What importable care act and the social contract, as you feel it between the government and Civil Society and those People Living with those disease, you have talked about research which may not help many of those within it. And as that come in discussion. If youre friends with a sick child that didnt have Health Insurance, you will never forget it as long as he lived. I was a student a few blocks from here brandnew wife and baby and no Health Insurance and my daughter had a problem and i said that i would leave the Law School Classes and wait to see who walked through the door. And i was hoping whoever came through the door was a competent medical professional and its a basic right that we should establish in america. It shouldnt just be this. When we get into this conversation about the role of government, thats where i come from. The Affordable Care act, most important thing ive ever cast. Down by 30 , the rate of growth of Health Care Costs is still an incline but planning just enough to get 13 more years to medicare system and we have seen that it is transforming the delivery of medical services and there are 16 million or 10 or 11 million fathers without Health Insurance thing that the right doctor walks through their daughter. I want to ask you one unfair question. If you are in the seat that obama had come how would you deal with this political environment differently than he has . What needles would you move . How would you deal with that task of making the nation healthier . I think we are surviving to constitutional challenges of the Supreme Court and we have soldiered on for some impossible challenges. And that includes in terms of legacy as we still have this in terms of the legacy, how could it have been benefited differently. And i really encouraged him to make it part of his president ial platform and budget. He hasnt quite been there. But hes moving with Precision Medicine which really tries to take this and tailor make what individuals need. And i think that he is a great communicator and messenger and i would hope that he would spend more time on this medical research issue. That is a good answer. Senator collins. Come on in please come join us here. Thank you for joining us. Let me just take a couple of quick questions for the senator burr were you run not. Do we have a microphone . And we toss it over fast . Are we going to have fun . Just. Hello, i am on both sides of helping the Alzheimers Association raise money and im also a caregiver to my father who is 88 years old and has alzheimers. And my challenge is we are raising money and i think it is wonderful for research. Because i dont want any other families to go through what we have gone through with her father. At the same time i want to be able to see that my father lives a life of dignity. Up to this point he was an active gentleman and very happy and charismatic. Where does the money come from and how do we get the different Nursing Homes and care facilities and inhome care to meet the requirements to continue to treat people with dignity. Because i feel that as we have been talking to some of the other caregivers, that that is one of the things that theres no standard and is a very high turnover rate and ive been very fortunate and have found an amazing place that i hope others can find and then i hear Horror Stories about what is out there. So when you talk about the Affordable Health care and how we all deserve it, i also think that people who have served in the war as my father had and supported his family since he was 14 he still has a level of care. We are also going to discuss this with the senator because she has been investing so much in this area. She can answer better. Susan was introducing a piece of legislation which gets right to the heart of the question. Thank you. First, let me thank you for hosting this forum and also say that theres no better advocate in the United States senate than dick durban for Biomedical Research and its been a great pleasure to work with them. Showing the both of us care so much about this. Just so we could go the senator and i introduced a National Caregivers act. And that includes answering some of the concerns that you just raised. We are spending 225 billion on caring for people and the majority of that is to have uncompensated care that the Family Members are giving up and we dont have a strategy for trying to ensure that caregivers have the support that they need whether it is Care Home Health care, whether it is support groups. It is modeled on the National Alzheimers Plan and i authored with the former senator and that has produced a National Strategy for alzheimers that has brought together all of the federal agencies that is most important that has to do with the appropriate level of funding for Biomedical Research. Let me get this gentleman right here. I commend the legislation with federal research and i think its part of the next two years. Why is it that when the government develops these next kinds of basic Research Things that the Drug Companies pay very little in terms of licensees and you are ultimately provided to taxpayer funding in the first place but. There is no reason why they shouldnt pay more. Its modest. Modest in terms of real dollars. We hope that even that modest investment will lead to some private breakthrough here but its revenues and resources suggest that it can be part of the solution then people will ultimately benefit from these research but some of them will benefit first in developing the new products and when i read this Fortune Magazine piece i sent a copy of it and it never mentioned this once in the entire article. There were 10 different elements of what basic research led to these developing with these new drugs. So there is a linkage there and i think engaging in funding some of this research. And with interest about the amount of money that is very large. Which is one third of the entire budget of the 666 million they put in. That includes those in the lab who are getting the market. Those that invest earlier usually are wiped out in the way that what he is deluded. There is a structural bridge that is not being met by most. To just say that they should do that doesnt necessarily figure out the intent of problem. I think that it makes sense for the business model. But i really view this whole Research Question not just by medical research but related research to be the kind of commitment that America Needs to make in this 21st century. Look at our competition. And what china is doing now. Theres a lot of concrete. They see this coming, they want to be dominant. We better wake up to this reality, i am not opposed to finding the cure for alzheimers and using it in the. What we did has been paid back to us 150 times over for every dollar spent in doing that. And it will continue to and it is an economic driver and not just morally. I just want to encourage us to look at this in a broader way. Alzheimer is the nations costliest disease that it is going to bankrupt medicare and medicaid if we do not invest in the research. The Alzheimers Association has said that if we could delay the onset by even five years it pays for the increase in research and i think that this is one of these issues we we are looking at it because if you look at this, it is the costliest disease, the return on investment, if you look at the tsunami of things that we are going to be facing just because they will be changing demographics as a country, we cant afford not to make this investment. Senator durbin, thank you so much for coming. [cheers] [applause] its great to see you. I think there is a story there. We were just talking about him moving from animal house into his own place and there had to be something theyre from the daily routine. Weve also talking about this, and he talked a little bit about how he was going to the gym with dick and they would target republicans at the gym sort of seduce over whatever legislative game they had. The work that way yourself . I have a far more direct approach and i just bring people fax and then badger them until they agree with me. I spent much of last night actually reading about the volume of things that you had done. And i was just reading tweets of diabetes and the whole broad arena of how to ink about designing homes differently and you must know more about the subject than any of your colleagues. Would you say thats the case . You have invested heavily. Prison while i had the privilege of sharing this committee and he wanted that job and i represent the oldest median age in this country. That certainly is part of it. But also i meet constituents every day including members of my own family who arent going with the issues that one of your questioners brought on they are the low incomes they we have a lot of families that have moved away and we need to figure out a way to make sure about this. The statistics are really a call to action for all of them. What we have been learning from the experts is by age 85 and many of us are going to live to at least 85 nearly one out of two of us will develop alzheimers or some other kind of dementia and the other one is going to be taking care of that person. And so to me that is a true call to action. Finally due to great advocacy , which ive never understood. What is that . I dont understand it. You know it would be whispered that she had it. And i didnt understand that either. And with alzheimers there has been, for some reason the desire to keep it hidden within the family and i think that that has really changed and that is what has helped us make progress and as they have already said, we have made tremendous progress in the appropriations bill and we have only been funding this at the highest level of 600 million and this is for a disease that caused our society 226 billion. 153 of medicare and medicaid in this year we got a 60 increase of the appropriations bill to bring us to 950 million and we should be at 2 billion and that is what the experts tell us. If less than 1 that we are spending. To durbin was sharing with us ill be at a different Inflection Point in technology and history and he was pretty modest because i was looking at his target for dealing with alzheimers and you got your colleagues to basically say this is a Vital National priority, lets move up the date. And when i think that 18 back 18 years ago we didnt have gadgets like this or all of the embedded sensors were the wearables. Do you feel in your service to the country that all this stuff do you see in the crystal ball Something Different in the next 10 years . Yes i do. I have tried with so many researchers and i spent a fascinating two hours at mass general with their Alzheimers Research and they are making Real Progress and it takes money. No matter where it is mass general university of pennsylvania, all across the United States there is finally a focus on alzheimers leaves me optimistic that we are either going to whine better treatment that will probably come first, but ultimately a means of prevention or a cure. Its the only one of the top 10 diseases and here is what makes me optimistic. When hiv and aids came on the scene, we really made some breakthroughs, look at the breakers that we have made in treatments of people with hiv and aids. It is just amazing and it happens, if you think about it pretty quickly. But it was because there is a National Strategy and the investment. Still spend 3 billion a year on hiv and aids compared to the meager 600 million, soon i hope to be 950 million for alzheimers. So for me, that shows the execs are concentrated effort. Back we had called this money would this and she said that she was sick of mice. When she was trying to say is that we can show that we have for them of alzheimers but the translation of thats what we are dealing with a soda limited and there are so many problems and she made two interesting points, one of them was that the stigma issue or something out there is still limiting those people willing to step he forward to have those genetic markers done and get into the pool that they would need. Hundreds of thousands of people is what they would need over a period of time and the second issue is that we have a ridiculously low tolerance for risk. But if you are having a valve procedure or other procedures in which the risks are high, people take them. But there seems to be a barrier to that. Have you ever thought about that dimension of risk and population pools . I have. One of the hearings that we held, we had the restauranteur to testify and she sadly has earlyonset and one of the wonderful things that she has done a Public Service announcement reaching out to africanamericans in particular. Because they are not participating in Clinical Trials and she is encouraging their participation and ive had members of my own family participate since this for alzheimers. But we need people to think not only about themselves but the nextgeneration and yesterday i met with two constituents who were struggling with early onset alzheimers which is the saddest kind. And there are genes that have been identified for earlyonset and so they can get tested for it and they talked about the dilemma of their 29yearold daughter who is about to get married and she cant decide whether to get tested or not. She cant decide whether she wants to have children or not because she feels that she doesnt get tested she shouldnt have children and that is a horrible dilemma for someone to be in. And i think it causes people when there isnt an effective treatment or cure to be hesitant about getting tested or genetic markers because they think well if nothing can be done do i really want to know . Him and i think that the more we can get people to participate. They still want it to be known. Sold part of our job is to do more forums like this to encourage people particularly celebrities for the we had Glen Campbell come. He played his music before going on with his daughters help and music has stayed with him and i have seen that before. You also had richard gere playing an older man who was homeless so there is the element of homelessness and not being connected. So a to be honest some democrats were not big on science but their savings to be a lot more in your party. [laughter] with the investment in science the belief it can deliver something is a point of contention is there ewe to bring over . Talk about the most conservative members of the caucus so go talk about Biomedical Research with your constituents so interested in this debate about science and if that is a challenge . The best answer i can give you is that the republicans are in control of the senate and for a the third time ever we had a 60 percent increased in the alzheimers funding. [applause] very good dancer. You make a compelling case about the National Security issue and victor been talks about that area of necessity. What is the problem to bring on more more quickly . There is a lot of serious diseases in this country to give focus on Cancer Research that we spend 5. 4 billion. Rebate to look at the successful investment of Cancer Research and cardiovascular diseases. There isnt an awareness of the prevalence of alzheimers. Partially because people used to die earlier and also people would say she has got to do and senile aunt they didnt realize that was the disease. Raising Public Awareness is critical to get that type of support that has been there for other diseases to those powerful advocacy groups that is what we need to do. Senator clinton was my first cochair. Has ben a while since she was in the senate but back then it was difficult now i have people clamoring to be that cochair. Now senator warner it is a real difference. To bring bipartisan efforts. Were in a jury a political season just about everybody know was running for president. I dont know donald trump [laughter] is there a responsible way to elevate . To talk about silly stuff but is there a chance to bring those issues to the broader discussion . Jeb bush called me to ask for my support. I am endorsing him but i took the opportunity to talk to him about alzheimers i had him on the phone. That is a treatable moment if you were tweeting. I would ask him to comment. Here is the good thing just a few weeks later he talked publicly about alzheimers disease his motherinlaw battle with alzheimers and said the for more investment. It worked. [laughter] but regardless of who you are supporting what is their position . Encourage them to make it part of the platform or the agenda and push them to speak publicly. It worked in my case. Lets go to the audience. If has not entered the discussion by interested how you think about that what are the ideal will pull things to check off the box it is beginning to percolate i will give my parents credit but they built their twostory house 1957 and smart enough to put a master bedroom and the bathroom on the first floor. And they closed off the top floor. But i cannot imagine hell they had the foresight to think about their ability to climb stairs. When my father had his tuttis replaced, was not an issue for them. I happen to have broken my ankle last december and the house that i lifted the goodness has the automatic chair that goes up the staircase. Little would i guess i would be