Apr 19 2021
** Click here for audio of this week’s column**
For the last year, our highest public health priority has been defeating COVID-19 and getting back to our normal lives. But this phrase means more than just our fight against the coronavirus.
In a column in February, I wrote about heart disease, another public health crisis that has plagued our country far longer than the pandemic. Despite being mostly preventable, heart disease kills more than 800,000 Americans every year. I helped introduce a resolution in the Senate that made February “American Heart Month” to raise awareness about this often-overlooked epidemic.
Unfortunately, heart disease often has a partner in crime: diabetes. Although not all people with heart disease also suffer from diabetes, many do, and people with diabetes are at more than double the risk of eventually developing heart disease.
Though it is not as deadly as heart disease, diabetes can lead to serious health problems. The high levels of blood sugar it causes can lead some diabetics to suffer from poor circulation and even nerve damage, which in turn can prevent people with diabetes from feeling pain in their legs and feet. This means that many diabetics often do not notice cuts and blisters they get – in severe cases, this can even require parts of their feet to be amputated.
Thankfully, there is a solution. Diabetic shoes have custom inserts and other features that are designed for exactly this problem. But if you are on Medicare, these shoes require a prescription in order to be covered, and that prescription can only be written by a doctor.
I recently cosponsored the Promoting Access to Diabetic Shoes Act, which Democratic Senator Sherrod Brown of Ohio introduced in March, to address this problem. This bipartisan bill would give physician assistants and nurse practitioners the ability to certify a patient’s need for these shoes, not just doctors.
This would make a big difference for Medicare patients in rural Nebraska, who often live miles from the nearest doctor, but within just minutes of their local PA.
In fact, Nebraska has more than 1,100 practicing PAs, and over 30 percent of them work in rural parts of the state. I spoke with a group of Nebraska members of the American Academy of Physician Assistants about this bill in March, and they shared their overwhelming support.
One of these physician assistants was Angela Hill, a PA who practices in Omaha. She told me that Medicare’s current rules “inhibit the PA that has diagnosed the patient’s diabetes and has been seeing this patient for several months, maybe even years, from prescribing another intervention to prevent this devastating side effect of diabetes.” She said she’s seen patients wait weeks for an appointment, and then drive as far as “60 miles to see the physician at the next closest clinic,” even though she could prescribe these shoes for them on the spot.
The Promoting Access to Diabetic Shoes Act would let her do just that. Republicans and Democrats in the Senate may not always agree, but some bills are just common sense. This is one of those bills, and I look forward to helping it get passed.
Thank you for participating in the democratic process. I look forward to visiting with you again next week.