JDF Legislative AlertAs a JDFI Government Relations Advocate, I thought you may be interested in receiving the text of Speaker of the House, Newt Gingrich's speech to the JDFI Annual Conference last Friday, June 6th. All advocates are encouraged to send Speaker Gingrich a thank you letter for his dedication and timely remarks regarding diabetes-related issues.
All letters should be addressed in the following format and sent to:The Honorable Newt Gingrich
United States House of Representatives
Washington, D.C. 20515
Dear Speaker Gingrich:
Please send a xerox copy of your letter to:JDFI Government Relations
Att: Eric Schutt
1400 I Street, NW
Washington, DC 20005
Or Fax: (202) 371-2760 or E-Mail: Eschutt@jdfcure.com
Speech before the Juvenile Diabetes Foundation International's Annual Conference Delivered by the Honorable Newt Gingrich, Speaker of the House of Representatives Friday, June 6, 1997
First of all, I would like to extend my gratitude for being invited to address all of you who make the Juvenile Diabetes Foundation an effective organization. For the last twenty-five years, you have worked hard to dedicate yourselves to the task of "funding research to find a cure for diabetes." It is a noble and important cause that goes a long way toward ensuring that the next generation of children will have all the good health and prosperity they deserve. It means they will enjoy life and have the freedom to travel widely across different time zones without concern for strict regimens or not having access to needed special health supplies and care.
For many of you, I know this is a personal mission. Many, perhaps most of you, have suffered the hardship of seeing your young children and loved ones develop this debilitating disease, one that they will have to learn to manage for themselves throughout their whole lives. It is a difficult challenge to convince carefree children of the importance of living according to a strict regimen, so I salute your individual efforts to teach your children and to give your free time to fighting against this disease. Your efforts today will ensure that your children's children may not have to suffer from diabetes and its resultant complications.
As we discuss the challenge of conquering diabetes, it is useful to note that this is the fifty-second anniversary of D-Day. As you know, D-Day represented a change of fortune for the allies in World War II, just as I think we are in a pivotal era for man's long march against debilitating diseases. Ever since the end of WWII, and during the last several decades in particular, scientific advancement against diseases has come a long way, but I think we are at a point in the field of research where if we do more we can reap dramatic results.
As many of you are aware, I've been outspoken for several years about diabetes for several reasons. First, the fact is, my mother-in-law has diabetes and I've watched how she cares for the disease. She actively practices self-management and leads a remarkably full life. I know that when people learn to take care of themselves and are educated about the disease, they can dramatically improve their quality of life. But we need to do more.
My good friends, Gay and Stanley Gaines, have been active in juvenile diabetes since their son, Stanley, Jr., was diagnosed with the Type 1 diabetes at the age of 13. Which brings me to my second reason for involvement -- it's the humane and intelligent thing to do. Studies have shown that with aggressive self-management training and education, we can reduce diabetes-related blindness by 90%, diabetes-related kidney disease by 50%, and diabetes-related complications and amputations by 50%.
We cannot turn our back on this disease any longer. The World Health Organization estimates that there are about 120 million people with diabetes worldwide. Here in the United States, the Center for Disease Control estimates eight million people are diagnosed with diabetes, while another eight million have the disease but remain undiagnosed. A new case is diagnosed every minute. Diabetes often changes an individual's lifestyle dramatically and significantly increases their chance of a premature death. Yet, half of all Americans with diabetes do not know they have it.
Those who know they have diabetes spend a good part of their day managing it. The estimated 800,000 people with juvenile, or Type 1 insulin-dependent diabetes, must monitor their blood glucose level up to eight times a day and inject themselves as many as four to six times a day. This means spending hours per day for diabetes treatment. Over a lifetime, the average individual with Type 1 diabetes will spend close to 60,000 hours applying self-treatment. The eight million diagnosed with non-insulin-dependent diabetes, or Type 2 diabetes, also have to carefully monitor their blood glucose levels as well as vigilantly manage their diets and exercise regularly.
Diabetes alone is one of the leading causes of death by disease. I know that the life expectancy of people with diabetes averages 20 years less than that of people without diabetes. Middle-aged people with diabetes have a death rate twice as high as middle-aged people without diabetes. People with diabetes are two to four times more likely to have heart and vascular disease than people without diabetes, and are 250% more likely to have a stroke. Diabetes is the leading cause of end-stage renal disease, accounting for more than one-third of new cases. It is also the primary cause of non-congenital kidney disease, accounting for one-fourth of all new cases. The death rate among infants born to mothers with diabetes is two to three times as high as for women without diabetes. The average lifetime costs of diabetes for a child diagnosed at age three is $600,000. These statistics indicate that we must find a cure for diabetes very soon.
The future of millions of Americans is at stake in our struggle with diabetes. As a society, we cannot sacrifice the potential contribution of a single person. We must devote the necessary resources to ensure every citizen has the proper health to acquire a quality education, to earn financial security for themselves and their families, and to have the God given right to life, liberty and the pursuit of happiness. We need to find the resources to provide the necessary research capability to find a cure for diabetes.
But before I continue to discuss research any further, let me share with you some ideas I have about advancing America's potential to remain the world's leader of health care and some attempts I have made to make our national health care system become more responsive to those in need of timely and affordable health care.
I'm proud to say that the Centers for Disease Control and Prevention is located in Georgia and I am fortunate enough to frequently have the chance to meet with their experts who inform me about the impact of diabetes and other diseases in human terms. In fact, I met with them earlier this spring and we discussed how the federal government can have an impact that will reduce the incidence of diabetes-related illnesses.
As a nation, we need to take advantage of the last two decades of medical breakthroughs and continue to make America the world's leader in medicine. In order to take advantage of these breakthroughs, however, we need to reduce the costs of American medicine by reforming our bureaucracy and our confused insurance system. By solving this problem, we will be able to better compete in the worldwide market and earn a net balance of trade.
There are five forces catapulting America toward becoming the great, prosperous center of worldwide medicine. Molecular medicine breakthroughs, computer sophistication, telemedicine advancements caused by the explosive growth in communications by satellite and fiber optics, cost reductions in transmitting information, and cost reductions in transportation have all brought our nation to the threshold of a real revolution in health care.
The rise of molecular medicine through breakthroughs in our understanding of DNA is having an astonishing effect on our ability to treat the human body. From the mechanical focus of nineteenth-century anatomy to the chemical focus and microbiological approach of the twentieth century, we are now entering an era when doctors will be able to work directly on the human gene. This means that previously incurable diseases such as diabetes, cystic fibrosis, and certain inherited cancers may now be treatable. There are a variety of "orphan diseases" -- obscure genetic conditions that force people to lead very restricted lives -- which may soon be curable through genetic surgery. These techniques will make us a world magnet for medical treatment in the twenty-first century.
Second, computers are allowing us to sort and store more data and to build more sophisticated systems. Soon we will be able to network knowledge from all over the world. Medical analysts in almost any country will be able to interface with the state of the art in hundreds of fields. Today, we are close to five percent of the way into this system, but it could become fairly common within two decades. With work, we could make it in five years.
Eventually, your local doctor will be able to diagnose your case by consulting a world database. The doctor would find who is doing the most work in that field and where the most advanced research is being pursued. Patients with rare diseases and parents of children with orphan conditions will rapidly become experts in the field, like many of you working with juvenile diabetes have become. We will have a better-informed public, lower costs, and a system that will be very attractive to foreigners. Actually, when we were studying other nation's health care systems, we found a large number of Canadians are already coming to American doctors and hospitals because they cannot get advanced treatment under Canada's government-run medical system.
Third, the explosive growth in our ability to communicate by satellite and fiber optics is creating an entirely new realm of telemedicine. The army is a pioneer in this area. It wants the wounded soldier on the battlefield to have access to the best brain surgeon in the world if that will save his or her life. Soon these breakthroughs will allow the most isolated rural hospital to have access to the best medicine in the world. Computer networks will bring together the best international experts, who will consult from their home offices. Experiments are under way in which surgeons practice their craft in virtual reality. They will have been though an entire procedure many times over before they finally step into the operating room.
The next wave of medical investment will be in satellite uplinks that allow the transmission of so much data that it is almost the same thing as being there. Surgeons may one day be able to operate by remote control. American doctors and hospitals will be called upon to operate on people in India. We will be able to market our health expertise in every corner of the world.
Fourth, the cost of transmitting information is dropping rapidly as more and more people are being wired into a worldwide market. In just a few years, you will be able to consult global databases with the same ease that you now flip through TV Guide. The child of a friend of mine, Jim Baen, was afflicted with an orphan disease. My friend is a computer buff and he was soon in conversation with doctors and libraries in Boston, London, Rome, and Zurich. The Internet is the forerunner of a worldwide system that will allow people to track down the best research, the best therapy, the best doctor, and the best hospital. Perhaps one day, we'll have developed an "Internet Health Care Encyclopedia" where everyone can access the latest health care information. It's exactly this kind of approach that the federal government should be encouraging. This is the kind of sophisticated information systems which will lead to better self-education and self-monitoring systems so patients will have more power over their own lives. All of this means a growing consumer market for our medical expertise.
Finally, the cost of transportation is dropping almost as rapidly as the cost of information. Northwest Airlines flies a Boeing 747 every weekend from Tokyo to Minneapolis so that Japanese consumers can shop at the Mall of the Americas. If people like our clothing stores and boutiques, what will they think of our heart, liver, lung, and kidney treatments?
By offering the best products, the best therapies, the best experts, and the best clinics and hospitals in the world, we have a dramatic opportunity to increase our foreign-exchange earnings. Much of this will be sold entirely via worldwide satellite and computer communications. Other people will come to the United States for health care. We may have a sales force traveling the planet selling American health care.
Health products and services could be our largest single source of foreign exchange in the twenty-first century. What we regarded only recently as a huge liability may turn out to be our biggest asset. That is what comes from taking problems and turning them into entrepreneurial opportunities.
I am pleased to say that we in Congress have begun -- this week -- to make progress on the first real changes to our nation's health care system in a generation. I have been fighting hard since I became Speaker to make the system work more efficiently while reducing health care costs. This week, the House Ways & Means Health Subcommittee unanimously reported out legislation that will improve Medicare policy by increasing preventive care coverage and ensuring the program's viability for baby boom retirees. While it is only a first step, it is a beginning. As the Chinese say, a thousand-mile journey begins with the first step.
We need as a nation to encourage preventive care to improve health, avoid illness and control spiraling medical costs. We must empower our citizens to take individual responsibility for their own health by changing Medicare benefits to become proactive and not just reactive. Right now, the Health Care Financing Administration (HCFA) will pay for your leg to be amputated, but will not reimburse you for learning how to eat right and exercise right in order to avoid the complications of diabetes and to avert the need for the amputation in the first place.
A March 1997 Government Accounting Office (GAO) study entitled "Most Beneficiaries With Diabetes Do Not Receive Recommended Monitoring Services" underscores the need for these diabetes reforms. The study notes that 'preventive and monitoring services can help physicians and patients manage the disease more effectively and control its progression,' and 'when beneficiaries receive less than the recommended levels of preventive and monitoring services, the result may be increased medical complications and Medicare costs.'
Further, HCFA is cited in the study as agreeing that 'interventions to prevent the progression of early complications... [that] cause significant morbidity are of key importance to this high risk population.' Indeed, by providing reimbursement for diabetes education and supplies, studies show we can lower the cost of providing care to those afflicted with the disease by reducing hospitalizations, visits to the emergency room and, in the longer-term, the serious complications of diabetes.
Leading corporations have realized the importance of these benefits. By providing preventive care measures, they have ensured greater productivity while simultaneously containing their corporate health care costs. Honeywell, Inc. received a 61% return on investment by making a commitment to provide the up-front costs of diabetes management. According to Honeywell, preventing illness before the fact made workers happier, more productive, and resulted in less cost for the corporation.
In San Antonio, Marriott's River Center Hotel contracted with Humana Health Care to provide its proactive diabetes management program in order to help contain high employee turnover. Many of the hotel's employees, who are Hispanic, are at greater risk of developing diabetes. By providing these same diabetes prevention benefits, Marriott has saved $2,000 per employee with diabetes and has been able to reduce turnover, enjoy an increase in productivity and a decrease in absenteeism and tardiness.
It is time for the Medicare program to implement these same cost-saving measures for the government. The inclusion of diabetes preventive care language in the Medicare reform package reported by the Ways & Means Health Subcommittee this week is crucial to helping find real savings in the senior health care program and critical to those beneficiaries who could benefit from these changes. These reforms help Medicare beneficiaries become empowered to take individual responsibility for themselves by encouraging outpatient self-management training services and uniform coverage of blood-testing strips for individuals with diabetes. It is a small investment compared to the dramatic end results.
Until we find a cure for diabetes we must continue to marshal our nation's resources toward greater research. During the Twentieth Century, most of the practical means of extending our life span and the resulting years free from chronic disease can be directly attributed to advances in research at the National Institutes of Health. In the last century, doctors could only treat symptoms, set broken bones and ease the pain of other medical problems, but not cure diseases. Now, thanks in large part to the NIH, people afflicted with many common diseases have longer, more productive lives.
The world-wide predominance of American health care stems from the NIH's humble beginnings in a small, one-room microbiology laboratory on New York's Staten Island in 1887. Its mission was directed at the suppression of epidemics, including fighting the rampant outbreaks of smallpox, cholera, yellow and typhoid fevers, and later, bubonic plague. Since 1912, Congress has provided funding for the basic science research to eradicate these diseases and, as a result, these diseases are rarely heard of in the United States today.
Since 1945, the National Institutes of Health has fueled America's medical renaissance. The NIH became the world's largest organization for medical research, working to ease pain and save lives from the ravages of chronic diseases. After World War II, the NIH dominated the medical field by either financing, or being directly involved in, most of the major medical advances of this century. By focusing on the new concept of molecular biology, or the processes of the body, the NIH was able to undertake fundamental, basic medical research into specific areas that led to important clinical dividends.
Now, as I mentioned before, with the advent of genetic material research, scientists have been making startling new discoveries. Over the past several decades, massive investments in medical research under the auspices of the NIH have yielded a deep understanding of the molecular structure and functions of biological systems. The biotechnology industry has applied NIH's basic research and has made previously undreamed of diagnostic techniques and therapy into reality.
In recent years, medical research funding at the National Institutes of Health has increased. I want to recognize the leadership of Congressman John Porter, chair of the Labor-HHS appropriations subcommittee, has shown in providing this funding increase for NIH. From 1987 to 1994, funding for NIH increased by 63 percent, or 7.25 percent per year.
However, as I'm sure you are painfully aware, funding for NIDDK, the primary institute researching diabetes, grew by only 4.95 percent per year during this time. Of the seventeen NIH Institutes, NIDDK ranked thirteenth in terms of budget growth between 1987-1994.
Current federal spending for diabetes is a little more than $300 million per year. When compared to the $138 billion cost to the nation from diabetes, $300 million for research toward the cure and treatment of diabetes is a small sum. The $138 billion spent treating people with diabetes is four hundred sixty times more than the amount spent on diabetes research. The $28.6 billion Medicare spends on treating people with diabetes is 95 times the sum NIH spends on medical research into the disease.
I was very disappointed with the President's extremely modest 2.6 percent increase for NIH in his FY 1998 budget request. Even more disappointing is the President's request to increase funding for NIDDK by just 2 percent.
I believe that we need to take a serious look at diabetes research compared with other illnesses. And, while Congress shouldn't encourage a "disease of the month" mentality for research, the numbers on diabetes support a significant research commitment. For example, for every $100 spent in direct costs of medical care, it is estimated that only $0.25 is spent on diabetes research compared with as much as $12 for some other diseases.
Studies show that if the prevalence of diabetes and diabetes-related complications can be reduced, many lives can be saved and substantial cost savings can be realized. The future holds great promise for finding a cure for diabetes. But I will need your help.
I look forward to our continued work together to fight this disease and improve the lives of so many people -- young, old, and yet-to-be-born -- that may be affected by diabetes.
Last Updated: Thursday August 29, 2002 20:59:48
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