We take most strenuous exception to the Nov. 21 front-page story using the orthopedic shoe bill as an example of budget pact provisions that conservatives oppose. In addition to having the wrong information, this apparent trivialization of a major health problem could result in devasting repercussions for the thousands of people with diabetes who undergo amputations every year.
The bill saves money. The orthopedic shoe provision, which has already been passed by the House, would allow Medicare payment for special shoes for diabetic foot conditions. The article implies that cost savings have only been "claimed" by "proponents" of the measure when, in fact, it was the nonpartisan Congressional Budget Office that found the net savings in the current fiscal year to be $24 million. By 1990, the savings are projected to be $45 million. No matter what the Reagan administration or "conservatives" say, the clear fact is that this provision will save the government money.
The bill reduces Medicare costs. The orthopedic shoe provision constitutes integral treatment for many people. Simultaneously, it represents one of the first times Medicare would provide a preventive service, and it would have dramatic long-term benefits. Some 11 million Americans have diabetes. Of the more than 30,000 diabetes-caused lower limb amputations performed in 1984, 12,400 were paid for by Medicare and cost the U.S. taxpayer nearly $107 million.
Studies have shown the bill's cost savings. If this provision were dropped from the budget pact, it is likely that the Department of Health and Human Services would be charged to study the issue and provide recommendations in four years. During that time, Medicare would pay more than $430 million for some 50,000 amputations. With proper foot care and therapeutic shoes, it is estimated that at least 40 percent of these operations could be prevented.
The bill improves quality of life. Perhaps opponents of the provision are not familiar with diabetic circulatory problems. Generally, the vascular complications of the lower limbs first require amputation of toes, then the foot and sometimes the lower leg. Factor in the cost to the nation in lost productivity and the emotional costs to the individuals and their families, and it makes us wonder just how much more human suffering people must endure before opponents would lend their support to this worthwhile and cost-saving measure.
S. DOUGLAS DODD Chairman of the Board American Diabetes Association, Inc. Alexandria