Guest Column

Currently, there is a legislative bill, L.D. 2282, that addresses cuts to help solve the current budget deficit.

As part of budget cutting measures, Humane Services Commissioner Rollin Ives’ office has included, as part of the bill, the exclusion of podiatrists from the Medicaid program. It is almost a token cut because money saved would be approximately $70,000. However, the Maine Podiatric Medical Association feels the ramifications of this cut extended well beyond the small savings. We feel that the health and well-being of Maine’s elderly and poor would be affected.

Podiatrists see both a large volume of patients who have diabetes, poor circulation, or both. It is documented that when diabetic patients receive regular foot care, the incidence of lower-extremity amputation decreases. The National Diabetes Advisory Board has estimated that greater than 50 percent of amputations within the diabetic population could be prevented by reducing risk factors for amputation and improving foot care.

According to the American Diabetes Association, the direct medical care costs for all amputations in the diabetic population within the United States is approximately $8,000 to $12,000 per case. If Maine citizens with diabetes did not receive regular foot care and went on to lose a limb, it would only require five or six cases before the $70,000 saved through budget cuts would be exceeded. Because the three-year survival of a diabetic who has undergone an amputation is 50 percent, the effect is much greater than that which can be measured in monetary terms.

In large teaching institutions, it has been shown that where podiatrists are part of a team treatment approach to diabetics, the amputation rate decreases by 50 to 80 percent.

The Maine Podiatric Medical Association feels that it is unfair to the citizens of Maine; the elderly and the poor would lose a vital service, and taxpayers would pay more in the long run through increased utilization of services.

We urge the citizens of the state to write to Gov. McKernan, Commissioner Ives, and their legislators and senators to prevent this part of L.D. 2282 from becomng a reality. Maine’s citizens deserve unlimited mobility; this bill can only serve to restrict that.

Alan S. Goldenhar, D.P.M., is secretary of the Maine Podiatric Medical Association.