dr. collins: that's a great question for dr. rogers since his institutes oversees diabetes research at nih. dr. rogers: thank you for the question. tibe two diabetes is increasing at an alarming level there. currently about 29 million people in the u.s. with diabetes and 86 million who have pre-diabetes. and there are two things we're doing about that. number one, for people who are established diabetes there's a common drug that started on patients. but unfortunately, in the great majority of patients, that drug will no longer be effective. we started a trial in which we are characaterizing the combination of this with one or four different classes of drugs to see what the next effective drug would be for a given individuals. this is actually a trial that involves 5,000 individuals in 45 centers around the country to determine the effectiveness. this really will eventually get to the area of precision medicine. the second thing for those people who are sort of underneets the iceberg, the 86 million americans who have a possibil

dr. collins? dr. collins: just like to add to that -- sen. cassidy: question for you, dr. collins. dr. collins: this will be quick. basically, you're never quite sure where the breakthroughs will come from and we have to be careful not to overly target research plans in a specific direction of a specific disease because the answer might come out of a different investigation or from basic science. as we were celebrating today with the nobel prizes. a quick example -- the biggest breakthrough i have heard about in the last month for als -- 1:45, can i: i got stop you for a second? you have a bunch of bright, aggressive people. they would not be who they are were it not for you being at the pinnacle. believe me, i am a doc. i know you are a pinnacle of the docs. you mentioned earlier the academic promise, the research promise of hiv-aids as a rationale to continue there. is it lacking elsewhere? one of the reasons to continue the funding in one area as opposed to others is the apparent academic promise in the one as opposed to the other. how do you balance these folks who have such promise

dr. collins, thank you for being here. i'm grateful, as we all are, for all you've done to champion the critical work that nih does. you have been a great partner and it's great to see you here and thank you to all of your team that is with us today. we look forward to hearing from all of you. all of us here today agree there's a lot more we need to do to keep our families and communities healthy and continue investing in priorities that strengthen our economy from the middle out. and the work of the national institutes of health is vitally important to that effort. the nih supports basic research that makes medical advancements possible and helps drive economic growth and competitiveness. in my own home state of washington, we have researchers working on ways to repair heart tissue that's been damaged by disease and injury. we have people decoding on difficult to treat forms of breast cancer. we use precision medicine to tackle eye disease and alzheimer's. the list goes on. those are just a few examples of the incredible

dr. collins. >> i'd just like to add to that -- and i have a question for you, dr. collins. >> this will be quick. basically the point here is that you never are quite sure where the breakthroughs are going to come from and we have to be careful not to overly target research plans in the direction of a specific disease because the answer might come out of some very different investigation or from some very basic science as we are celebrating today with the nobel prizes. just a quick example, the biggest breakthrough i have heard about in the last month for als -- >> can i stop. i have a minute and 45 seconds. which top you for a second? you've got really -- you've got a bunch of bright aggressive people who they would not be who they are were it not for you being the pinnacle, believe me, i can a doc, i know you are the pinnacle of the docs. should mentioned earlier the academic promise, research promise of hiv aids as a rational to somewhat continue there. i guess what i was trying to figure out is is it lacking elsewhere? one of the excuses -- one of the reasons i

dr. collins, to talk to you and the other institute directors about the work you are doing and the work you would like to do,rgr certainly every family faces health concerns during their lifetime and there are so many things that can be done by nih that i think can't be done as well anywhere else. new treatment could take a decade or longer to develop and can cost billions with a high failure rate even when you think you are on the right path. certainly it's necessary for the federal government to invest in b biomedical research and it represents the hopes of lots of people and families and particularly now as we see conditions growing as people survive heart problems and stroke problems, we see more people with alzheimer's and cancer challenges, and we see the potential for designer medicine, largely because of the great work that was done to figure out how to define and understand the human genome system in a better way. this year this committee, the sub committee and the full committee placed a high priority on this research, and we have planned for and have a bill that includes $2 bill

dr. collins and his leading researchers for the united states of america, and we asked them what happens if our budget process breaks down, if we go into sequestration, which is an across-the-board cut, or we go into a continuing resolution, which is the continuation of this year's budget, what happens at the premier medical research facility in the world,s the national institutes of health? dr. collins told us in very honest and somber tones, it would mean that we would suspend research in areas like precision medicine, destined to, i think, save lives across the world. we would suspend research, brain research in areas like the alzheimer's disease. once every 67 seconds in america -- once every 67 seconds an american is diagnosed with alzheimer's. last year we spent $226 billion as a federal government in medicare and medicaid on alzheimer's. we estimate about the same number, over $200 billion, was spent by families trying to care for those afflicted by dementia and alzheimer's. and there's a suggestion now that because our failure on budget negotiations will lead to the suspension of

dr. francis collins, as well as several directors testified at a hearing at the sub committee on health anduman services, and they address their need for more funding and to which areas they would like the money to be applied and best spent. >>> the appropriations sub committee on labor health and human services education and related agencies will come to order. i am certainly pleased we could have this opportunity this morning, dr. collins, to talk to you and the other institute directors about the work you are doing and the work you would like to do,rgr certainly every family faces health concerns during their lifetime and there are so many things that can be done by nih that i think can't be done as well anywhere else. new treatment could take a decade or longer to develop and can cost billions with a high failure rate even when you think you are on the right path. certainly it's necessary for the federal government to invest in b biomedical research and it represents the hopes of lots of

dr. matias' concerns became reality. collinsg with another inmate and was confined to his cell while officials investigated the matter. >> apparently another guy over there said that i hit him and that's all it took because of my, you know, my history for violence on the idu. it means a setback. a serious setback. i'm not allowed to come out but one hour a day. no matter what i do. i can whistle dixie all day long, not talk to nobody, cause no problems, not say nothing, i'll still be over there. he told me that. >> how badly injured was this man? >> no injuries. not a mark on him. >> i got the impression he was vastly minimizing what had happened. i think that part of the problem is we're a television crew standing in front of his cell, and for him to admit it, other people would have heard the truth. indiana state prison allowed us to give certain inmates little personal cameras that we would leave with them and they could film themselves. i gave a camera to brian, and all i asked of him was to be honest. he might be a little m

dr. collins and the commonwealth fund for continuing to do research and invest your research dollars into work that informs people on the ground. very much appreciate your ongoing effort. but influences our approach on the ground. i would also like to think that howard for his many years of leadership. he, i'm sure, mentored many people in this room. his leadership and his contributions we will miss and maybe he'll reconsider retirement. the affordable care working in the district of columbia, just like it is working in kentucky and most states. according to the census, our uninsured rates dropped. in the district of columbia, as many of you know, we had a very low uninsured rate for many years. through the years we have invested a lot in coverage expansion. and expansion to medical care efforts. my whole team was very proud when the census report came out. it really did matter that we were on the ground finding a hard to reach population. we are not done yet and we will not stop until every single person, child, individual who lives in the district or works in the district has access to

dr. collins and the commonwealth fund for continuing to do research and invest your's our research dollars to the approach on the ground. i would also like to think that howard for his many years of leadership. he, i'm sure, mentored many people in this room. his leadership and his contributions we will mess. maybe he will reconsider retirement. the affordable care working in the district of columbia, just like it is working in kentucky and most states. census, our the uninsured rates dropped. in the district of columbia, as we had a veryow, low uninsured rate for many years. through the years we have invested a lot in coverage expansion. and expansion to medical care efforts. team was very proud when the census report came out. it really did matter that we were on the ground finding a hard to reach population. wille not done yet and we not stop until every single person, child, individual who lives in the district or works in the district has access to affordable, quality health coverage. since october 1, 2013 when we opened for business, over 166,000 people have come through us. on the i

dr. collins and the commonwealth fund for continuing to do research and invest your research dollars intohat actually informs people on the ground. very much appreciate your ongoing effort. not only in forms, but influences our approach on the ground. and i'd like to also thank ed howard for his many years of leadership. he, i'm sure, mentored many people in this room including myself, fresh out of law school. so his leadership and his contributions we will miss, and maybe he'll reconsider retirement. [laughter] so the affordable care act is working in the district of columbia just like it's working in kentucky and in most states. we, according to the census, our uninsured rate dropped by 20%, and in the district of columbia, as many of you know, we had a very low uninsured rate for many years. through the years we've invested a whole lot in coverage expansion and expansion to medical care efforts. so my whole team was very proud when the census report came out that it really did matter that we were on the ground finding the hard-to-reach population. we're not done yet, and we won't stop

dr. francis collins is the director. an extraordinarily man, medical doctor who was given the task that -- task of mapping the human genome. he did an extraordinary way. he a new information and new opportunities. a doctor from mayo clinic explained what it meant. it meant that we have now reached the point where we can map the genome of individuals for dna and we can then make decisions on the appropriate prescriptions for illnesses and diseases they face. in doing that to be more effective and to save lives. that is what medical research can mean. it will not only have a basic lack of fan or medical record when we were born and some of the basic illnesses we face but also our individual map of our dna which will instruct doctors when it comes to treatment of cancer if it should strike us or some other disease. it's an amazing leap forward. it's a leap forward that would not be possible without medical research they get in the 12 years we have seen a downturn in investment in medical research of more than 20%. more than

dr. collins has talked to us about in that he hopes to be able to do it? -- weis, dr. collins sometimes joke he has become a born-again neuroscientist. he was trained in another area, he has discovered how spectacular neurosciences today and of almost any area in science, this is the place where we have some attraction and excitement. the brain initiative launched by the president in april, 2013, has moved forward. we are funded in her second year, $84 million we have invested for over 100 projects across the country. >> is this within your agency? >> the money is nih. there are 10 institutes within nih that are engaged in this. orisch and i lead it. darpa,artnership with sonsf there are many different federal agencies involved. the important thing to understand -- >> is $84 million the total funding? >> that's nih funding. the president has asked that that should go to 100 50 and in the house and senate, there is ambition to go beyond that for next year. not about the specific diseases or brain disorders. it's about developing the technology to be able to understand ho

dr. francis collins is the director, an extraordinary man, a medical doctor who was given the task of mapping the human genome and did it, did it in an extraordinary way, creating new information, new opportunities. a doctor from the mayo clinic explained what that meant. it meant that we can now reach map the genome of individuals, their d.n.a., and we can then make decisions on the appropriate prescriptions for illnesses and diseases they fa face. and in doing that, we can be more effective, save lives. that's what medical research can mean, that each of us will not only have a basic biography in our medical record -- when we were born and some of the basic illnesses we faced -- but also our individual map of our d.n.a. which will instruct doctors when it comes to treatment of cancer, if it should strike us, or some other disease. it's an amazing leap forward. it's a leap forward that would not be possible without medical research. but yet in the past 12 years we've seen a downturn in investment in medical research of more than 20%. more than 20%. and it's meant that a lot of research has b

dr. and mrs. kroot. >> chairman collins, ranking member mccaskill, distinguished senators on the committee. thank you for the opportunity to appear before you today and testify about our family's experience with pension advances. we are here today as husband and wife, because in our 34 years of marriage, we've always operated as a team, and ours is a shared, cautionary tale. for 22 years, i served our country in the navy as a physician. when i retired as commander, i continued to work as a doctor and i did see as an e.r. attending physician in several hospitals. today i continue to work as an e.r. attending at a hospital in lexington, kentucky. my wife kathie has been at my side throughout most of my career, has done incredible work as an advocate for organ donation, and as a dedicated volunteer at our synagogue. when i left the military, we planned to continue to provide for our family through work and through my military pension. but due to a perfect storm of unfortunate events, we were left with debt spiraling out of control. first, we received bad tax planning advice and moving funds fr

dr. kroot, thank you for your service to our country. >> thank you. senator warren? >> thank chair collins to thank you for holding this hearing today and thank you to all the witnesses for coming. we really appreciate you coming and telling the story. i know it's hard to do that. but it's very important that we understand what's happening here. i just want to see if i can pull this together so we all kind of get it in one place. so define benefit pensions, the steady guaranteed income stream throughout retirement, we know these pensions are disappearing, and the americans who still have them know they are lucky to have these pensions, but now there's this interconnected industry that's targeted to getting their hands on the pensions. so these pension scam companies turn a profit by offering retirees cash in exchange for a fixed amount of the buyer's future pension, as you testified to, plus, of course, interest and fees. and according to a 2014 report from the nonpartisan government accountability office, and also from senator collins, these loans can have pretty shocking fine print, for

dr. and mrs. kroot. >> chairman collins, ranking member mccaskill, distinguished senators on the committee, thank you for the opportunity to appear before you today and to testify about our family's experience with pension advances. we are here today as husband and wife because in our 34 years of marriage, we have always operated as a team, and ours is a shared cautionary tale. for 32 year -- 22 years i served our country in the navy as a physician. when i retired as commander, i intended to work as a doctor, and i did so as an er attending physician in several hospitals. today i continue to work as an er attending at eva hospital in lexington, kentucky. my wife kathie has done incredible work as an advocate for organ donation and as a dedicated volunteer at our synagogue. when i left the military, i planned to continue to provide for our family through work and through my military pension. but due to a perfect storm of unfortunate events, we were left with debts spiraling out of control. first, we received bad tax planning advice and moving funds from 401(k) and incurred around $100,000 in unexp

dr. and mrs. kroot. >> chairman collins, ranking minimum mccaskill, distinguished senators on the committee. for the opportunity to appear before you today and testify about our family's experience with pension advances. we are here today as husband and wife, because in our 34 years of marriage, we've always operated as a team, and ours is a shared, cautionary tale. for 22 years, i served our country in the navy as a physician. when i retired as commander, i intended to work as a doctor, and i did so as an e.r. attending physician in several hospitals. today i continue to work as an e.r. attending at a hospital in lexington, kentucky. my wife kathy has been at my side throughout most of my career, has done incredible work as an advocate for organ donation and as a dedicated volunteer at our sin gogs. when i left the military, planned to continue to provide for our family through work and my military pension, but due do a perfect storm of unfortunate events, we were left with debt spiraling out of control. first, we received bad tax planning advice and incurred around $100,000 in unexpected f