[Congressional Record Volume 170, Number 10 (Thursday, January 18, 2024)]
[House]
[Pages H193-H194]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                             DIABETIC SHOES

  The SPEAKER pro tempore. The Chair recognizes the gentleman from 
Oregon (Mr. Blumenauer) for 5 minutes.
  Mr. BLUMENAUER. Mr. Speaker, as I face the last 50 weeks as a Member 
of this Congress, I am appalled at the amount of time we waste on 
performances on things that will never become law, that shouldn't 
become law, and, in fact, the American public doesn't care that much 
about.
  However, yesterday, the front page of The New York Times was 
something that people should care about, talking about the problem of 
diabetes and the complications that can lead to amputations, especially 
among men.
  It is no secret we are facing an epidemic of diabetes. Nearly 15 
percent of American adults, more than 38 million people, have diabetes, 
and it is even worse among Americans 65 years or older, with a rate of 
nearly 30 percent. It is the eighth leading cause of death in the 
United States.
  Right now, we are marking up a commission to deal with the budget 
deficit in our Budget Committee. The direct and indirect costs of 
diabetes alone in 2022 were $413 billion, and the extra costs for a 
diabetes patient were more than $12,000 per patient.
  We should make improvements in delivery that prevent the disease and 
the progression, not only for the health of

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the patient but also for our healthcare system.
  Type 2 diabetes is a huge factor dealing with modern diet and our 
health habits. These factors, combined with genetics and limited access 
to healthcare, can make it a challenge to control blood sugar levels 
and contribute to the progression of the disease. It can result in 
serious, life-threatening consequences on relatively minor events.
  People can have a problem with their foot. It starts small with some 
nerve damage and maybe a foot ulcer, but it explodes, if untreated, to 
more intense conditions like gangrene and requires amputation to save 
the life of the patient.
  Nearly half of diabetes patients develop this nerve damage, and many 
go on to develop the foot ulcers I referenced. It is worse for people 
of color. African Americans are two to three times more likely to need 
an amputation.
  When we know that millions of Americans suffer from diabetes and face 
dire complications, why wouldn't we take the opportunity to do 
everything in our power to limit the progression of the disease? There 
are, in fact, low-cost solutions that can remedy the situation.
  One that I have been working on for several years is a simple 
treatment of diabetic shoes, which deal with the foot conditions that 
are such a problem for people with diabetes, that can help prevent the 
problems that lead to those amputations.
  Unfortunately, diabetic shoes require a prescription from a doctor. I 
mean, it is not rocket science. It could be done by a nurse 
practitioner or by a physician assistant, but we don't allow that. It 
is also an extra barrier for people who have problems navigating the 
healthcare system; they might give up or ignore it. It results in extra 
cost and extra time.
  These delays can have profound consequences, as I mentioned. It is 
not a barrier for people with private insurance; if they needed these 
shoes when they were at 64, it wouldn't be a problem.
  Congressman LaHood and I have a simple legislative fix to address 
this unnecessary quirk in our healthcare system. It would allow nurse 
practitioners and physicians assistants to satisfy the documentation 
requirements, at no extra cost to the patient, no extra delays, and do 
it directly. You shouldn't need a doctor to prescribe these shoes.
  This is just one of dozens of examples of commonsense, bipartisan 
reforms that will reduce spending, improve outcomes, and, in fact, save 
lives and limbs. I hope we can focus on simple, commonsense things like 
this that are bipartisan in nature that aren't expensive and that make 
sense.
  Mr. Speaker, I urge my colleagues to support this legislation to save 
a life and save a limb.

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