Statement of The Honorable George R. Nethercutt, Jr., M.C.,Washington

Testimony Before the Subcommittee on Health
of the House Committee on Ways and Means

Hearing on H.R. 15 "Medicare Preventative Benefit Improvement Act of 1997

March 13, 1997

Mr. Chairman and members of the Subcommittee, I am pleased to testify before you today in strong support of H.R. 15, the Medicare Preventive Benefit Improvement Act, and specifically in support of section six of the bill, the diabetes benefits improvement section.

In the last session of Congress I sponsored legislation, H.R. 4264, that would accomplish the results of the diabetes portion of H.R. 15. This legislation has been reintroduced in the 105th Congress by my colleague from Oregon and me as H.R. 58. The provisions of H.R. 58 and of your legislation would improve the Medicare program by providing coverage for diabetes education self-management and blood testing strips for diabetics. The importance of these measures cannot be understated.

I know from personal experience, as the father of a daughter with diabetes who was diagnosed at the young age of six, that self-management education and access to blood testing strips are crucial to controlling the costly complications of the disease. In addition, in my former position as President of the Spokane Chapter of the Juvenile Diabetes Foundation, I came in contact with hundreds of diabetics who benefitted, in terms of better health and lower costs, by learning from professionals how best to control their disease and avoid complications.

Diabetes is a very individualized disease. Each diabetic, and there are over 16 million in the United States, must learn how their own body reacts to food, exercise and insulin, and adjust accordingly. Managing diabetes requires the constant monitoring of blood glucose levels. Both insulin dependent (type I) and non-insulin dependent (type II) diabetics must vigilantly check their blood glucose levels to avoid the debilitating and costly consequences that will result from poor management. Checking one's blood glucose requires the knowledge of when to check the blood and having the blood testing strips to conduct the tests.

The statistics associated with diabetes are staggering. It is estimated that 90 percent of diabetes-related blindness is preventable, 50 percent of kidney disease requiring dialysis is preventable, 50 percent of diabetic-related amputations are preventable and 50 percent of diabetic-related hospitalizations are preventable. Through its reimbursement system, Medicare tragically does not encourage proper management. I strongly believe that this results in higher long-term costs. Last month, I toured the Diabetes Institute at the National Institutes of Health (NIH). The researchers at NIH expressed their frustration to me that the most simple health management techniques that they pioneer to reduce serious and costly complications are not being taught to the Medicare population.

As you know, a high percentage of the Medicare population has diabetes. Many more have the disease but will not discover it until their symptoms progress to more serious health problems. Finally, Mr. Chairman and members of the Subcommittee, you should know that there is strong support within the House for addressing the complications of diabetes. I formed the Congressional Diabetes Caucus with Representative Furse during the last session and we now have 50 members of the House who have committed to raising the awareness level of the disease, addressing its complications and working to find a cure. I ask that a list of the Caucus members be made a part of the record.

Mr. Chairman and members of the Subcommittee, I sincerely commend you for including diabetes preventive care benefits in H.R. 15. Thank you for providing me with the opportunity to testify before you in support of the bill.

The Congressional Diabetes Caucus