Need to be ready for anything. Comcast supports cspan as a Public Service along with these other Television Providers giving you a front row seat to democracy. , cup, the joint Economic Committees testimony on Economic Impact of diabetes. During the hearing, medical experts and policy advocates addressed the rise in diabetes diagnosis, the need for increased access to healthcare and the link between diabetes and obesity. Witnesses also outlined the federal governments role in combating diabetes. [inaudible conversations] [inaudible conversations] shall be give this hearing a start . For this joint economic hearing i actually have 2 give senator heinrich and the entire team, democrat and republican staff, has been in discussion for quite a while. As we look at the Health Statistics of the nation, particularly diabetes, its cost to society not just in healthcare costs, but in so many of our brothers and sisters that just have misery. Where this partially came from is 2 or 3 years ago we were doing a weird experiment. Whats the real cause of income inequality in america . And yes, we saw education, we saw other things but the one thing we werent prepared to see was health. The numbers of folks, hate to use the economic term, that had real Health Issues, the number of it was diabetes and so we have spent almost two years digging around in the literature trying to understand whats going on in society, particularly the growth of our population that are suffering but also we are seeing our young people, a chart came out three weeks ago that basically said at the end of this decade almost half of our kids will technically be obese. The cascade effect of potential diabetes with that, maybe there is a moment here, this is not republican or democrat, right or left, it is focusing on whats going on in our society and our moral obligation to find a way to end, and good economics. Our two witnesses and hands it over to the good senator. Doctor herman serves as chief of the section, i always get the word wrong, and roque analogy and metabolic at Baylor College of medicine, practicing doctor, the primary focus is on diabetes treatment and care. An expert in metabolic the research has improved the understanding of diabetes it self as well as made advancements in diabetes treatment. We did our best on this. Doctor benedic ippolitos senior fellow economics and policy studies at the American Enterprise institute. s research focuses on Public Finance and health economics. He has rescued written on competition and pharmaceutical markets and economics of value of medicine innovation. He earned his phd in economics from university of wisconsin madison. I want to start by thanking vice chairman schweikert for his passion in this area and it is something that touches all of us and touches our two states, the Economic Impacts of diabetes on our economy, are really astounding. And another 96 million adults, with an estimated one in 3 americans expected to develop the disease at some point, with so much hot healthcare costs. The high price of medications and treatments in Doctors Office and through employment rates and cost of early retirement. These costs are borne by the patient, by health systems, employers, and entire communities as we hear about today. Thats where we focus on this hearing today, and finding Bipartisan Solutions that ensure we had a healthy population, and all americans have access to quality affordable healthcare no matter their means or where they live geographically. When patients lack access to healthcare, minor challenges can quickly become major challenges with lack of proper diagnosis and treatment and that is true of rural and tribal communities is increasingly prevalent. Too Many Americans living with undiagnosed or untreated diabetes, they cant afford or see a doctor to pay for prescribed medication or travel long distances required to get a provider. And and extreme complications, and ability and Diabetes Prevention and Early Intervention and Health Education are costeffective and lead to Better Health outcomes. Beyond that we must understand address upstream causes of the disease including factors like socioeconomic status and access to quality nutrition. Food insecurity is closely associated with tight 2 diabetes. When families have access to nutrition programs like snap they are able to more consistently access healthy food. Weve seen associated reductions in poverty and health care expenditures. Fortunately, medical science has recent breakthroughs on pharmaceutical Treatment Options for diabetes and im looking forward to hearing more about how recent breakthrough treatments have had positive outcomes for patients and helped change their lives for the better. Unfortunately, many of those Treatment Options remain unaffordable for many patients. The Inflation Reduction Act was an important step in controlling drug costs which it established several cost control measures like limiting insulin copays for medicare beneficiaries, 35 a month and capping annual outofpocket prescript and drug costs at 2000 starting in 2025 the act gives medicare the ability to negotiate the price of high cost Prescription Drugs and forces Drug Companies to pay a penalty when the prices they charge medicare rise faster than inflation. These actions put downward pressure on drug costs while having little impact on innovation. It is clear that the most effective treatments for diabetes require a comprehensive crutch addressing diet, lifestyle, Mental Health and other societal factors alongside medical treatments. Weve had some successes on this front such as with special Diabetes Program for indians which congress established in 1997. This Program Provides funding for Diabetes Prevention and Treatment Services to over 300 Indian Health programs across the United States and provides flex ability to design and implement diabetes interventions that address locally identified priorities. Through this program we see youthbased outreach, planting of community gardens, running and fitness events and Partnership Programs with pharmacies that help patients manage their prescriptions. The special Diabetes Program for indians has been extremely effective. Since it started, the prevalence of diabetes and end stage renal disease and diabetes related i disease among American Indians have all declined. We need to increase the funding for this program to keep up with costs and better serve all tribes. Looking beyond tribal communities we should look to this program as a model for how we can design and implement comprehensive Disease Treatment and management nationwide. I am pleased to join my colleagues from both sides of the aisle to explore these issues and work in this bipartisan hearing and im looking forward to hearing more today on the impacts of diabetes on our communities, the ways we can address upstream causes to the role of health and nutrition programs in prevention, treatment and the role of pharmaceutical interventions. It is my pleasure to introduce our two other distinguished witnesses. The tenth president of the Navajo Nation, and office he assumed in january of this year, he also serves as the navajo area representative to the national Indian Health board. He previously served as the chief commercial officer for the navajo engineering and construction authority, we need more engineers around the here. A quasiindependent tribal enterprise headquartered in new mexico from 201018. He was a National Operations trainer and project manager at a multibilliondollar Construction Companies that build schools, Senior Living homes and Public Safety facilities from nevada to florida. He also served as the first president of the changed labs board of directors, a nonprofit that continues to support navajo and hopi entrepreneurs with basic tribal specific technical assistance. He has a bs in Construction Management and nba from Arizona State university. Youve heard of that, right . And doctor of education in organizational change in leadership from the university of southern california. Janet brown friday is the president of healthcare and education at the American Diabetes association, missus brown friday has been a registered nurse for 40 years and most recently served as Clinical Trial manager at the Albert Einstein college of medicine diabetes Clinical Trial unit. Mrs. Brown friday has previously served on the National Board of the American Diabetes association and she remains a current member of the Nyc Community leadership board. Mrs. Brown friday previously served as a Committee Member for the National DiabetesEducation Program and as a special Government Employee and counsel member for the National Institute of diabetes and digestive and Kidney Disease advisory council. Mrs. Brown friday holds mph in community Health Education and ms in Community Health nursing from Hunter College in new york city, new york. We are going to begin with president nygren and then go right to left, left to right down the dice today. Welcome, we look forward to hearing your testimony. Good morning, chairman heinrich, esteemed members of the joint Economic Committee. Im doctor bill migrant, president of the Navajo Nation, i serve the navajo area, representative to the national Indian Health board. I come before you to speak about a matter that not only affects the welfare of our nation but also a significant issue for all Indigenous People across the United States. We are here to discuss the importance of special Diabetes Program for indians. The Navajo Nation provides Governmental Services to over 400,000 members, and on reservation population is 200,000 which accounts for one third of all natives living in Indian Country. Like Many American indian tribes, navajo people experience higher rates of preventable nutrition related diseases such as obesity, diabetes, Heart Disease and cancer, than the general Us Population. These Health Issues are not part of our heritage but the consequences of painful history marked by colonization, forced assimilation, displacement from our tribal homeland and relocated to reservation lands. Historically our communities, farming, herding and hunting, there were nutritious foods, and it was systematically eroded over time, salt have replaced traditional food sources, and lack of transportation, congress established, a clinical response to the escalating diabetes epidemic in Indian Country. This program as mentioned earlier is a budget of 150 million, fund 300 communitybased intervention programs to discuss type 2 diabetes. Despite these efforts diabetes remains a persistent Public Health problem among our people. In 2,011 the Navajo Nation in collaboration with ihs changed their approach. We begin to engage local Community Input to develop and implement interventions that are culturally relevant, and sensitive to our unique circumstances. Recognizing inherent sovereignty we have initiated our own disease prevention activities, data collection, policy develop into an Evaluation Initiative is. In 2014 the Navajo Nation and acted the healthy action act that introduced a 2 tax on unHealthy Foods, this generated 10 million funding vital local Community Wellness projects. This approach provided muchneeded funding and promoted healthier eating habits in our community. However this effort is not enough. The special Diabetes Program for indians is critical in providing quality Diabetes Care and prevention practices resulting in lower incidents of in the stage renal disease and lower prevalence of type 2 diabetes among native americans. All these things save taxpayer dollars and medical costs, 19962013 incident rates of end stage renal disease among native americans and diabetes declined by 54 . This reduction alone is estimated to have a value of 520 million over nine years. These programs have had a tangible impact on our communities, the navajo Wellness Centers have already shown promising results, providing Health Screenings and conducting wellness activities, these centers help detect and manage diabetes and have been successful in promoting Overall Health and wellbeing in our communities. The current funding levels are barely enough to maintain existing initiatives. We need to ensure every navajo individual fighting this disease has access to the resources and care they need. All i ask is the reauthorization of the increase in funding that will enable us to expand our programs, reach more people, ultimately turn the tide in this fight against diabetes. We support legislation passed by committee in each chamber that would renew for two years at the funding level of 170 million a year to serve more native americans effectively, the Diabetes Program for indians is the Gold Standard when it comes to diabetes treatment and considered one of the most effective public Health Programs ever created. We urge you to consider human safety behind the statistics, our elders, our children and families. They all look to you and hope their government will continue to support them in their fight against this devastating disease. You have the power to turn this hope into reality. Thank you for your time, your consideration and your continued support. [speaking in native tongue] thank you. And distinguished members of the joint economic midi, thank you for inviting me to testify on behalf of the American Diabetes association about cost of living with diabetes. We thank you for considering this topic at this critical time. The nations leading voluntary Health Organization fighting the diabetes epidemic and People Living with diabetes thrive. For more than 80 years the ava has been driving discovery and research to treat, manage and prevent diabetes while working relentlessly for a cure or. Today i would like to take this opportunity to describe and offer context for the most significant drivers of Cost Increases for People Living with diabetes and the work ada is doing to make managing diabetes more affordable and prevent adverse outcomes. According to the cdc, more than 37 million americans live with diabetes, one hundred million americans have prediabetes. Diabetes is the most expensive chronic condition in the United States. People with diabetes account for one of every 4 spent on healthcare, one third of medicare drug spending. People of color and other underserved populations, those who lack access to Adequate Health insurance coverage, Healthcare Services and the tools they need to manage their diabetes, a disproportionate share of the