American Diabetes Association Postgraduate Meetings—2011

Abstract

At the American Diabetes Association(ADA) Postgraduate Meetings held 25–26 February 2011 in New York, a discussion of health-care reform and diabetes was opened by Herbert Pardes, chief executive officer of New York-Presbyterian Hospital, who stated that “the focus on health care by the entire country … and the world has never been so great.” His medical center is one of the largest hospital networks in the country, with 2,300 beds and two medical schools, and is the largest private enterprise in New York. He discussed the Naomi Berry Diabetes Center, treating >10,000 diabetic individuals, with one of the largest pediatric diabetes practices in the U.S. At the Weill Cornell Hospital, surgical treatment for diabetes is being studied. Safety programs are being developed in hand washing and in error prevention. Information technology is being expanded, with (as an example) software tools to reduce deep vein thrombosis. More online access to medical records by patients and initiatives such as health information exchanges are being studied to avoid “costly, redundant tests.” Hospitals around the country are, along with politicians and the general public, focusing on health-care reform because of increasing costs, large numbers of uninsured individuals, and increasing numbers of individuals with chronic diseases, in part because of increasing longevity. Cost-effectiveness is an issue, with the U.S. ranking first in per capita spending but far lower in health outcomes. “A lot of populations,” Pardes said, “are not getting the kind of care that they should.” Health-care reform efforts include measures to increase coverage, eliminate exclusions for preexisting illnesses and “lifetime caps,” allow older dependent children to remain on parents’ plans, and to eliminate costs to patients for annual preventive care. All these concepts are relevant to the treatment of diabetes. Quality has also become an important focus, with proposals that “the provider needs …