I'm sorry to report that the first day of the two-day Diabetes Forum 2009 conference here in snowy Washington, DC, was not very encouraging. Don't get me wrong, the event was extremely well-organized, well-attended, and fascinating. It's just that what we were hearing was a lot of bad news about the state of diabetes care in this country and the gargantuan task ahead of policymakers in reforming our healthcare system. Not much new there.
However, there was some hope expressed with Obama's appointment of Nancy-Ann DeParle as our nation's new "healthcare czar." Her close ties to healthcare technology initiatives are generally seen as a good thing, as in "she get's it," so will hopefully be "pushing the envelope" (as they say) on using new technologies to their fullest.
In terms of diabetes specifically, here are some interesting tidbits I picked up on Day One:
* Every 24 hours, 36,000 new cases are diagnosed in this country
* The HEALTHY study, a nationwide middle school "intervention" program to reduce the risk of diabetes, found that almost 50% of participating 8th graders were overweight or obese. Only 16% had fasting glucose numbers considered "normal" (puberty notwithstanding)
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* Millions and millions of dollars have been invested in diabetes research, yet "for all of our spending, our return on investment is not good," according to the ADA speaker here (ouch)
* Lots of folks are working on a Value-Based Insurance Design (VBID) model for Medicare and possibly private insurance eventually too — the idea being that if you lower insurance co-pays and offer low-cost or even free medications to patients who need them most, the system could save millions of dollars in hospitalizations and ER visits. Great idea, but try selling that to short-sighted insurance providers...
* According to the editor of the prestigious Pink Sheet, public opinion has shifted to where people are actually more adverse to healthcare reform now than they were in 1993 ("It's the economy, stupid!")
The most disconcerting part of the day was in fact the final panel -- the one we'd all been waiting for -- featuring two Washington heavyweights: Wendell Primus, Senior Policy Advisor to House Speaker Nancy Pelosi, and Dan Elling, Minority Staff Director of the House Committee on Ways and Means Health Subcommittee.
These gentleman were on hand to discuss "prospects for key legislation," which looks so exciting now that the Obama administration has officially made healthcare reform an immediate priority. Here they stood in front of a bright-eyed audience of leaders of national diabetes advocacy groups (ADA, JDRF, AADE), expecting something meaty, and yet their panel quickly derailed into the old-standby political repartee over Democratic vs. Republican views on government spending and how much government can or should "get into peoples' living rooms."
By that I mean that Mr. Primus talked a lot about what Bush did wrong, talked up the value of controversial expensive "comparative value" research -- which tests the effectiveness of certain drugs and treatments against competitor's products -- and spoke inspirationally about empowering patients and improving healthcare quality.
Then Mr. Elling got up and proceeded to pick apart much of what Wendell had said: his party has "many concerns" about Obama's proposed $76.8 billion budget for rescuing health care. "Why throw money at a broken system?" he asked -- although he readily admitted that it's easier to be the opposition, poking holes in proposed legislation, than the team trying to craft reasonable legislation in the first place.
Whatever. Politics as usual. How exactly are we going to help patients (people who rely on the broken healthcare system most) in all of this? I asked myself. No one has the magic answers. But with all this high-level policy talk, I was definitely getting antsy to start addressing patients' everyday concerns. Stay tuned here for my report on My Report, Day 2.