the justice department is helping to do that, but we have a long way to go. what the 2012 you in the credit party platform says. party platform says. i would to see what you would do in terms of recommendations to add. we have increased overall funny did combat hiv-aids to record levels. president obama established the first ever comprehensive national hiv-aids strategy. and thehe outside push president is that on world aids day. responding to the domestic epidemic which calls for reducing hiv incidence and increasing access to care, optimizing health outcomes and reducing hiv related health disparity. this is an evidence-based plan guided by science and takes direct resources to communities

at risk, including gay men, blacks, latinos and other at high risk of infection. we will continue to support america's ground breaking programming. that was a platform in 2012. how should we expand on this? >> that is a good place to start. somenk there are from -- of the mental things to address. we can virtually, nearly eliminate transmission, treatment as prevention. we need to make sure we had treatment on demand. any person living with hiv should have access to life-saving treatment. not only for their own health, but also because of the dramatic reduction in transmission. we can enter up acquisition of the virus. anyone at risk of hiv should have access to treatment that would prevent acquiring hiv.

number three, we need to address the issue around stigma. for example, if you are trance trans woman and your state discovered it against you, you, we have to deal with the stigma issue. number four, when he to continue to be a leader -- we need to continue to be a leader in the research front. hiv knows no boundaries. where we find hiv, we need to fight it at home and abroad. when he to continue to be a leader in the global fight by continuing to support the tremendous work we have done in our support on the global side as well. when the last platform was written in 2012, prep was just

emerging. other ways that we can use the platform -- are there ways we can use the platform to make more people aware of this possibility? what are the biggest needs and taking of what is a remarkable development and spreading it widely four years from now? >> three things. one come as many of your previous because talked about, comprehensive hiv education. people understanding that is important. number two, awareness about prep . we just that a 22 city tour talking about prep and people thought we were going to meet resistance. we did not meet resistance before we met was an unaware populace. to were angry because they did not know about it already. we need to raise awareness. number three, we need to make sure it is acceptable and that people understand it for what it is.

it is not the super bowl. we keep looking for silver bullet, we will undermine our efforts to it is a tool. everyone should understand what it is everyone who needs it should have access to it. >> thank you very much. >> thank you. [applause] >> katie kennedy is a member of the national association were retired american executives board. her background includes 30 years and telik mitigations all about a career in social work and health care and information assistance. especiallyr seniors, pensions for retirees. thank you very much. >> thank you, mr. chairman. i get to hear from the old

folks. hear from the to old folks. i am from tucson and a volunteer. i'm here on behalf of the alliance for retired americans. we are grassroots advocacy organization with 4.1 million people who fight for retirement security for all americans. i give her the opportunity to testify today. our members what the democratic party platform to address retirement security needs of older americans. many of the most successful government programs and our nations history are the result of democratic leadership, especially social security and medicare. the 2016 democratic platform should build on that progressive legacy and address the challenges facing america today. not surprisingly, the skyrocketing cost of prescription drugs are at the top of the health care concerns. drug costs are out of control. a study from april shows that the top 10 production drugs

increased on average more than 100% since t11. since 2011. 2014, research and drug skyrocketing at the same time, 20% of the population did not fill a prescription because they said they cannot afford it. my primary care doctor says she things it is more about 50% and she is resolved when she discusses the new drug with a patient to even check the price because she says they will not fill it if she does not do it. real faces one the problems of prescription drugs and suggest cosseting for souls -- cost-saving proposals that we should endorse. a local tucson retiree his granddaughter's perception for crohn's disease said the drug caused, $3000 for a cake kit containing

two vials of the drug. we have seen advertising for many production drugs on tv ask your doctor. this advertising is a tax break. we call for the end of direct to consumer advertising subsidies and require drug companies that benefit from taxpayer support to invest in research more than marketing. my friend had a conversation with his wife about how long he could afford to live because it is estimated medicare co-pay for his leukemia drug was almost $2000 per month. he and his wife made a plan that rather than leave his wife destitute, because they would use of their life saving, he would choose to die. then he learned that his veteran benefits provide the same prescription drug for a few hundred dollars per month. the da can negotiate drug prices can negotiate- va

drug prices and medicare cannot. steve is a member of the arizona legislature forced to acquire hiv-aids drugs at affordable prices. he tells us that the cost of quickly increased more than 500% here in arizona. while the same medications can be bought for about a dollar a pill in most other western countries. democrats must support allowing americans to safely import drugs from a broad. doctors diabetic and her had her controlling her diabetes until one morning she received a phone call from her medicare advantage plan. she was told that her diabetes drug cost were approaching the doughnut hole requiring a change to less costly medications. her diabetes drug prices have increased 25% in 2015 and midyear funny 5% by

2016. emma krasny to support penalties by midyear 2016. democrats need to support penalties. democrats must unite and fight for policies to consider patients, not just profits. democrats should join the members of the alliance for retired americans to support strengthening and expanding medicare to allow retirees for early retirees to purchase medicare policies at affordable premium rates. we support expanding medicare to include dental, vision, and hearing benefits. we need solutions for the cost and quality of long-term care. we support the developing of a comprehensive care system so all seniors can receive affordable care based on health and physical needs. --kers expect to retire

expecting to retire, face and income challenge. i retirement savings fall short and companies have eliminated traditional pensions. our social security system can be part of the system and the democratic platform must include expanding hard-earned social security benefits. bills pending in congress will expand social security benefits and adopt a more accurate formula for determining cost of living increases. the alliance supports several of these bills including proposals by senators bernie sanders and brian shaw and represented peter deutsch. it is now time for all, including the leaders who earn more than 118 million -- $118,000 a year to pay into social security. scrapping the annual cap, we can ensure that everyone, including minors, can pay their -- including millionaires, pay

their fair share. playing a role to offer seniors to -- the pension benefit guaranty corporation must be given the right tools and in the future to meet its obligation to protect earned pension benefits of more than 40 million american workers. that's respect work in the workers who have made our country strong. i know i speak for all members of the alliance for retired americans when i say that the government needs to stand up to big drug companies, preserve and expand social security and medicare and prevent -- protect our pension to the well-being of american seniors depend on it. we tell our seniors nothing less than a dignified, secure retirement after a lifetime of work. we're the ones who made america already great. thank you, mr. chairman.

[applause] >> i would think you per your testimony -- for your testimony your discussion on production drugs. and a lot of people don't know it, but it is the number one health issue. democrats, republicans, and independence. even with republicans, his past their opposition to affordable care act. try to address the issues, they go to the center of people's lives, this is a major issue. we're going to continue the fight and it is wonderful that both bernie sanders and hillary clinton have stood up on this issue big-time. i've herbert from the other side -- word on the other side.

>>, to echo the remarks of the chairman the multiple ways there are agreement between senator sanders and secretary taken on the issue of prescription drugs. -- clinton on the issue of perception drug. breaks for, tax direct to consumer advertising, medicare negotiations, reimportation, a whole list of issues. muchssue of how pharmaceutical companies are researchinvesting in versus marketing, their proposals out there to address -- there are proposals out there to address the discrepancy. from cynical company today is investing more in advertising than actual research. proposals to rebalance

that. what are your thoughts on that issue because i think that is an area that we can find a lot of agreement? believe the alliance has an exact position. i know that we can do that because if you will remember under the affordable care act, we determined that insurance companies must bend 85% of the premiums they taken to get health care back. as a matter fact, united health care had to give some rebates because of that. i know there are ways to do that. anhave not come up with actual agenda. there are ways to create rules that say the percentages have to happen. we can keep them from gaining it. we do under the affordable care act. >> great. that would be a great idea. >> thank you for much. i want to commend the chairman work onoutstanding

lowering prescription drugs. terrific work on that. we have enjoyed working with you. out that since 1998, prescription drug companies have spent over $3 billion on lobbying. they spent far more than any ther industry with second-leading industry being the insurance industry. they spent $2 billion over that time period on lobbying. what does it say to you, as you say, we spend more on prescription drugs than any wherecountry in the world one out of five americans can't afford to fill the prescriptions that the doctors prescribe?

and makee fight back sure that every american can afford to fill the prescriptions that their doctors fill? >> was that question rhetorical? if the brain sitting in this room have not figured out that answer, this volunteer cannot begin to do. -- begin to do it. retiree to lots of groups and a matter what we talk about, yeah people need hearing aids, people need the glasses, but prescription drugs, have you not ever heard people say they were at a walgreens and heard little old couple discussed which one will pick up the description -- prescription? i hear that all the time. i was not trying to be flippant. try to find that answer is certainly the giant puzzle.

representative cummings has been great in leading what has happened, but i don't know how we stay ahead of the game when someone says my diabetes drugs insulin. 25%, it has been around for over 70 years. it is not generic. it is an incredible question. thank you for your testimony. you are a very articulate cohort of my age. the rising american electorate. senior citizens. [laughter] myself and every thing that has been said about prescription drugs. to theo made reference social security issue.

who stolee asked me my cola. i wanted to know if this is something you have dealt with as well. you've had a couple years with no cost-of-living increment and part of the problem is because of the conversation that went on a couple years ago about chained easily lured into believing that the administration and president obama has cheated them out of cola they had coming and we have to -- i'm very concerned about it sounds like people have written on the

internet or have heard from somebody that they really believe that this happened and maybe there is a way for us in to thetform to commit restoration of cost-of-living allowances. >> the cost of living that is for social security and veterans andfits is called the cpiw the problem with it is that it is weighted toward the spending patterns of workers, not retirees. what we have been asking for it that we re-examine the cpi that is used for social security and way it -- weigh it on the spending patterns of elderly people rather than working people. entertainment is not the thing it is when you are 21. health care sure is.

thank you. cpi based ong the what you're talking about. as all things are connected, we have been talking about by mental health and recently, -- environmental health, and recently in seattle washington, there was a study inducted by the national oceanic and atmospheric and ministration and areafound that seattle salmon are loaded with drugs things to waste. over 4000 pharmaceuticals are currently in use or development in the united states. that is quite extreme, but if you look at where the pharmaceuticals, where that is going to come it is going into the water, our environment, i'm hoping that are drafting

committee can come up with better solutions to the pharmaceuticals that we are overusing in america and change to a little more holistic and healthy approach to not only the cost of discretion drugs, but also how are we providing remedy to life here that is much healthier and save not only for only for thoseot taking pharmaceuticals, but the informant as well. i don't know if you have thoughts on that. salmon.pacting our we are called the people of the salmon and let me open up our salmon and there are pharmaceuticals and toxins in the salmon, that is a problem and spiritual problem for us and we are hoping to find solutions

and as we look at all things being connected, i'm hoping we can find some solutions to the issue. >> i have not talked with anyone from the environmental perspective that you are talking about, but what does play into .hat is lots of conversations the alliance for retired americans is the umbrella for all of the afl-cio retirees. part of what we talk about is the overuse of drugs. the person using 17 drugs and the good to lunch with their friends and trade pills. thing, they need to go back and challenge. you have a pain so you get this drug and then that gives you the side effect say the doctor gives you this. and to stop the 17 pills you are taking. from that perspective, we have talked about it. but not extended it to what you are saying. i will add that to my repertoire. >> thank you.

thank you very much. [applause] dr. wynn's the health commissioner. she has been reimagining the role of public health has been critical to all aspects of revitalization and transferred of approach involved in engaging hospitals and returning citizens . launching one of the most vicious opioid overdose -- ambitious opioid overdose program trying to save lives in opening a citywide health and wellness dratted g. -- strategy. i will be frick what he preaches the commissioner in baltimore, which is my city, -- she is the

commissioner in baltimore which is my city and surety is incredible -- she is incredible. good afternoon, everyone. i'm here to speak about the health threats faced by communities across america. i'm an er doctor. in the er, i see patients are desperately seeking help for drug addiction and mental illness. they know that they need help. their families know they need help. sorry, but them weight is weeks or months. some are able to wait. die.go home, overdose and the opioid epidemic is sweeping our country and we know that addiction is a disease just like diabetes and heart disease. yet, nationwide, only 11% of individuals with addictions can get the help that they need. do find that acceptable for any other disease?

a say to take patient with -- patient with chest pain that we can't to you for heart attack? see me in three weeks. during the primaries, every candidate for both parties talked about their personal addictions. that rhetoric is to be a company by a commitment to action. we must find what works like medication assisted treatment. we must start 20 47 ers dedicated to addiction and mental health. we must expand recovery housing because we know that housing is healthier. we must offer mental health services in the community where people are. including our schools. we must call out when things don't make sense. approvedess has not the president funding of the zika, the cdc has been forced to take money away from local public health to pay for national efforts.

this will cut my emergency staff by a third, which is deeply ironic because these are the staff who respond to disease outbreak, hurricanes, and other emergencies. keeping our country safe requires an investment in public health. there is a security argument, ebola and terrorism. economic argument, one child born with severe defects from zika can saw society -- call society millions of dollars. there is a moral argument, like so many other diseases, zika is a disease of poverty. can we stand by and watch generations of our unborn children suffer the consequences and communities that are already hardest hit by legacies of determination? constant comings talks about going beyond common ground to find higher ground. appealto end with an

to higher aspiration, can we kill our angst about addiction and mental health international plan that will make us the global model for treating patients with urgency, rigor, and community? can we go beyond lack of moral emergencies and implement a -- w mole emergencies in the coleman a plan that makes us -- and implement a plan that makes us safer? public health is a powerful tool to level that playing field. to bend the arc of our country away from distrust and disparities and back towards equity and justice. that is our highest aspiration that i urge the platform committee to take on today. thank you. [applause] questions.

>> thank you so much for that. i'm also from baltimore. i associate myself with the chairman. 35 years ago, i lost my younger brother to addiction and depression. we knew much less than that we know now and we were a family with resources. with a trained social worker and could not help. -- i was a trained social worker and could not help. i think this is a staggeringly important problem. we have to get past the bias. we have to get past that prejudice. we have to get past the sense that someone who gets addicted to drugs, or has depression or mental illness is somehow other than the rest of us. this exists in every family. somewhere, someplace, somehow and we need to bring it into the .aylight and talk about it why am always willing to talk

about my brother and what he went through, what our family went through and what we can do to stop this. thank you very much. >> thank you. >> thank you ms. schaefer. >> thank you ambassador sherman. this is a huge, huge health yet, it is not looked at as a health problem. the stigma around mental illness and addiction is just as bad or worse than it was around aids and it has to stop. if i walked into an emergency help, itsaid i need would be a big different story. this was a great analogy. i think the city needs to look

at this. too many of my friends have died. i grew up in agriculture -- a drug culture of the 60's. if you did not get clean, he died. died. it is an issue. thank you for bringing this to light. life in remote, areas. the places that offer some of the highest addiction rates, i was grateful for all the suggestions. i don't know the answer to this question. i know a lot of people were casually foriates

things and ended up having their lives wrecked. should we be thinking about that end of this funnel as well as we are working on this? >> thank you all for sharing your various stories as well. it is time for us to get out from behind the veil and talk about how we have been treating addiction that as a disease, but as a crime and that that is inhumane, ineffective and unscientific. an addiction is something that affects all of us. all of the community. we talk about intersection alley. intersection alley with -- with civilnaliy rights and human rights. it is very important for us to focus on the prevention aspect. certainly, we cannot just look at doctors overprescribing medications without also look at

the misleading tactics used by drug companies to market pain medications over the years to the point that there are about 259 million prescriptions of opioids given per year which the enough for one for every american. look at the overprescribing is a big part of it. we also know there is a big gap. that is the issue i fear --. -- i have here. we have one of the most aggressive over those in baltimore. in addition, we cannot to save a life today. we are fighting water. let's we can get people into treatment when they need. we know what works. the science is there. that is the frustrating part. we know what works. we just have to get funding. >> barbara lee. here andyou for being your testimony and work you do each and every day. i listened very carefully to what you say and i appreciate

you making the suggestion that we come up with some kind of plan to address addiction and mental health. i'm a clinical social worker by profession. plan, to ask you, in this there have been so many young african-americans and latinos who have been put in jail when they should have been put in rehabilitation and treatment. as we move forward to talk about how we develop as democrats a plan for treatment and rehabilitation and prevention, how do we make sure it is broad enough to include those who may still be in jail with some addiction issues and should be in treatment and rehab? we have to look at that the only as a script and drug opiates, but every type of addiction that has disproportionally incarcerated people rather than put them in treatment and rehab. >> three things, every interaction needs to be the opportunity for intervention.

some is incarcerated and have them mental illness or addiction, they also need to be provided treatment at that point. second, we have to switch how we think about individuals with addiction. it is not a crime, it is a disease. we don't incarcerated but for having heart disease. we have a program in baltimore and we're starting work individuals, small a large -- most of drugs will be offered treatment instead of incarceration. we have to look at programs like that and expanded. third, i believe it is important for us to look at our people and resources. who are inividuals long-term recovery to work in the middle unit. we believe people are the solutions, not the problem. r representative these -- eese. >> i would do thank you for your testimony as well. just following up on what the congresswoman is talked about,

that is the biggest thing i keep hearing from constituents and particularly, african-americans. when it was the crack epidemic, it was considered you are a criminal. you are going to jail and through a lot of folks in jail. of boldhaving some kind statement, many people don't get treatment until they are mentaly in jail for health. the three things that you point , a, is there a statement strong addiction statement that would include not only heroine and opioids, but also acknowledging that the crack epidemic that has destroyed many the african-american community is also a disease, is there a strong statement we should start with and talk about the action steps? need to acknowledgment

everything we're we are doing now is coming too late for too many people. i see that in our community, i see our residents, people are dying of overdose for decades. why is it that now there are white people in suburban areas dying that we care. it is important that we called out. policies ofical discrimination that have led to where we are, but this is our opportunity to make a difference. let's save a life today. if we can't say they like today, there is no hope for a better tomorrow. then let's get everybody into treatment at the time they need. instead of looking at a criminal justice issue. let's address that people may be taking drugs and becoming of deep trauma, spiritual trauma, emotional trauma, because they are not sure what is on the other side with it is a job, housing, we need to provide all these other things that also make life worth

living. >> i will be quick. platformi think the definitely has you recognizing point of addiction problems for all communities and that it is an injustice that we are traditionally thinking as criminal. some addictions and have for many decades, not talking about these issues as a public health crisis. that does not take away from the fact that a public health analysis is a proper analysis. earlier today, there was talk about the inequality and how they are rising mortality rates for white working-class people. professor eaton made a great study in the color that is, as far as we know now, not health insurance rates, but truly drug addiction and suicide.

so, that is a large sign of major problems we have from a public health perspective. what kind of levels of investment should we make to address these challenges? it can'tgnizing that just be about these addictions, the broader addictions as well. we need to make a conscious effort to identify the problems, just can't beit enough for us to talk about the experience is. this is my greatest frustration that i hear, i hear legislators on both sides, hear people talking about the individuals they are meeting for telling their stories of losing a loved one, not been able to get them of the one, but we de paula that up and say, let's invest in this. timers --t during all alzheimer's, we would expect a financial investment. that is why it is important for

us to identify the problem. we have to call it a problem and treated as well. it is so closely related to addictions, trauma and mental health. we have to remember to invest in early identification and prevention. not just to say to somebody, you have to wait until you get a diagnosis breast to you, but how can we -- before we treat you, but how can we develop trauma informed practices and how can we invest in public health as a way to make our communities healthier and safer? >> before you leave, one more thought. i remember when we had the ebola crisis, there were some in congress who said it will never ,et done, and lot of naysayers but we dealt with it, did we not? that is the can-do attitude we're talking about. >> absolutely. we ever have a patient in front of us who is dying, it would

never be our option to say this patient is to complicated, i can't do anything. i see the same thing for all these health issues that we face. there are some examples and congress cummings that the stairwell, within six years, it has closed the disparity of black and white by 40%. it has decreased the percentage of children dying from dying in this league, babies dying to reduced teen birth rates because of reproduction services that we do. this to make this a national model. >> thank you very much. [applause] >> donna crane. herhas been with

organization for more than seven years, the lead lobbyist, she represents pro-choice american views. welcome. around 16 years. i've aged before your very eyes. >> big mistake. >> i would take the seven years. i'm honored to speak with you today about the importance of reproductive freedom to the democratic party puffer. the vast majority of americans support reproductive freedom. seven in 10 americans agree that this includes access to safe, legal abortion. ,his is true across generations ethnicities, and geography. and is true in red states the number often goes up in purple and blue states. this is true even among those who do not believe that they would choose abortion themselves , do not want politicians making that decision for others.

in the year since abortion has been legalized nationwide, women's lives and health have been saved, children health has improved, families have become more stable and women have been able to participate in society in ways that were unimaginable to our grandmothers and great-grandmothers. activist persist trying to roll back our progress. throughout, only the democratic party has to for the fundamental right to the platform. we urge you to continue standing proudly. i like to a knowledge a trail blazing woman who is dedicated her life to reproductive freedom. hillary clinton. we know that women's dignity and economic security is strictly linked with reproductive freedom. be able to choose when, if, and how to have a family is not only critical to taking care of the family, it is critical for a woman's ability to be a full

partner in society. our recommendations to you for the platform. first, we need universal access to birth control. only woman should be in charge of her reproductive destiny. not a boss, senator, or pharmacist. a woman must have traded access to safe and legal abortion, the matter where she lives, how much he earns, immigration status or source of health insurance. yet today, this right things by thread with texas's outrageous law. making matters worse, doctors and women are enduring a resurgence of anti-choice threats and violence, even encouraged by some elected officials. we must call these crimes what they are, acts of domestic terrorism. instead of researching access, we should be expanding it. that means repealing the abortion coverage ban such as the hide and helms amendment.

third and fourth, call for protective of pertinent women who faced termination in the workplace and for better policies of paid leave. supporting partner women and parents as part of reproductive freedom too. let's be clear from our opposition is not antiabortion. if they were, they would work with us to prevent unintended pregnancy and they would endorse common sense policies who support women that two to be mothers. they fight these measures as well. , five providesrs better due to all americans. freedom and autonomy. fight forfright -- equality and dignity over half the population. this is what our opposition party gets -- fights against and this is why we must work harder to achieve it. [applause] >> questions. thank you very much.

>> dr. alina roots. she serves as president and ceo of the national hispanic medical association are present in hispanic additions in the united states. president ofes as the association of national hispanic health. new york university. thank you very much. >> thank you, chairman and committee. i'm honored to provide you with key strategies to reduce health care and health disparities from the national hispanic medical association presenting 50,000 licensed hispanic numbers in a network of national hispanic

health association and state medical societies. we support the aca and the tremendous progress that has been made to increase affordable access to care, but we need improved federal strategies to decrease racial and ethnic health disparities. at that you consider the congressional tri-caucus. health equity act introduced in convert this week in the written testimony i've already submitted. racial ethnic health is good continue to exist in our country. they are not proving. hispanics are now the largest ethnic group in the country 54 million, 17%. living in poverty or in middle-class neighborhoods where they live with chronic stress, whether it is from low income job, high unemployment, crime, drugs, and inks, substandard --

gs, substandard housing, lack of nutritious food, lack of clean air and water and the undocumented family members live in constant fear of deportation. socialsequences of these determinants of health are what we are seeing in our communities continuing to rise. early childhood obesity, adolescent suicide, young adult heart disease, diabetes. they progress faster to high rates cases. hepatitis c. hispanics have genetic theetermination for tennessee. cancers, chronic disease. all cyrus disease. -- alzheimer's disease. and more. latino families depend on our generation for long-term care. we recommend that your pot farm raised the cycle of health disparities for hispanics and underserved.

number one, access to health care and behavioral health care. we do allow all residents of america to have access to these care and follow california's medicaid health care for all kids for a more seamless medicaid program for the undocumented. eliminate the five-year waiting. residencts.egal educate state policymakers on the medicaid expansion. support telemedicine with spanish lady in -- language options. address the crisis puerto rico. zikaith their secr -- virus. partner with public health efforts to restart public health

care services and to mentor students to stay in puerto rico and serve their communities. second, the transformation of health care delivery. we need to develop an integrated health care system that is more holistic based on what is patient centered medical homes with translators. linkage services. education that addresses healthy lifestyles with economic jobs,pment for more school counselors, nurses, health workers. to transform our communities to real learning communities to share best practices on how to be healthy in our neighborhoods. transformation initiative payment structure and an to the mom and pop doctors new risk adjustment

quality measures. treatment needs of the hispanic. linkage services. phase in the new macro structures for reimbursement which will be very conversing -- confusing. maintain risk adjustment subsidies that we have now for insurance. develop the patient centered resources the community. family support programs, not just patient. community health workers. social workers, diabetic educators, home-help services. cooking classes. these are all things that can be done in our communities health. -- that will address health. insurance premiums for individuals, small groups, drugs , subsidies, we need a new care program that is going to look at

long-term care and counseling on end-of-life. in proving nursing care. third thing, preventer. we need to design disease prevention with community leaders and organizations. multimedia platforms. video, social media, internet. use health -- to care. how to reach families and cornet hispanic federal leadership with our physicians and verses. -- nurses. obesityarly childhood classes. start with breast care -- dating care. -- breast-feeding care. educate on malnutrition. support nurse cooking for poor mothers. diabetes, the federal

heart disease, high risk education, training stations, there -- immunizations, there are 70 programs we need to expand. -- so many programs we need to expand. you cannot have health disparities change without having a workforce. we need a hispanic health workforce initiative. expanding the health professions .orkforce for hispanics scholarships, counselors, we need a more correlated approach ih and thesa, n department of education. we should court may be health care counseling and mentoring with hispanic serving organizations, the department of education science fund, but have the stem students in these programs have counseling and

mentoring record opened their eyes to the importance of health career jobs. these are the students of the future. develop debt reduction. i believe, with the service opponent so that our health professionals of the future get to work in our communities and help our communities. revise the international medical graduate entry program, increasing the number of residency and licensure slots so that we could have more mexican doctors and latin american doctors that live here practice. develop a hispanic health research program led by nih built on the study of latinos to develop more knowledge on improving strategies of health for hispanics and families. lowly payment, mentoring of junior faculty and clinical

trials also need to include more hispanic researchers. lastly, about a national effort across the board, federal and private sector foundations, corporations to have executive leadership element training. training.ment we don't have this in existence. our programs are focused on delivery of service. we need others to take over the jobs of our linux and community hospitals and medical schools to be able to on the boards of trustees, ceos, to make decisions and help with the redesign of health care to reduce health disparities. in summary, i thank you for the opportunity to share these strategies and look forward to working with you. >> thank you very much. [applause] any questions. ? >> thank you.

entering --- from puerto rico. a few months back, that the divide people of the united states, puerto rico was the only people did not leave puerto rico. never traveled anywhere. mosquitoes, how it is, very different for all the rest of the hundreds of millions of american citizens. thank you. we're losing a doctor every other day. given the crisis. daye losing doctors every , we are losing nurses. thank you for bringing that up.

we have to look at that. i just want to share, that as we look at health care and health care disparities, one of the things we look back, i was happy when they passed the aca because baruchel got three point -- puerto rico got temporary money. the reimbursements for medicaid and marriage care -- medicare are about half. if you are paying taxes, you should get it back. colleagues, with my obama said about kenya, where his daddy was born has a special place. puerto rico will always have a special place to me and thank you for listening. >> thank you very much. [applause] ctor. you very much, do .> lewis shelley

she is responding for directing programs, have had more than 20 million veterans nationwide, ensuring veterans and family members receiving the access to va health care and benefits that they have earned through their all 1700 services in hospitals and clinic for she is a 22 year veteran of the united states army and thank you for your service. >> thank you for being with us. hen you think about veterans this campaign season, remember the number two. there are 22 million veterans and the united states. each day, 22 veterans with their

battle with depression and commit suicide. two, there are two issues that i would like to highlight today, veterans mental health and poster medic stress disorder. stress dramatic disorder. chairman cummings, members of the democratic platform drafting committee, on behalf of national commander dale barnett at his 2.2 million numbers that make up the largest ever in service organization in the country, the american legion, thank you for the invitation to present our pillars of the relate to your platform. veterans middle health are not the same thing. while veterans ptsd is part of the mental health makeup, not every entering in need of mental health services suffers from ptsd. our veterans represent your constituents. the 22 million veterans

mentioned earlier will, parents, .hildren and friends who vote you are speaking to a potential everyf 100 million voters time you address the veteran community and we are listening. we are listening and waiting to see what you have to say. wo--the issues i've been asked to present on today, america is in the midst of a rising epidemic of overdoses stemming from over-the-counter medications and veterans are no different. we are your constituents. for more than a decade, the market legion has worked closely with the a medical centers for a program called the system worth saving and between this program, ptsd and tbi committee and research which indicates the couple mentoring alternative their base, this epidemic will -- therapies, this epidemic will only get worse and disproportionally affect

veterans who suffer from these diseases. mindfulness therapies, recreational therapies, a growing number of their piece that take advantage of emerging research. all have been proving -- proven effective in assisting veterans to battle mental health issues. a progressive organization, the american legion donates millions of dollars to research conducted isva facilities and violating the value of cannabis-based therapies and scientific studies that seek to research the chemical properties of this plant and their effects on a number of conditions including seizure disorders, crohn's disease, and yes, even posttraumatic stress disorders. as you develop a platform over the next couple weeks, remember the number 2. a partnership between the members seeking election to lead this great nation and the

american legion who stand ready to work closely with legislators elected members today and through the next administration. thank you for inviting the american legion to present the data today. a full copy of my remarks will be found in the written testimony that i asked to be included as part of official testimony. >> thank you very much. [applause] thank you. any questions? much. you very [applause] he works on health care organizing the policy for the national nurses united with 190,000 members. it is the largest organization of registered nurses in the

united states. also works in california which represents or million californians and over 60 unions. committee to replace and private health insurance with improved medicare for all. thank you. >> thank you. good afternoon. nurses are here today to address the important issue of finishing the job of health care reform and energy to a drop -- adopt medicare for all. and to join nurses in the fight for health care justice. chairman cummings, you spoke of pride when the aca was passed. we are moved that you feel so strongly about health care as a human right, unfortunately, for nurses, the tears continued to flow daily. it is real.

nurses cry daily because they go home after meeting patients who can't afford their care. they can't afford medication, and can't afford the high co-pays, they can't afford treatment for the children to keep them alive. this is the reality of our health care system. even though it is a hard pill to swallow. the aca has had great danes and pre-existing conditions putting lifetime caps, allowing children to stay on their parents children longer. no one can dispute that those are important things and have greatly impacted people's lives. but we do need to finish the job of health care reform. we are not there yet. nearly 30 minute americans remain uninsured. uninsured.hat are they have insurance but they can't afford their co-pays, the decibels, the high premiums. that means they are not going to

the doctor when they need to. they are delaying care so they come in sick or. verses are seen people who have insurance and preventable issues, but they come in sicker and harder to heal because they are afraid to go to the doct because they can't afford it. no wonder that the majority of u.s. bankruptcies are from medical expenses. the majority of those were people who have insurance. people are going bankrupt to have insurance. such a cruel system. it is a cruel system. inequality is hardwired into our health care system. whyontinue to see disparities based on gender, race, where you live, what you , a health, enrichment care does it because a hospital shut down. now you have to travel on a busy highway to be able to get to in minutes n er when

means life and death. baltimore has different equal to the west bank and honduras. luckily, nurses have the cure. improved medicare for all. provide a single standard of care, freedom to choose a doctor while saving over trillion dollars over the next 10 years. plus, it is not based on the size of your wallet, he would not go bankrupt because of a diagnosis like cancer. nothing can refute that medicare all, saveuld save money, and cover everyone. thatstudy shows nurses believe you can't put a price tag on human life, but i do want to share in one number. $1 trillion. one chilling dollars would be saved over the next 10 years with medicare for all. we've been thinking about medicare for all in the wrong way. it can be invested in free

tuition for college, to be invested in fighting climate moree, including job, infrastructure projects, if we want to prevent health care from crippling our economy, we must pass medicare for all. it is in fact a stimulus for our economy and not the opposite. this is not theoretical, you should include in your platform current bills that can move this forward like hr 676, senate bill 782, hr working 64, california has a drug price relief act that is up in november, the perfect opportunity for the credit party to push back on a a.armaceuticals -- big pharm you can also oppose the tpp. the should be in the platform and move forward with unanimous

democratic support. nurses are not alone. 56% of all americans support medicare for all as you have heard today. support andrats medicare for all system. how can this not be in the democratic that form? -- platform? your bases with you. beyond that, it is election season and we care about independence. -- independents. 60% support medicare for all? and you heard earlier, 46% of republicans support medicare for all. the american public is with you on this bike. -- fight. as your mother said, sometimes you have to wait for people to catch up on you do the right thing. this is certainly the right thing.

the party needs to see this as an opportunity to make bold change. otherwise, people are dying and going bankrupt while they wait for the democratic party leadership to catch up. shows that if the democratic party thinks big, americans will overwhelmingly be with us. inc. mental change like transparency bills -- incremental change like chris christie bills and the been the same difficult fight against republicans. we saw this already. to put theoing public option in there, it is the same fight as single-payer, it is the same heavy lift as single-payer, we need to be bold, we need to make sure that this is going to be the right fight, the one that makes a real difference all americans. despite nurses, help me for medicare for all. it will truly save lives, save trillions of dollars, and with the majority of americans supporting it, it might even

save this election. thank you. [applause] >> thank you. think you very much. -- thank you much. i like to say the people on the ground that the things on a day-to-day basis are the experts. nurses saying what you see eing what you see everyday, you have a viewpoint that we will never have. i want to thank you for your testimony. >> thank you, mr. chairman. thank you very much for being here for your testimony. i want to believe that, again, health care should not be an industry, it is a human right. we need to get there. passed and iently spent half of my life in the

last 10 years in either emergency room's in arizona or -- i have spent many day and night with nurses. say, the chairman knows, thank you. all of us have those experiences. with our family members. we cannot survive, they could not have survived if it were not for the care under duress. you all have a lot of work to do. the nurse patient ratio is too large. i don't know how you do it. >> i don't want to misrepresent i staff for the nurses and i worked for the nurses. i hear the stories you are talking about everyday. >> staff, nurses, nursing assistants, everyone does a great job.

going past the aca, the next stage. cover and to 25 92 are not covered, we have single-payer options, public options, medicare for all, how do you see all of the options and how we should evaluate what is next? >> thank you for that question. single-payer is basically how we pay for medicare for all. there has been a lot of misunderstanding around this primary season that the idea of medicare for all is to scrap everything and throw it out and start fresh and get rid of the aca. medicare for all is not a new starting from scratch idea. we have medicare. it has been around for 50 years and it is wildly successful. it covers the sickest, oldest people of our society at 10 times more efficient than the industry of insurance. we have it and it is very

simple. age to 0hange the instead of 55. instead of insurance companies getting in the way, i think a lot of people equate health care to insurance and that is a fundamental flaw in the thinking because insurance companies mostly get in the way. if you have been in the hospital helping your mother over these years, you know that you have to do with insurance companies all the time to get the treatment they need, the medications they need, the tests they need, they are mostly a block to access health care. as long as our system is based on an insurance-based model, it is not going to provide the health care that people need in this country. wayoving them out of the and all the health funds going to one single-payer, the

government, you still have had a doctors and hospitals and all the providers that exist now, it is just that instead of getting paid by the thousands of insurance companies that exist, they are going to get paid by one single-payer. i'm doing everyone a great information -- giving everyone a great information. argument forsiness why there is a benefit for single-payer. there's a businessman canada this is does not understand why we don't have it. he would go bankrupt over health car casts -- health care costs. every time i show that in rooms of hundreds of people, everyone is flabbergasted. we know that it costs $85,000 a

year to fund just the people who have to arm wrestle with the insurance companies. it is a simple solution. it is a very simple solution. it saves money and i think there has been a miss -- under -- [laughter] miscalculation [laughter] miscalculation towards attacking the system rather than seeing the system as broadly supported. it actually solves the problems that everyone is talking about today. all of these different fights at different angles that we have to go at health care on a constant basis, tweet this, addressed folks havesure these health care, it's all that. if we put all of these efforts into one fight where there are american people behind you, we will win this. >> thank you so much for your comments. i really appreciate them. i have two questions.

one, a lot of people have talked about the polling for siegel know, ihich i very much think the highest one is 58%. i would note that at the beginning of our debate about the aca, the level of support for the aca will introduce that bill, you know it was? >> 70%. you know what has given it down, ads against it by insurance companies and pharmaceutical companies. the koch brothers. the question i have, do you not spend money against the single-payer plan? >> no. we understand you were up

against the goliath. i come from the nurses union, we fight against billion-dollar health care corporations all the time. we know what it is like to go up against them and we beat them all the time. we continue to fight. the polling that you are talking about has changed for the better of the last six months of this campaign or medicare for all has been talked about the national stage despite the misinformation from the media and the misinformation around cost and what it will cost people. that is a poll in may higher than the gallup poll in december of 2015. if anything, it is a different time and health care reform the hillary clinton had to go through. i understand that was a scathing process. it is a different time and people are in a different place. people are ready for this. they want to change and they have seen that the great changes by the aca are not enough and

they are still suffering and the need solutions. >> my question was, and thank you for answering that, my question, has there been a single negative ad run against medicare? >> the republican's are constantly on the attack against medicare. foxnews news is a constant advertisement against medicare about privatizing medicare. there always these elements in place. in california where the pharma bill is coming up, they already amassed $70 million. >> that is not medicare for all. >> it is one of the interest that will be involved. nurses are not afraid of fighting against greedy interest and medicare. we know we are on the right side and americans know that. >> on a question quickly. final question.

under medicare for all, i'm a 100% champion of health care i would love to get your sense of how we get there with the congress we have. >> we will need a change in the upcoming election. i think it is more likely that it will be a change in our favor the democratic platform takes on this issue that is representative of where americans are at and where overwhelmingly, democrats are at. >> last question. >> thank you for your testimony. it strikes me that the elephant in the room is our corrupt campaign finance system. we can talk about the people's will all you want but big pharm and big insurance companies stand in the way.

the nra stands in the way of gun control. there has to be some way of the flaunting of peoples will given the .remendous power of lobbyist this is to inform policy and domestic policy. >> absolutely. nurses for a very long time have supported getting money out of politics and are 100% behind that fight. great politicians would have wrestle with being legalized bribery victims. how do we deal with the vicious circle? >> is a big problem. -- it is a big problem. m talking about cars in general. general.ss in

>> we have about my more witnesses. quick. >> i will be as quick as i can the big insurance companies and big drug companies are going to fight against the care for all, but that does not mean -- medicare for all, but that is coming don't stand up with everything we can to fight against them. i think one of the most refreshing things about this campaign is that we have shown that you don't have to go to the big health insurance copies in the big drug companies -- companies and big drug companies to follow the will of their lobbies. that is something we need to look at. a couple of things i want to ask you about, if you could talk more about the california drug price leave act. that has not gotten a lot of attention.

the prescription drug companies are estimated to spend about $100 million against that initiative. why are they doing that? how much do you think telefonica sa -- california could save if the initiative is passed? second question, is there potential merger between sigma and anthem. ? there would be only three big health insurance companies left. , from mya regulators understanding, have asked the justice department to oppose that merger. in connecticut, there is health insurance regulator that will have a major say in the merger. that is a former lobbyist for sigma.

does that make sense to you? >> no, that is my short answer. the more that insurance are on the board like they are, the more that they are making decisions about our health care, the more it will be about making profit instead of people's needs. in terms of the drug price relief act, this is an act that would basically set the va price for drugs. as we talked about the four, it is illegal for medicare to negotiate drug prices. set the da price -- va price for drugs for allstate -- all state. here is the thing, in terms of health care corporations, insurance, hospitals coming up against us, it will come up against us until we stand up to

them. they will try to crush every tiny piece of regulation that we do. in california, we had a big bill that was sickly to help people safely discard their pharmaceuticals. rma thought that tooth and nail. when the sponsors of the bill ended up sitting on a plane accident lobbyist and had a conversation about why in the short answer was that they don't want to be regulated because it is a slippery slope. until we take on regulating them, we stand up to them and show them we can win, they're about everyht little regulation we do and we're going to get caught in this small fights instead of fighting the big fight around medicare for all. >> thank you. >> thank you. [applause] >> thank you very much. to restorets

insurance coverage and elevate efforts of young people and women of color working to lift bans that deny funny. -- funding. she led the organization's efforts to engage latinos -- all aspects of the mission and work. thank you for being with us. >> thank you for having me. it is an honor to be here with all of you. as chairman coming said, i'm here on the half of my group. 115re campaign of reproductive right organizations. we envision a world in which is jim buss -- each of us have the tools we need to build the family and future we desire. reality, a woman must have access to a full spectrum of reproductive health care including abortion. for far too long, antiabortion

politicians have interfered with reproductive politicians by banning insurance cartridge -- coverage. not only has cars passed the hyde amendment, every year since 1976, they have passed restrictions that target women based on their insurance or care. who is affected? a woman enrolled in medicaid or medicare? federal employees enrolled in the federal employee health benefits programs. peace corps volunteers. number of armed forces and dependence. women in federal prisons including those detained for immigration purposes. retro alln to these bands, policymakers and 25 states have restricted coverage of abortion and insurance plans and policy makers and 10 of the states have also banned abortion coverage in all private plans.

toh restriction is intended further their ultimate goal of making abortion unaffordable and undecidable -- unavailable for as many people as possible. unfortunately, the strategy is working. for those who are struggling to make ends meet, women of color, young women, a coverage ban might be a ban on abortion might as well. studies has done restricting decade coverage of abortion or since one and four oh income -- low income women to carry an unwanted pregnancy to term. a woman and i'd abortion is more likely to fall into poverty. illustrates how devastating coverage ban research and can be on real women's lives. creates onendment of it, if not the most, owners barriers to abortion care. onerous barriers to abortion care. times are changing.

as congressman lee, the taping on the hill noted, last year, she and members of the house of representatives made history by introducing equal access to abortion coverage act and is the each woman act. this would reverse the hyde amendment and related abortion coverage and restriction. , aan advocate, a latina woman and a mother, i see the trans formative potential. the potential to restructure the experiences, lives and struggles for whom the legal right for a safe abortion has not been made real. not only does this legislation now have 119 cosponsors in the house, it also has the support of the american people. planreleased last -- released last year show support that this should pass. the market people are dumb behind amendment and done with the hundreds of anti-choice was

vested in the way of woman getting the care she needs. it is time to end this insidious policy that targets low income women. we urge you to add a strong statement here platform so that each of us can access a safe, legal affordable abortion if we needed. we are waiting for our rights to thrive, we are brave, united and equal. we're asking you to join us. [applause] >> thank you. questions. >> thank you very much. young women have done this all around the country. we need you with us. reproductive justice. that means repealing hyde. >> thank you.

>> thank you, again. dr. katrina peters. [applause] >> she is a clinical hazard of -- psychologist of psychiatry. for the delicate california medical association and is the chair of the national medical association region six which encompasses 14 u.s. states . the national medical association is the oldest and largest medical association a primarily african-american physicians in 1895. thank you for being with us. you for the invitation. we have addressed in equities and health care throughout its history, especially at they have affected the african-american

community. i would like to speak to the issues of disparity in violence and aspects of mental health truman. we are focused on the decreasing archimedes. of it is often it's important we understand and obtain the behavioral tools to eliminate violence that have impacted the african-american community disproportionately. numerous barriers to obtaining appropriate mental health treatment especially african americans and other minorities. despite recent progress in developing party with physical healthcare accessing mental health treatment is separate and unequal. barriers include affordability. many psychologist and psychiatrist do not take

medicaid. there are a few providers who are able to provide competent care. for example in california, african-american and latinos and other ethnic groups make 47% of the population. only 14% of active physicians belong to these ethnic groups. 3% are african-american and 4% latinos. 1-20 adults and 1-13 children suffer as serious mental illness. half of these adults did not get their needed treatment. in the african-american community it's much worse. additionally the african-american community still suffers from fear of the stigma of a mental health diagnosis, in part stemming from the deep mistrust of the system that has misdiagnosed and mistreated them for centuries. the limited community access for evaluation and treatment puts

eople at risk for severe decompensation. worked at zuckerburg since 1989. there were 88 acute psychiatric beds. now there are only 22 beds. d others who are waiting for beds at lower level of care that doesn't exist. those who are discharged to the treat have no place to go to complete their recovery and many are afraid to stay in the shelters even if they are able to get a bed or just a chair to sleep on. it's no surprise that they relapse and return of the e.r. and hospitals are penalized for readmission in less than 20 days. l.a. county jail is one of the largest mental health facilities

in this country. however jails and prisons are not equipped to be a treatment facility or hop. many of these patients wind up on my unit at zsfg even though a few days ago they were down in the community unit. once in the criminal justice system it becomes extremely difficult for many to get out due to their mental illness. substance abuse problems can lead to a path of incarceration or more mental illness. opioid abuse and prescription meds are being targeted to safer practicing prescribing for physician but there are disparity and treatment options for african-americans. chronic pain often leads to depression due to changes in the brain chemistry and pain pathways over time. historically african-americans have been undertreated for pain.

pain management specialists and clinics are supposed to be the safest way to help those with chronic pain. however those clinics often are difficult to access especially for african-americans and other underserved groups. many don't accept medicaid insurance. california physicians who was asked to evaluate pain management clinics in one northeastern state did not find one in the entire state that took medicaid. even prince tragically could not be prevented before he was able to accept access his appointment san francisco with a pain manage. if even an entertainer could not have access to care how could someone else do so? we must don't be courageous and take bold action to eliminate them. i thank you for giving me the

opportunity to speak today. [applause] >> thank you very much. thank you. questions? >> thank you very much. i appreciate your testimony. o -- jodene jumbert is speaking on behalf of the 190 ,000 direct care nurses of national nurses united. >> good evening, auguste body. i'm really happy to be here. many of you are my idols. and thank you, the audience for amazing issues that are dear to my heart that have been brought up. my name is geraldine shamburg. i live in san diego where i've been a registered nurse for 33

years. my mother was a mass nurse in pearl harbor and had a career of over 50 years. so together we have almost 100 years in nursing profession. i am here today as a proud representative of national nurses united to ask that medicare for all be included in the platform as core principle of the democratic party. one of the critical roles of a nurse is to be a strong patient advocate. today, i am here to not only advocate for medicare for all -- salud, because it would benefit my patients but also because i'm a patient myself. my story started a year ago when i had a life-threatening incident. i was treated and placed on disability. and after a year, i thankfully resumed working but not before i completely used up all my life to cover my bills.

through this time -- so even though i have insurance through covered california, our state aca exchange financially, i have no margin of error to get sick. i'm a single mom raising two sons one of whom has autism. autism alone can be financial devastating. but my sons have prospered and however there's nothing left over for a medical emergency. currently i pay my healthcare premium but i can't afford to use my insurance. he cost of my lifesaving medicine are out of my reach. i understand the struggles of my patients because like them, i a have put a band-aid over

hemorrhage. i've been forced to the extreme situation of driving across the border into mexico to get affordable care. when in mexico, i drive to the doctor's office building. i park and i walk past the many heavily armed guards who are there to protect the doctors from being kidnapped in order to get my care. and last time i went, i was detained while a bomb squad cleared the building. still, when i faced the reality of not having the money to pay for my healthcare, i fortunately have an alternative to our expensive a.c.a. plans and was -- medicalchase meda care. i can now afford to see a doctor, pay for my medicine and get my required lab work and

tests at 1/5 of what i would pay in the united states. well, they're not up to u.s. standards of care. something is better than nothing. and right now it is keeping me alive. in america, we have access to health insurance but not access to healthcare. system it's a broken in which cannot be tweaked. it's broken when we cannot access healthcare because of our inable to pay. it's broken because when you marry a foreprofit insurance system, you get a system based on denying and reducing any access to healthcare. america does rank 39th in the world for medical outcomes and medical care while paying two and a half times as much as other countries. 29 million people have no health insurance and twice are 31 million people are like me

underinsured. we've talked today about what that does to outcomes on lifespans, how many it years it takes off your lifespan. but really for profit medicine is dictating how it's practiced today. i have hundreds of stories i could tell you but i could tell you one. i know a man who's brother had open heart surgery. he had open heart surgery on monday and friday he was in his little wheelchair at the curb. and he is brother was going to pick him up and on the way home, his brother died. i believe he died because he was discharged too soon. i believe that for profit medicine cuts corners and puts our lives in danger. finally, half of the nurses training is in assessment. when a nurse first meets a patient, she is assesses them

and creates a plan to restoring the patient to optimum health. if as a nurse and a lifelong democrat i were to assess the d.n.c., i would have to say i see an anemic patient who needs an infusion in order to stay viable. the treatment would be to don't something substantial to don't medicare for all. we know it's wildly popular. 81% of democrats support it. and 58% of all americans. so with that kind of base that can save the democratic party for going on life support. i'm also delivering petitions today of 21,000 americans who are joining nurses and calling you to boldly lead by making medicare for all part of your platform by including the language of the afl-cio adopted -- that they adopted at their 2009 convention. we can save the lives of people across this country, thousands

of them and we can recover trillions of dollars in healthcare savings and show that this is the kind of care and smart leadership that truly makes america great. so on behalf of nurses, national nurses unite and 190,000 nurses across this country, i thank you for your time and we look forward to seeing medicare for all included in your platform. thank you. >> thank you very much. [applause] thank you. any questions? thank you. >> thank you. daniel martinez? mr. martinez is the arizona state president in this volunteer role. he leads more than 100 state volunteers and is the spokesperson on the national and

state on issues and in addition he chairs the state's organization as a volunteer executive council. mr. martinez has been 17 years as an academic advisor and rofessor of reading with the maricopa community college. >> good afternoon. [speaking in spanish] my name is daniel martinez, and i am the president of aarp, a volunteer position. i'm the caregiver of my wife lily anne. two years ago she suffered a mild stroke at the age of 68. she was also in an accident leaving her with second and third degree burns. thankfully she has made a nearly a full recovery but as her primary caregiver, i'm all too familiar with the obstacles that we face that so many families struggle with every day.

gh prescriptions are harming too many people. my wife is among of them. among several other drugs she was prescribed to reduce the possibility of another stroke she was also put on another drug o manage or dee dye -- diabetes. resulting in sky rocking cost. while the affording care act is phasing out these costs, patients using high cost drugs need relief sooner. 90% of seniors and half of americans take a prescription drug. a typical senior on medicare spends $500 out of his or own pocket. and that's on prescription drugs. individuals with chronic health conditions or serious illnesses can spend thousands of dollars

each year in and out of pocket spending to afford prescription drugs. once more, out of pocket expenses are growing faster than people's wages. a kaiser family foundation study found that the average deductible in 2015 has grown seven times faster than workers' income since 2010. that means, folks, hard earned income goes to paying incredibly costly medical expenses. 31 million face out of pocket cost compared to their income. something must be done to change this. the democratic party platform should include improvements to the affordable care act where policies fall short and sup part other concrete solutions to minimize excessive out of pocket and prescription drug costs. to build on the aca we should reduce cost ordinary doctor

visits and create a new tax credit for americans burdened with the excessive out of pocket cost of care giving for our loved ones. americans will benefit if there are disbanded disclosure requirement to insure they're required to pay no more than innetwork cost for any emergency services. to lower drug costs, we need to hold pharmaceutical companies accountable by promoting competition and leverages our nation's bargaining power. we must demand a stop to excessive profit tiering on new and existing drugs. we should require greater drug transparency and use comparive effective research. right now we have no idea whether a new more costly product is better than a less expensive one that is already on the market. given the billions of dollars we

spend on prescription drugs every year, manufacturers should be willing to explain their value and how they're pricing them. we should focus on the large ams of money spent on markets and direct to consumer advertising and how that leads to even higher out of pocket costs. if you watch any tv it seems that every other ad is about drugs. my goodness. consumers simply can't continue to afford ever-growing out of pocket cost. through my own experiences, caring for my wife and speaking with aarp members struggling with rising costs, i've seen many attempts to close the loopholes and lower expenses. some patients are able to work with their primary care physicians and obtain medication samples provided by pharmaceutical companies. but that's only a temporary solution. those getting care from the v.a. are able to benefit from the fact that the v.a. negotiates

lower drug prices with pharmaceutical companies. if the v.a. can negotiate significant discounts on behalf of its beneficiaries, this should be a solution for folks on medicare as well. the democratic party platform has a crucial role to play in guaranteeing costs going down and not up. caregivers like myself, patients like my wife and elders like those that represent here in arizona are constantly challenged by those opponents who make it harder to access affordable healthcare. we cannot let this happen. in closing i want to leave you with a saying. it says, there's never a wrong time to do the right thing. i ask that you do the right thing for the 88 million members of aarp. thank you.

[applause] >> questions? >> thank you very much. >> thank you. >> mary woodley. she's the president of research america, the nation's not for profit memberships of supported grassroot public education and advocacy organization committed to making medical and health research a higher priority under her leadership. research america has earned attention and respect with the record of innovation and advocacy for research. she's an elected member of the national academy of medicine. thank you. >> thank you, mr. chairman and thank you for serving the public interest. it's a high honor and one i know you take seriously. in the interest of your time this evening, i've cut back my remarks so it's not to be redundant with the many

wonderful statements you've heard this afternoon. i'm glad that i had a chance to hear them. t i do have full comments in submitted testimony. research america is in alliance with scientific societies and philanthropies. encompassing in all about 125 million americans. we are committed to achieving faster medical progress by putting research and innovation to work at their full potential. in order to find the solutions to what ails us. and that's what it's about. finding the answers. one of the founders of research america and a mentor of mine mary lasker famously said "if you think research is expensive, try disease." she was right then.

it's true now. research finds solutions. i'm old enough to remember the fear of polio, the initial terror of h i.v., aids. and i'm gratheful for the remarkable progress that -- cine is putting on h h.i.v. and polio. americans have all the right to fear all the threats we have this afternoon. but america wants to know why we're not moving faster. why sit that america's leaders are not making it a top priority to make a 2021st century environment which will give research a chance. we believe that a full throated commitment to help security through research is as highly

valued by the american public as is a commitment to defense. the american people believe that speeding medical progress is crucial. we know this from national surveys that we commission regularly. in a national survey conducted earlier this month, a majority of americans say they would pay an extra dollar a week in taxes if they knew those dollars were going toward medical research. we're not advocating that. but i think it's a powerful statement about something that's important. americans also want to to what they plan to do to make progress faster. i say we want more officials like senator barbara mckolsky unflinching an champion. she will be sorely missed. we do hope that many new

champions will be elected this season. our surveys furrer tell us that 77% of our americans say it's important for the mex -- next president to assign high priority to putting health innovation to work to assure continued medical progress. what this means is robust funding if the national institutes of health, the world's largest funder of basic or discovery research and an institution that also funds clinical and prevention and translational research all around the country as well as in its headquarters campus in bethesda, maryland. it tackles every disease and disability you can think of. nd in addition, the critical underlying basic discovery science that can lead in directions we can't predict in advance. it amazes most people to hear that the n.i.h. works to achieve

the public's understandably high expectations for less than $100 per american per year. yet, it can only fund 15% to 16% of all the good ideas it sees from extraordinarily well qualified investigators. it could do so much more. people rightly are asking what are we waiting for? we also need to equip the centers for disease control and prevention to fully protect and advance population health and insure that the agency for healthcare research and quality or arc can identify evidence based solutions to the costly and deadly shortcomings in our complex healthcare system. medical errors are, in fact, the fourth leading cause of death in this country. that's a crisis we just simply have to overcome. speeding medical progress is also about doing what it takes to make sure that the life

science -- the life sciences industry of our economy k continues to produce new medical advances. so we propose to you a platform that would say achieving faster medical progress is an american imperative. we will do what it takes to overcome diseases that rob the people we love of hope, independence, and time. we can do this. if we make research and innovation a higher national priority. we will grow funding for this national institutes of health, fueling research and assuring today's diverse group of young scientists that they have a young future in understanding and defeating the scourges that ail us. we will bolster funding if the c.d.c., f.d.a., arc and nsf. these agencies play a crucial roll in advancing health and healthcare. and we will assure a policy

environment that propels rather than holds back private sector medical innovation and public, private partnership. thank you. >> thank you very much. [applause] questions? thank you very much. >> thank you. to the members of the committee, we have three witnesses left. and we'll be finished. j.j. carlisle is a member of the served ndian community, as a council's chair. -- chairwoman. vice chairwoman and secretary. joined the action service center in 1979. as appointed the director in 1994. thank you. thank you for being here so late with us.

i guess i'm on east coast time. >> oh, yeah, you definitely are. probably east coast weather too. > oh, mr. chairman, good evening. my name is sidga car del and i'm the chairman of the action indian community, which has 83,000 members. we're 35 miles of downtown phoenix. historically we've always been a farming community and while we still run a 16,000 acker farm today, we are also working hard to address the 21st century challenges of a rapidly growing community that which surrounds us. as a federally recognized indian tribe we have a government to government relationship as recognized under federal law and the u.s. constitution.

while this relationship has been better during the obama administration than almost any other time in history, the united states still falls far short of upholding this treaty and trusts responsibilities to indian country. under president obama the indian healthcare improvement act became permanent. but it still spends more per federal prisoner than it does on native people. two r life expectancy is years more. 3-5ve americans will suffer be sexual assaulted. the work group recently found that the need base estimate for indian health service was 27.6 billion dollars in fy-2015. budget'sresident's ihs

request was less than 20% of the demonstrated need for healthcare funding in indian country. likewise the bureau of indian affairs which is responsible for public safety in indian country is so backlogged for corrections facilities that it would have taken over a century for my community to receive b. inch a. funding to construct a much needed jail at current construction funding levels. these short falls squarely on tribes themselves like many other tribes have self-funded projects to-the tribe to fill the gap left by the federal government. we have built a central plant, wastewater treatment facilities, roads, infrastructure projects and most recently our multipurpose justice complex.

we understand that budgets are about priorities. thankful for the progress of the past eight years and this platform is to build upon the progress that in certain native americans in the programs are protected and expanded rather than rollback, yet again, as we have seen too many times in our history. i would like to thank the platform committee for listening to my comments and for doing the work you have been appointed to do. thank you. [applause] >> thank you. >> first of all, thank you for being here today and thank you for allowing us on your traditional