in mental illness we have a tendency to want to treat schizophrenia. what is schizophrenia? it is a combination of symptoms. if we moved our strategy to treating symptom clusters, we talk to the patients. for a pharmaceutical company trying to sell something, the large trials, very big affect, it is very difficult because it is hard to say everybody who is depressed needs the same treatment, everyone who has bipolar disorder needs the same treatment, schizophrenia is the most complex example of it. pharmaceutical companies develop treatments, what is it you are treating? it is much harder than if you are trying to treat the specifics like getting your blood pressure down. that is different. >> congressman gephardt, i have a great deal of respect for you, followed your career. thousands of issues must have come across your desk. why this issue? what does it mean to you? >> i have always said health care is more important to my constituents than any other issue. i used to tell crowd you could be bill gates and have $50 billion but if you get sick with a horrible disease, the m

half of the nursing-home the country, talk about depression, schizophrenia, any of these things. we need a cap tax budget in the united states. we need to put the money in translation research to find better remedies. we are on the threshold of personalized madison, we know that if we can no your gene map we can probably taylor something that would treat your depression. and on and on. there was a study recently on prostate, they said there are probably 50 kinds of prostate cancer but we don't know how to diagnose that so we treat everybody the same. the same with lipitor. lipitor may not work for me. we can see the future but we can't quite get there. the only way is a capital budget at the federal level, where we borrow the money, make the investments and move the needle. it will save us billions of dollars. [applause] >> congressman gephardt has outlined the objectives of individualized medicine including mental health. let me pose a question this way. what is the rate limiting said? >> everyone says we are not where we should be. >> why not? if we were able to wave a magic wa