Addressing Aging Issues In Maine And Across Our Nation

I recently had the opportunity to speak at the 10th Annual Geriatrics Day Conference at Maine Medical Center in Portland. The fact that this is often a sold-out conference with a waiting list illustrates the importance of aging issues to medical professionals throughout our State. With Maine being the oldest state in the nation by median age, the active involvement of health care providers is essential, and it was an honor to meet with them.

Maine’s growing population of older individuals, the rapidly changing demographics of our nation, and the challenges created by these changes are among the reasons why I pursued a leadership position on the Senate Special Committee on Aging, a Committee on which I have served since I joined the Senate. Throughout its history, this committee has spurred Congress to action on issues important to older Americans through its hearings, investigations, and reports.

One disease that takes a tremendous toll on far too many of our older citizens is diabetes. As the co-chair of the Senate Diabetes Caucus, I have learned a great deal about this terrible disease that affects 29 million Americans. It also has a cost to our nation of $174 billion and consumes nearly one out of three Medicare dollars.

Fortunately, we have seen some encouraging breakthroughs and are on the threshold of a number of important new discoveries. This is particularly true for the estimated 1.2 million Americans living with type 1 diabetes. Advances in technology, like continuous glucose monitors (CGMs), are helping patients control their blood glucose levels, which is key to preventing costly and sometimes deadly diabetes complications.

We are also moving closer and closer to our goal of an artificial pancreas, which would control blood glucose levels automatically and revolutionize diabetes care. The National Institute of Health and the Food and Drug Administration have been extremely supportive of these innovations in diabetes care. I was therefore troubled to learn that insulin-dependent Medicare beneficiaries are being denied coverage for continuous glucose monitors, or CGMs. More than 90 percent of private insurers cover CGMs, yet Medicare lags behind and does not do so. To fix this problem, I have joined New Hampshire Senator Jeanne Shaheen in introducing legislation to create a separate benefit category under Medicare for these monitors. It simply makes no sense that Medicare does not provide coverage for CGMs, and I am working to change this policy.

Another important issue is home care and hospice. Our health care system now stands directly in the path of a tidal wave of aging baby boomers who will be retiring at the rate of 10,000 a day for the next 20 years. That system will clearly have to adapt and change if it is to survive the impact.

One of the most important things we can do is to shift our orientation from institutional to community and home-based care, where appropriate. Advances in technology and medical practice have made it possible for older adults who previously would have been hospitalized or moved into a nursing home to stay just where they want to be, in the comfort, privacy and security of their own homes.

Yet, Medicare beneficiaries continue to face unnecessary barriers in getting home health services. To ensure that our Medicare patients get the home care they need, when they need it, I have introduced the Home Health Care Planning Improvement Act to allow advance practice nurses and physician assistants to order home health care for their Medicare patients.

I have also introduced legislation to extend the modest increase in payments for home health services in rural areas that otherwise will expire on January 1 of next year. The delivery of home health services in rural areas can be as much as 12 to 15 percent more costly because of the extra travel time required to cover long distances between patients, higher transportation expenses, and other factors. If this rural payment is not extended, agencies may be forced to decline service to rural patients with greater care needs.

Not long ago, I participated in a National Action Conference on End-of-Life Care. This can be a difficult topic for many families to address. Too many Americans fail to plan for their health care, and, as a result, their care may not be what they would have chosen. Working with former Senator Jay Rockefeller, I authored the law to include a discussion regarding advance care planning during the initial physician visit to which all Medicare beneficiaries are entitled. We must do more, however, to encourage families to have these important discussions, difficult as they may be.

Among my highest priorities as Chairman of the Senate Aging Committee is to ensure that the goals set forth in the National Plan to Address Alzheimer’s disease are achieved. That is why I recently authored a bipartisan amendment to the Senate Budget Resolution that calls for an increase in our federal investment in Alzheimer’s research.

I have also been joined by my colleague, Senator Amy Klobuchar, in introducing a resolution declaring that that the goal of preventing and effectively treating Alzheimer’s by 2025 is an “urgent national priority.” Our resolution calls on the Senate to double the amount of funding the United States spends on Alzheimer’s in fiscal year 2016 and develop a plan to meet the target of $2 billion in research funding recommended by experts. According to Alzheimer’s Association, if the federal government were to invest this amount, it would recoup its investment within the first three years a treatment or means of prevention becomes available.

As I presided over a recent Committee hearing on Alzheimer’s disease, the packed hearing room was filled with hundreds of Alzheimer’s advocates from throughout the nation, including many from Maine, who wore the color purple to symbolize their support for finding a cure. This “sea of purple” served as a stark reminder that 5 million Americans suffer from a disease for which there is no cure, no effective treatments, and no means of prevention. The color purple currently represents support for Alzheimer’s research, the patients and their families. I hope that someday the color purple will be worn by Alzheimer’s survivors.

The changing demographics of our nation will affect every facet of our society. But at the heart of it all is the work that medical professionals do day in and day out. I applaud them for their expertise, dedication, and compassion.