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Committe For A Responsible Federal Budget Urges Focus On Controlling Health Care Costs, US
The Committee for a Responsible Federal Budget urges policymakers to make controlling health care cost growth the focus of health care reform (see Principle #1: Slowing Health Care Cost Growth ).
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Issue Brief Examines Social Security COLA, Medicare Part B Premium
"The Social Security COLA and Medicare Part B Premium: Questions, Answers and Issues," Kaiser Family Foundation Medicare Policy Project: The issue brief examines how Social Security recipients for the first time in 2010 are not expected to receive a cost-of-living adjustment, with no or a low COLA expected through 2012. The brief examines the relationship between the Social Security COLA and the Medicare Part B premium and the effect that such changes have on beneficiaries of both programs (Kaiser Family Foundation release, 5/27).
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Reps. Ryan, DeLauro To Introduce Bill To Reduce Need For Abortion
Reps. Tim Ryan (D-Ohio) and Rosa DeLauro (D-Conn.) on Thursday will be joined by leaders of the Planned Parenthood Federation of America and NARAL Pro-Choice America in announcing the latest version of a bill that aims to reduce the need for abortion by preventing unintended pregnancies, among other measures, Time reports (Sullivan, Time, 7/23). Ryan and DeLauro first introduced a version of the bill in 2006 (Crary, AP/San Francisco Chronicle, 7/22). However, this version "represents a dramatic break from nearly four decades" of political debate since Roe v. Wade, as both conservative antiabortion-rights groups and abortion-rights advocates have expressed support, according to Time (Time, 7/23).The bill would increase support for comprehensive sex education programs, improve access to contraception, expand Medicaid family planning coverage, increase programs for pregnant or parenting college students, and expand adoption assistance. The Congressional Budget Office has not yet conducted a cost-analysis of the bill, the AP/San Francisco Chronicle reports (AP/San Francisco Chronicle, 7/22). In developing the bill, Ryan sought the help of Rachel Laser, director of culture programs at the policy and strategy think-tank Third Way. According to Time, Laser worked with advocates on both sides and modified the bill to help gather their support, while preventing the measure from becoming "uselessly watered down or split into two."DeLauro noted, "We had to reach a level of trust" with people on both sides and allow them time to become more receptive to the bill"s goals, adding, "Because so often this issue has been one about which there was nothing other than trying to score political points." DeLauro said she hopes the Obama administration will look to the bill for guidance as it crafts its strategy for reducing the need for abortion and preventing unintended pregnancies. President Obama is expected to make an announcement about the plan next month, according to Time (Time, 7/23).DeLauro and Ryan also noted that Rahm Emanuel, Obama"s chief of staff, endorsed an earlier version of the bill when he served in the House, which they hope could mean that Obama would support their measure. DeLauro said, "This is a bill that seems to mesh with the president"s interests," adding, "I see no reason why the White House could not endorse it."Joshua DuBois, director of the White House Office of Faith-Based and Neighborhood Partnerships, said the administration is still reviewing the information it has gathered in recent meetings with representatives on both sides of the abortion debate.Laurie Rubiner, director of Planned Parenthood"s Washington, D.C., office, said "This isn"t a radical bill," adding, "It only seems radical because it"s been so long that we could have a constructive conversation ... with both pro-choice and anti-choice groups around the table."The Rev. Joel Hunter -- an antiabortion-rights evangelical pastor in Orlando, Fla., who serves on the White House Faith-Based Advisory Council -- called the bill "a landmark bill for the culture wars -- a prototype for how we can approach things in the future." He said the bill"s strengths were in its appeals to both liberal and conservative beliefs, adding, "When you realize you need someone who"s been an adversary to help you advance your own projects, that"s a big deal" (AP/San Francisco Chronicle, 7/22).
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Americans Who Don't Know They Have Diabetes Incur $18 Billion In Health Expenses Each Year

Americans living with undiagnosed diabetes incur an estimated $18 billion in healthcare expenditures each year, or $2,864 per person in medical services and lost productivity from diabetes-related complications, according to a new study initiated by the National Changing Diabetes(R) Program and published in the journal, Population Health Management. Undiagnosed diabetes represents 8.3 percent of the $218 billion cost of diabetes and pre-diabetes estimated for 2007. "For the first time we are beginning to get a sense of the total economic burden of diabetes to our health care system and economy," said Timothy Dall of the Lewin Group, which conducted the study. "The cost is particularly astonishing, given that a significant number of diabetes cases and related complications are largely preventable." About 25 percent of the 23.6 million Americans living with diabetes are not aware that they have the disease, according to the study, published in the April issue. Data also show the prevalence of undiagnosed diabetes increased with age (until age 70) and was more common in men. "These data demonstrate the urgent need for policies that encourage the early diagnosis of diabetes so that the disease can be managed aggressively before it leads to costly complications," said Dana Haza, Senior Director of the National Changing Diabetes(R) Program, an initiative created by Novo Nordisk to drive change in diabetes education, treatment and policy at the national and local level. The cost of diagnosed diabetes was estimated at $174 billion in 2007. Pre-diabetes was associated with $25 billion in health care expenditures, and gestational diabetes resulted in $623 million in costs. Because people with undiagnosed diabetes cannot be identified using medical claims, the study identified a proxy for the undiagnosed population--people within two years of first diagnosis. The study compared medical claims from 2004 and 2005 for two groups: the undiagnosed proxy population consisting of 29,770 people diagnosed with diabetes in 2006, and 3.2 million people with no history of diabetes during this three-year period. People in the former group who went on to develop diabetes were shown to have significantly more ambulatory care, emergency visits and hospital stays than those in the group who did not develop diabetes. Diabetes is a complex disease that affects virtually every system in the body. Diabetes is associated with increased risk of cardiovascular disease, neurological symptoms and renal and endocrine complications. Diabetes is the nation"s leading cause of blindness and amputations. Many people newly diagnosed with diabetes already have chronic conditions linked to the disease, such as neuropathy, arterial disease, cardiovascular disease and coronary heart disease. "We would expect to see a significant impact on cost if diabetes were detected and managed early," Dall said. "The goal is to substantially slow the progression of the disease with aggressive management of diet, exercise and medicine so that costly complications can be avoided." A separate study published in the journal broke down the costs associated with diagnosed cases of Type 1 and Type 2 diabetes. While about 90-95 percent of people with diabetes have Type 2, or adult-onset diabetes, costs for the 5-10 percent of people with Type 1 diabetes were shown to be far higher on an individual basis. People with Type 1 diabetes have twice as many physician visits for complications compared with people with Type 2 diabetes. The average Type 1 patient with diabetes under age 44 had annual medical costs of $4,044 a year. Yet costs increase with age. For Type 1 patients over age 65, the average annual cost was $35,365 per patient. The increased cost associated with people over 65 is the result of high use of expensive nursing and residential facilities. Sixty-six percent of the 165,000 Type 1 patients over age 65 will spend at least some portion of the year in a nursing home. "There are about 16 times as many people with Type 2 diabetes as with Type 1, so health care policy focusing on Type 2 diabetes has the greatest potential to lower the overall economic burden of the disease," Dall said. "Yet the very high costs associated with Type 1 diabetes -- particularly among the elderly -- highlight the importance of aggressive disease management to prevent costly complications." The overall economic burden of diabetes is significant. However, both studies note that the total cost to society is higher than any estimate when the impact of reduced quality of life is taken into account. About The Lewin Group The Lewin Group is a premier national health care and human services consulting firm with nearly 40 years" experience finding answers and solving problems for leading organizations in the public, nonprofit, and private sectors. With its industry experience and knowledge, The Lewin Group provides its clients with high-quality products and insightful support to help them maximize the delivery of programs and services that make a difference in the lives of their constituents. The Lewin Group is an Ingenix company. Ingenix, a wholly-owned subsidiary of UnitedHealth Group, was founded in 1996 to develop, acquire and integrate the world"s best-in-class health care information technology capabilities. For more information, visit www.ingenix.com. The Lewin Group operates with editorial independence and provides its clients with the very best expert and impartial health care and human services policy research and consulting services. About the National Changing Diabetes(R) Program The National Changing Diabetes(R) Program (NCDP) is a multi-faceted initiative that brings together innovators in diabetes education, treatment and policy to improve the lives of people with diabetes. NCDP strives to create change in the U.S. health care system to provide dramatic improvement in the prevention and care of diabetes. Launched in 2005, NCDP is a program of Novo Nordisk. About Novo Nordisk Novo Nordisk is a healthcare company with an 86-year history of innovation and achievement in diabetes care. The company has the broadest diabetes product portfolio in the industry, including the most advanced products within the area of insulin delivery systems. In addition to diabetes care, Novo Nordisk has a leading position within areas such as hemostasis management, growth hormone therapy, and hormone therapy for women. Novo Nordisk"s business is driven by the Triple Bottom Line: a commitment to social responsibility to employees and customers, environmental soundness and economic success. With headquarters in Denmark, Novo Nordisk employs more than 27,000 employees in 81 countries, and markets its products in 179 countries. Novo Nordisk"s B shares are listed on the stock exchanges in Copenhagen and London. Its ADRs are listed on the New York Stock Exchange under the symbol "NVO". National Changing Diabetes Program


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