WHAT IS THE OHIO DIABETES COST REDUCTION ACT

The Ohio Diabetes Cost Reduction Act would require private health insurance companies in Ohio to provide coverage for diabetes equipment, supplies, and medication, and also diabetes self-management education, for all covered people who have diabetes.

Examples of medically necessary equipment, supplies, and medication that would be covered include, but are not limited to:

What health insurance plans would be covered by Ohios Diabetes Cost Reduction Act?

Ohios Diabetes Cost Reduction Act would apply to all individual or group health maintenance organization contracts; individual, group, or blanket sickness or accident insurance that provides coverage for other than specific diseases or accidents only; and public employee benefit plans.

Ohios Diabetes Cost Reduction Act does not affect Medicare or Medicaid coverage, or coverage provided by self-funded insurance plans, which are exempt from state regulation under the ERISA Act.

Not at all! As of June 2001, 46 other states have found the cost-saving evidence so compelling that they have passed legislation similar to Ohios Diabetes Cost Reduction Act. Furthermore, among the provisions designed to reduce Medicare spending in the federal budget agreement of October, 1997, the United States Congress included expanded coverage of diabetes education and diabetes supplies. These provisions had strong bipartisan support; they were endorsed by both President Bill Clinton and House Speaker Newt Gingrich.

SAVE MONEY AND SAVE THE LIVES OF OHIOANS WITH DIABETES.
SUPPORT OHIO'S DIABETES COST REDUCTION ACT.

Diabetes is a disease that affects the way the body uses food for energy. It affects the body's use of carbohydrates (sugars and starches) the most. When a person has diabetes, the body cannot absorb carbohydrates properly and use them for energy.

There are three main types of diabetes: Type 1, Type 2, and Gestational. All three kinds cause the body to have abnormally high levels of dissolved sugar (glucose) in the blood.

Type 1 diabetes occurs when the pancreas is not making any insulin. Since insulin is needed to help the body absorb carbohydrates properly, insulin injections (shots) are needed. Type 1 diabetes usually begins before 20 years of age.

Type 2 diabetes occurs when the body is still making some insulin, but it has trouble using the insulin properly or is not making enough insulin. It can be treated with diet and exercise, or pills, or insulin injections. Type 2 diabetes usually begins during the adult years. At least 90% of the people with diabetes have this type.

Gestational diabetes occurs when a woman develops high blood sugar during pregnancy. It affects both her and her developing child.

When the body is not able to absorb and use carbohydrates properly, dissolved sugar (glucose) builds up in the bloodstream. When the blood sugar level builds up and stay high for a long time, complications often occur. Many indispensable parts of the body are damaged.

High blood sugar can harm and even destroy many vital organs. It damages the blood vessels, and therefore damages every part of the body that needs good circulation, such as the heart, the kidneys, the eyes, and the feet. It can cause heart attacks, kidney failure, blindness, amputations, and also impotence. In pregnant women with diabetes, high blood sugar can cause many serious problems, including birth defects.

These costly and devastating problems can be prevented. People who have diabetes can learn how to control it and keep their blood sugar levels close to normal. To do this, they need both diabetes self-management education and necessary diabetes supplies.

DIABETES CONTROL PREVENTS COSTLY AND DEVASTATING COMPLICATIONS.
SUPPORT OHIO'S DIABETES COST REDUCTION ACT.

WHAT ARE DIABETES COMPLICATIONS?
WHY IS PREVENTION OF DIABETES COMPLICATIONS IMPORTANT?

Diabetes complications are problems that result from the blood sugar going too low or too high. Both low and high blood sugar can cause short and long term problems that are expensive to treat, and also are disruptive and even devastating to the person's life.

Short term blood sugar emergencies are expensive and disruptive. They often require treatment in an emergency room or a hospital stay. These are very expensive forms of medical treatment.

Extremely low blood sugar can be a result of too much diabetes medication, too little food, or an unusually large amount of exercise. It can cause a person to lose consciousness and have convulsions; if untreated, it can even cause death. It often requires treatment in an emergency room.

Extremely high blood sugar can result from infections and illness, extreme stress, too little diabetes medication, and too much of the wrong kinds of foods. It can cause a person to lose consciousness, and if untreated, to die. It often requires a two or three day hospital stay.

Long term high blood sugar can harm and destroy vital organs. Uncontrolled diabetes can cause:

Heart Disease - People with diabetes are 2 to 4 times more likely to have heart disease, and 5 times more likely to suffer a stroke.

Blindness - Diabetes is the leading cause of blindness in working-aged people in the U.S.

Amputation - Leg amputations are 27.7 times more common among people with diabetes.

Kidney disease - Diabetes accounts for 1/3 of all cases of kidney failure, which requires dialysis or a transplant.

Treatment and rehabilitation of diabetes complications in Ohio is expensive. Over 700,000 Ohio residents have diabetes. That is about 1/16 of our population. Annual Ohio healthcare expenditures for people with diabetes exceed $4.5 billion. This means that 1/7 of Ohio's healthcare costs are spent on diabetes. Every year, 33,000 more Ohioans are diagnosed with diabetes.

These costly and devastating problems can be prevented. People who have diabetes can learn how to control it and keep their blood sugar levels close to normal.

PREVENTION OF DIABETES COMPLICATIONS MEANS PREVENTING UNNECESSARY SUFFERING AND UNNECESSARY MEDICAL EXPENSES
SUPPORT OHIO'S DIABETES COST REDUCTION ACT.

Over 700,000 Ohioans have diabetes. That is a significant number of our residents, about 1/16 of our population. Among those who have had diabetes for more than 10 years, preventable devastating and expensive diabetes complications are quite common.

Amputations: Every year, more than 2,500 Ohioans suffer diabetes-related amputations of the leg or foot. The average cost per amputation is about $21,500. This represents the cost of medical care only, and does not include the cost of lost work time or disability payments.

Blindness: Every year, about 1,400 Ohioans become blind due to diabetes. Complete rehabilitation services for a person who is blind from diabetes cost about $40,000. This does not include the cost of lost work time and disability payments.

Kidney Failure: Every year, about 1,300 Ohioans develop kidney failure because of diabetes. This rate is increasing by about 8% every year. There are now about 3,000 Ohioans living with kidney failure. To continue living, they need dialysis, at a cost of about $50,000 per person per year, for the rest of each person's life. Unfortunately, many people's lives are drastically shortened by kidney failure, even when they have dialysis.

Death: Every year, more than 11,000 Ohioans die due to diabetes. Ohio has the second highest death rate due to diabetes in the U.S. The death rate due to diabetes in central Ohio is twice the national average. For African American men in central Ohio, it is four times the national average.

Diabetes complications can be prevented when people who have diabetes have what they need to control their blood sugar. To do this, they need both the knowledge and skills that are taught in comprehensive diabetes self-management education, and also necessary medications and supplies.

The Diabetes Control and Complications Trial (DCCT) and the United Kingdom Prospective Diabetes Study (UKPDS), large clinical trials including thousands of people, both showed that when people with diabetes are given the knowledge and the supplies they need to control their blood sugar, diabetes complications can be dramatically reduced. The research results were clear and decisive.

UNCONTROLLED DIABETES IS DEVASTATING AND EXPENSIVE.
SUPPORT OHIO'S DIABETES COST REDUCTION ACT.

Research consistently shows that providing people who have diabetes with medically necessary diabetes self-management education and supplies is cost-effective. Of the many studies available that have demonstrated this, only a few are summarized below.

* Study: The State of Maryland recently conducted a study on the costs of providing comprehensive diabetes care, including education and supplies, for a group of Medicaid recipients who have diabetes.

* Study: The State of Maine and the Centers for Disease Control and Prevention sponsored a diabetes self-management education program in 30 hospitals and health centers, following 1,488 patients over three years.

* Study: In Los Angeles, as reported in the New England Journal of Medicine, 6,000 people participated in an integrated system of diabetes self-management education and care.

* Study: The Diabetes Control and Complications Trial (DCCT), a very large clinical trial carried out by the National Institutes of Health, compared clinical outcomes of people receiving standard diabetes care with those receiving intensive diabetes self-management education. Necessary supplies were provided for all study participants.

Results: The DCCT showed that when people with diabetes are given the knowledge and the supplies they need to control their blood sugar, diabetes complications were reduced by an average of 60%. The research results were so clear and decisive that the researchers ended the study one year early; they decided that it would be unethical to deny the benefits of intensive self-management to the individuals in the standard treatment group.

These and many other studies clearly show that providing medically necessary diabetes self-management education and supplies reduces the risk of expensive and devastating diabetes complications. Yet diabetes education and supplies continue to be inaccessible to many Ohioans because their insurance does not pay for them.

It is expected that sponsors Representative Michelle Schneider (R-Cincinnati) and Senator Jeff Armbruster (R-North Ridgeville) will re-introduce the DCRA in January.

Tentative plans now include a Press Conference to announce the introduction on January 27th at the Statehouse.

There will be new leadership in the Senate. It is expected that Senator Doug White (R-Manchester) will become Senate President. Speaker Larry Householder (R-Glenford) is expected to retain his position.

Once the bills are introduced, letters and calls from constituents will be essential. Use the information below to make your contacts.

1. Call or write to your State Senator /Representative, and ask him or her to support the Diabetes Cost Reduction Act.

* If you do not know who your State Senator/Representative is, you can find out by calling your local board of elections or public library.

* You can write to any State Senator/Representative at the State House, Columbus, OH 43215.

* A personal letter from a constituent receives far more attention from elected officials than form letters or petitions. They tend to think that if something was important enough to you to write that it is also important to many other constituents.

* Your letter can be very simple and short. At a minimum, it should include:

- An opening statement that you are writing in support of the Diabetes Cost Reduction Act.

- That extensive research has shown that providing diabetes self-management education and supplies saves money and saves lives.

- That over 700,000 Ohioans have diabetes.

- A short statement about your personal experience with diabetes.

- A request that your State Senator/Representative support the Diabetes Cost Reduction Act by voting for it.

2. Tell your family, friends, neighbors, and co-workers about Ohios Diabetes Cost Reduction Act, and ask them to call or write their state elected officials, too.