Dave Camp (R), Congressman 4th Congressional District, (MI), Chairman of the Ways and Means Committee, Midland

Office 125 Ashman St Midland, MI 48640 (989) 631-2552 Dear Congressman Camp, My name is Amanda Hubbard. I live and work in your 4th Congressional District in Michigan. I am a Registered Nurse at Memorial Healthcare in Owosso and live in Durand. I have been a diabetic for thirty-two years and have a thirteen year old son who has the diabetes gene. He was diagnosed at the age of two with diabetes and luckily has not had to be on insulin for some time now. Diabetes is a daily struggle and consumes a vast amount of time and money to control. Even with insurance there are things that I am unable to afford that would greatly improve my quality of life. According to the American Diabetes Association (ADA), twenty-six million adults and children have diabetes and seventy-nine million people have prediabetes in the United States. In Michigan, according to Michigan.gov statistics, nearly 760,000 people over the age of eighteen have diabetes and another 250,000 people are thought to have diabetes but are undiagnosed. Diabetes kills more Americans than AIDS and breast cancer combined on a yearly basis (ADA).These statistics are staggering. The financial cost of controlling diabetes is also overwhelming, but there are things that can be done to help people with diabetes management. Education for diabetes should not just be given when a patient is newly diagnosed or when problems arise. Most education programs focus on teaching a newly diagnosed diabetic the Washington D.C. Office 341 Cannon House Office Building Washington D.C., 20515 (202) 225-3561

basics of self-management. Follow up care is done if problems arise and the patient needs a refresher course. The lack of support programs for people with diabetes is causing a great disservice to this population of people. Education and support does work, but it needs to be ongoing. According to the statistics in Michigan, education programs help to prevent or delay complications and manage healthcare costs. Yet according to the statistics, not even 60% of diabetics receive formal teaching, less than 80% self-monitor their blood glucose levels, and only 50% have their hemoglobin A1c levels drawn and yearly eye and foot exams in Michigan (Michigan.gov). What this population needs are programs that are all inclusive. They need to be regularly based programs that educate patients from the time that they are considered to be prediabetic through the end of their lives. These programs need to cover diet and exercise, blood glucose management, yearly tests and physicals. These programs need to be run by knowledgeable staff and have volunteers that have diabetes and are winning the battle of everyday self-management. The cost of programs like this would be high at first but would be less expensive than caring for diabetics that have major complications such as kidney failure, heart attacks and amputations. The ADA states that, The total estimated cost of diagnosed diabetes in 2012 is $245 billion, including $176 billion in direct medical costs and $69 billion in reduced productivity. These numbers are even higher than stated if you figure in the costs for people that are undiagnosed. Diabetics need all of the help that they can get from this disease. With the work that you do on the Ways and Means Committee in setting healthcare policies, there are things that you can do to increase funding to this population of constituents. Polices for diabetes education and programs can be introduced to help these people get the care they need.

To help save the quality of life, not only for myself and my son, but for all Americans with diabetes and the ones not yet diagnosed, your help in reforming healthcare and policies are greatly needed. In the end not only does it help these people, but it would help the country by reducing healthcare costs in the long run. Your help would be greatly appreciated by many Americans and Michiganders for which you serve. Sincerely, Amanda Hubbard, RN 805 Manfred St. Durand, MI 48429 (810) 513-8823

References American Diabetes Association (2013). The Cost of Diabetes. Retrieved from: http://www.diabetes.org/advocacy/news-events/cost-of-diabetes.html. American Diabetes Association (2013). Fast Facts Data and Statistics about Diabetes. Retrieved from: http://professional.diabetes.org/admin/UserFiles/0%20%20Sean/FastFacts%20March%202013.pdf. Michigan Department of Community Health (2013). Diabetes in Michigan Update.Retrieved from:http://www.michigan.gov/documents/mdch/Diabetes_in_Michigan_Update_2013_4 16620_7.pdf.