclosures. In the midst of all of these issues, there is, admittedly, the need for a stimulus package.

I am concerned about the House bill in a number of respects. I believe, for example, there is insufficient money in infrastructure. Pennsylvania Governor Rendell has assured me that the spending on highways, bridges, and roads could begin within a period of some 6 months.

There needs to be more on the tax cut side, in my opinion. There are many programs in the stimulus package which are very good programs--programs which I have fought for during my tenure as chairman or ranking member of the Labor, Health and Human Services, and Education Subcommittee--but many of these belong, really, in the appropriations process as opposed to a stimulus.

It is my hope, as we work our way through the bill, that the bill will be improved. I would like to see a bill emerge from the Senate that would be really directed toward stimulus, a bill which I could enthusiastically support.

The amendment which is offered here today is for the National Institutes of Health, which has been starved recently. During the decade when I chaired the Subcommittee on Labor, Health and Human Services, and Education, with the support of the ranking member, Senator Harkin--who is now chairman, and I am ranking member; and when Senator Harkin and I shift chairmanship, it is a seamless transfer; we work together on a partnership, bipartisan basis--together we took the lead in increasing NIH funding from $12 billion to $30 billion. Some years, the increases were as high as $3 billion, $3.5 billion. Lately, with the budget crunch, that has been impossible to maintain.

The cost-of-living adjustments have not been made, and there have been across-the-board cuts, so there has been an actual decline of some $5.2 billion of NIH funding in the last 7 years. This $10 billion allocation, if enacted, would correct that. It would give a boost and would provide jobs, high-paying jobs, at a time when the passage of the amendment would kill two birds with one stone. It would stimulate the economy by producing good, high-paying jobs, and by reducing major illnesses, which I will specify in a few moments, it would cut the cost of health care. What better way to reduce health care costs than to prevent illness, prevent heart disease, reduce the time of Alzheimer's, and cut back on the incidence of cancer? The statistics show there would be good-paying jobs created by this $10 billion. According to NIH Acting Director Dr. Raynard Kington, the $10 billion would result in the creation of some 70,000 jobs over the next 2 years. These funds could go out in a range of 6 to 9 months, and certainly in less than a year, so it has the impact of being very promptly disseminated.

The benefits are statistically demonstrable by the high costs associated with diseases which these funds are designed to cure or to ameliorate. For example, the annual cost associated with cardiovascular disease amounts to $448.5 billion a year; cancer, $219 billion a year; Alzheimer's, $148 billion; and so it goes on down the line.

The recent statistics show significant improvements on these maladies, I think attributable, fairly, to the advances by NIH research.

For example, between 1994 and the year 2004, the number of deaths from coronary heart disease declined by 18 percent and the stroke death rate fell by 24 percent. Were it not for groundbreaking research on the causes and treatment of heart disease, supported in large part by NIH, heart attacks would most probably account for an estimated 1.6 million deaths per year instead of the approximately 440,000 deaths experienced last year in 2008.

The absolute number of cancer deaths in the United States has declined 3 years in a row despite the growth and aging of our population, which is a truly unprecedented event in medical history. The 5-year survival rate for localized breast cancer has increased from 80 percent in the 1950s to 98 percent today. That is a pretty encouraging figure for people who have breast cancer or are fearful of getting breast cancer. For childhood cancers, the 5-year survival rate has improved from less than 50 percent in 1970 to 80 percent today. The 5-year survival rate for Hodgkin's lymphoma has increased from 40 percent in 1963 to more than 86 percent in the year 2003. For non-Hodgkin's lymphoma, the survival rate has increased from 31 percent in 1963 to 63.8 percent in 2003. Over the past 25 years, the 5-year survival rate for prostate cancer has increased from 69 percent to almost 99 percent.

Now, if you take anybody who is in the category of breast cancer or prostate cancer or Hodgkins or non-Hodgkins, those survival figures are very encouraging. I didn't know--when I joined the Appropriations Committee and selected the Subcommittee on Labor, Health, Human Services and Education and led the fight with Senator Harkin to increase NIH funding from $12 billion to $30 billion and to have the National Cancer Institute funded by $5 billion--I didn't know I would one day be standing on the floor of the Senate citing statistics which include me. When we talk about non-Hodgkins, that is Arlen Specter. I was shocked in February of 2005 to find that I had non-Hodgkins; tough chemotherapy, recovery, lost all my hair, got it all back, and fine. Then, last year, I had a recurrence; more chemotherapy, more rehabilitation, maintained my Senate duties, was on the floor, presided over the confirmation hearings of two Supreme Court Justices in 2005, worked with Senator Harkin, right down the line. So those are pretty important statistics if you are one of them--if you are one of them.

It is my opinion that it is scandalous in this country that we haven't done more by way of combating these illnesses. I requested an estimate from the cancer community of what it would take to make a major attack to virtually cure cancer. We can't talk about curing cancer, but the kind of a major attack which would reduce cancer very materially. We got back a figure of $335 billion over 15 years. Well, those are big numbers, but they would pay off in very substantial rewards when you consider the cost of cancer is over $200 billion a year. The cost of heart disease is almost $450 billion a year. There are ways and economies within the Federal budget to deal with those issues.

Today we are talking about a much lesser figure. We are talking about $10 billion. That would be a downpayment and a sign of a serious effort to go after these maladies. When you have a stimulus package of $819 billion in the House bill--it may go up higher than that--this is a relatively small sum. When we structured the original bill at $3.5 billion, we talked about what would be doable. We came up with $6.5 billion. I am not sure that we didn't make a mistake, that we ought to be looking for more of the $800 billion plus to deal with these maladies, but at any rate, that is where we are.

Senator Harkin and I have a little difference of opinion on the funding as to whether there ought to be an offset. My view is it is a minor difference of opinion, but one which we are going to present to the body for a vote. In looking over the allocation of the entire budget, I found there is $79 billion in what is called a State fiscal stabilization fund. Well, I think there are limits as to how we ought to go on stabilizing the States' fiscal policy, but at any rate, included in that amount is $24.7 billion to be used for a wide range of public safety and other governmental services which may include education or may not include education. All of these funds are proposed to go out under a population-based formula, but are in no way targeted to States with the biggest economic problems or greatest budget shortfalls.

It is unclear what stimulating effect this funding would have, and the purposes of the funding are undefined. So when you have almost $25 billion with the purposes of the funding undefined, it seems to me it is a much better use of that money, about a quarter of it, to fund the $6.5 billion which is the subject of the amendment which I have just described.

Senator Harkin and I have discussed this in an amiable way, as we always do. He is going to speak next and is going to propose a second-degree amendment so that there not be the offset. I have already stated my preference to have an offset because we are dealing with very serious deficit problems, and I thought that if it were possible to do this funding with an offset which was reasonable, it would be preferable than adding to the deficit. But if Senator Harkin prevails on his second-degree amendment and there is no offset, so be it, and we will have reached the core principle of trying to get these funds into the National Institutes of Health.

I yield the floor.


Mr. SPECTER. Madam President, just a very brief comment about the offset. The State fiscal stabilization fund does have substantial funding for education, as represented by the Senator from Iowa. But there is a portion of it--$24.7 billion--which is to be used for a wide range of governmental services, which may include education, or may not. In that $24.7 billion, there is wide discretion given to the States as to how they are going to handle it. Those funds go out under a population-based formula, in no way targeted to States with the biggest economic problems or the greatest budget shortfalls. The purposes of the funding are undefined, so there is a substantial amount of money which may not be used for what the Senator from Iowa has described, or education.

As I see it, it is a question of whether we are going to add to the deficit of $6.5 billion or whether we are going to establish a priority where the State has the discretion to use it with undefined purposes or use it for the three alternatives you have, which are to use the $6.5 billion for NIH, which we have described, or undefined purposes in the State fiscal stabilization fund, or add to the deficit. I think we ought not to add to the deficit. I think it is preferable to use them for NIH and not for the undefined purposes.

I thank the Chair and yield the floor.


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