Greensboro News & Record: Another reason to expand Medicaid in NC: Rising cost of treating diabetes

September 3, 2014

The following editorial appeared in the Greensboro News & Record:

Diabetes is a costly epidemic in North Carolina, and it is rapidly expanding. That’s a disturbing finding headlining a report by Harvard University researchers released earlier this year.

While North Carolina is fortunate to be the focus of a diabetes study by the Center for Health Law and Policy at Harvard Law School, the reason for the attention is ominous: North Carolina has a huge problem.

The rate of diabetes here has doubled over the past 20 years. It is the seventh-leading cause of death in the state – and it’s more deadly than that for African-Americans and American Indians. By 2025, if this trend continues, diabetes will take many more lives and “cost the state’s public and private sectors more than $17 billion per year in medical expenses and lost productivity,” the report says.

Risk factors include being overweight, exercising too little and having high blood pressure and cholesterol levels. Lifestyle choices are important for reducing risk or managing the disease.Unfortunately, the authors say, many North Carolinians lack access to medical care or programs that help them reduce risk or manage disease.

They recommend a number of policies to improve those conditions. One, already rejected by political leaders, is broadening Medicaid eligibility. This report gives another reason to reconsider.

North Carolina already operates some programs targeted at diabetes, but much more should be done, the report says.

The state needs to build a “whole-person model of diabetes care,” requiring lifestyle modification and management services, primary and specialty medical care and access to community resources ranging from healthy food options to financial assistance to opportunities for physical activities.

The YMCA of Greensboro recently announced it will participate in a nationwide diabetes prevention program, offering classes to help people reduce their risk. Community initiatives like this can have a big impact.Statewide, coordinated care models can help – Community Care of North Carolina’s diabetes management program saved the state $1.5 billion in Medicaid expenses from 2007 to 2009, the report says – but too many people don’t fit into them.

The 150-page report is full of detailed analysis and recommendations for battling this disease. In debates about Medicaid costs, the Affordable Care Act and state budget issues, there’s been hardly any mention of diabetes care. So this comes as an important reminder that people’s lives are at risk and that such a serious threat to good health poses a big financial liability.

If policymakers want North Carolina to be an attractive location for businesses, they should pay attention to diseases that rob the workforce of its vitality and cost employers more money in insurance costs, productivity and taxes for public health.

North Carolina’s supposedly healthy business climate depends on the good health of its population.

Link to the article here.