Health Policy and Diabetes Care: Is It Time to Put Politics Aside?

The burden of chronic diseases is enormous and growing, not only in the U.S. but also around the world. The control of chronic diseases requires effective approaches, including patient education, provider knowledge, and team care. Effective policies must also be enacted to address chronic diseases at a local, state, and federal level. This is especially true with regard to diabetes, which in the U.S. cost $245 billion in 2012 and consumed 1 in every 10 health care dollars (1). The current trajectory for economic costs for the U.S. is not sustainable … perhaps the time is right to reevaluate our health policies.Implementing policies to prevent or treat a disease is clearly not a trivial matter, and such efforts seem to be more effective when there are specific goals. Childhood immunizations provide a good example. In the 1990s, half of the children in this country were not appropriately immunized against communicable diseases (2). As was elegantly summarized (2), “It took strong evidence and a powerful political and organizational movement to get 90 percent of the children in this country immunized. That meant winning the support of the states, professional groups, pediatricians, and health maintenance organizations; obtaining funding from Congress so the shots could be provided in doctors’ offices, clinics, hospitals, and pharmacies at almost no charge; and developing an immunization tracking system.” What health policies might similarly alter the medical landscape for chronic diseases such as diabetes? In this regard, evaluating the impact of the Affordable Care Act (ACA) in general, and Medicaid expansion in particular, on diabetes identification and treatment would be of interest. In this issue of Diabetes Care , Kaufman et al. (3) provide one of the first reports on the effect of Medicaid expansion on diabetes diagnosis. The authors reported that in states that expanded Medicaid, …