‘Why Is Health Insurance Critical?’: Don Beyer Questions Witness On Diabetes Coverage

first of all Mr Vice chairman schweiker thank you for convening this I really greatly appreciate it thank all of you for being here I thought I knew a lot about diabetes and I've learned so much this morning I want to add one factoid that came from our last joint economic committee meeting when Mick Mulvaney used to share the the office of budget management OMB we're talking about how much of the Medicare budget spent on end stage renal disease on dialysis and the number he came up with is 31 percent there's roughly 250 billion dollars a year of taxpayer money just spent on dialysis you know uh Senator Lee just talked about not incentivizing the status quo a perfect comment because we're marking up the the agriculture a five-year farm bill right now and uh this is a very real big because the farm bill entrenches food policy in a way that supports our current food behaviors by subsidizing commodity crops our current food and rather than working on ensuring that specialty costs can be produced we're sort of denying the nutritious greens that we need to do and we're really good at making corn sheep and sugar cheap and and that then of course it gives us a food industry that specializes in making highly processed foods without the education intervention that will keep us from just continuing to promote type 2 diabetes so we need to be concerned about unintentionally structuring a farm system at the federal level that supports the trend of obesity but if you look at the rest of the farm bill you have snap and Wick we know that the citric supplemental nutrition assistance program reduces severe food insecurity between 12 and 19 percent and it is food insecurity and inadequate nutrition Mrs Brown Friday pointed out you know the lower the income the more likely you are to get diabetes and the higher the income the better the food the less likely we're struggling with a budget right now where they're talking about fiscal year funding for 2024 for the snap program at a level of 2007. I mean rolling it back decades same with with the WIC program women infants and Children's Program they're going to cut it by 800 million dollars which is 5 million women children losing fruit and vegetable vouchers so we've really got to look hard at the farm bill in in the light of the diabetes challenge that we're facing right now uh Miss Brown Friday talked about food deserts president can you specifically talk about food deserts in the Navajo Nation Congressman thank you when it comes to food deserts Could you um how big a challenge is it for you with the The navajos Who Live both on the reservation and off in terms of the ability to get the healthy food okay we'll give them the lifestyle they need okay thank you Congressman uh when it comes to food and having grown up myself the nearest grocery was 75 miles which is Farmington New Mexico so in order to get to a Walmart you had to go 75 miles where I grew up from and most of the time the nearest grocery store is the local trading posts or the local gas station so all of us have been in a gas station if you go to a Speedway or Sinclair or whatever the gas station is most of the time it's candy food chips things that are normally for people that are just on the road and headed to a certain direction so I know that one of the things that that's why we impose that tax on junk food to try to hopefully encourage our grocery stores and our gas stations to at least carry some fresh fruits some fresh vegetables and things like that but it's just when you're in really remote locations like Navajo it's difficult to get access to Quality Foods that's kind of the the landscape of the Navajo Nation is you can go one hour two hours and the only thing you'll find is gas stations so I think the the location of more um stores that offer Farm Goods would be great because I know on Navajo we're really trying to encourage a lot more of our people to be Farmers to utilize some of the water to go back to traditional practices because overall I think that when it comes to being able to be able to farm and sell foods and groceries I think that's a way with the as president I'm trying to encourage our people to do that but regular grocery stores they're hard to find great thank you very much Mr Brown Friday as you know so much of the debate on the hill the last 20 years has been about health insurance and access to health insurance through the American people can you talk from your perspective at Ada and others about why health insurance is critical for people with diabetes especially we talked about cgms the continuous glucose monitors how do you get a CGM if you don't have health insurance thank you so much for reminding me I would say it's basically impossible to get a CGM without health insurance because most people who are under are uninsured do not cannot afford the cost of a CGM and all the supplies that go with it and so therefore the American Diabetes Association is really supporting people having better access to health insurance uh easier access to health insurance so they can have they can afford the medications and the um the instruments and the technology that could actually help them have a better life with relation to their diabetes thank you very much and Dr Herman I'm very excited about the the agonists and in the impact that they're having um but I but I agree with you that we can't just think about taking a pill to solve all this problem what are you at all concerned about the downsides the there have been latest reports about stomach paralysis or gastroparesis how are we how are we balancing the negative side effects on these agonists so that's that's a really uh important question and it's quite clear that the the glp-1 receptor Agnes and many patients that take them um uh experience some sort of gastrointestinal side effect including gastroparesis so slowing of the Gap the transit of food through the GI tract and and some combination of constipation diarrhea or abdominal distension um and and we've we've put together kind of algorithms for titrating these medications to try to to avoid some of those uh side effects um the most people if they continue those medications they tolerate them even with some of the side effects the side effects can go away with time so those gastrointestinal side effects do not seem to be permanent or persistent some people can't tolerate the medications because of these side effects and they choose not to continue them and then we we move to other options but the majority of patients can tolerate those medications and those side effects tend to wane now the the other aspect of your question is what are the long-term potential adverse effects and um and and today we we have not identified any significant uh long-term Adverse Events or effects related glp-1 receptor agonists they they are clearly in large clinical studies reducing you know reducing the use of insulin lowering glycemia reducing the use of insulin but reducing cardiovascular events reducing all-cause mortality um say they are they are saving lives and we have not identified any long term adverse consequences at this point thank you Mr Byron MS melatakis

Channel: Forbes Breaking News

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Length: 7min 41sec (461 seconds)

Published: Tue Aug 08 2023